CalAIM & Enhances Care Management
Written by: Brenna Rizan & Christopher Bell
If you are a Medi-Cal recipient in California, it is important you know about your rights and the services Medi-Cal offers. Recently, there have been some major changes that came about when the California Momnibus Act and California Advanced and Innovating Medi-Cal (CalAIM) were passed in 2021.
The goal is to advance a “whole-person" care for pregnant and birthing people, and to ensure and expand access to reproductive health care.
Things can get very overwhelming very fast when you are juggling being pregnant and your normal daily demands. The last thing you need to worry about is how and where to get access to the services you need to stay safe and healthy. This is why California is expanding benefits to Medi-Cal recipients in 2024 to include eligibility for ALL income-eligible residents, regardless of immigration status, and greater access to preventive care before pregnancy.
But that is not all!
CalAIM currently provides growing families with several important and NEW Resources available through your Medi-Cal insurance provider:
California residents receive 12 months of postpartum coverage for all Medi-Cal services, regardless of income changes, citizenship, or immigration status.
Doulas are a covered benefit. Doulas are specially trained providers that give pregnancy education, labor support, postpartum and pregnancy loss support to families. They also help with transportation assistance and other social needs.
Community Supports: Managed care plans have upgraded and can now offer the following 14 new services, in response to health-related social needs. Those supporting pregnant peoples include but are not limited to:
Housing Transition Navigation Services
Housing Deposits
Hosing Tenancy and sustaining services
Short-Term Port Hospitalization housing
Recuperative Care (Medical Respite)
Respite Services
Day Habilitation Programs
Personal Care and Homemaker Services
Environmental Accessibility Adaptations (Home Modifications)
Medically Tailored Meals/Medically-Supportive Food
Sobering Centers
Asthma Remediation
Factors like having several complex health conditions, experiencing homelessness, transitioning back to the community after incarceration, or coming from a community that experiences more health disparities (such as identifying as Black or African American) can increase the risks you face in pregnancy.
With ECM services, you will have access to a Lead Case Manager who will coordinate your health and health-related care and services AND they will connect your family community resources making sure that you are successfully connected to services. The best part – you do not need a referral. Simply call your insurance plan and let them know you are interested in Enhanced Care Management. They will provide you with an intake and route you to the most appropriate services.
At BeMomaware we believe that 100% of birthing people need support.
So, the question is -
What do you need to feel safe and healthy in your pregnancy or postpartum?
Not sure? Check out our 7-Steps to a Rock Solid Support Plan, Self Care Essentials, or take the Edinburgh Postnatal Depression Scale to see if there are things missing from your support plan.
Did you find this article helpful? Let us know!
Are you on a journey of recovery from a maternal mental health condition? Tell your story HERE.
For additional information check out these links:
California Health Care Foundation -
Our Approach to Health Equity - California Health Care Foundation (chcf.org)
CenCAlHealth- Enhanced Care Management (FAQ)
pcsecmfaq0123-e-emcfaqs20230125.pdf (cencalhealth.org)
Center for Health Care Strategies – How California’s Medical Program Advance Health Equity for Pregnant People -
DHCS- Enhanced Care Management and Community Supports -
Health Affairs- Extending Medicaid Coverage For Postpartum Moms-
Extending Medicaid Coverage For Postpartum Moms | Health Affairs
Partners in Care Foundation-
Enhanced Care Management (ECM) Model of Care | Partners In Care Foundation (picf.org)
Webinar-