SACRAMENTO, California – California’s latest Medi-Cal numbers tell a simple story with a complicated lesson: sometimes health care begins with a meal, a safe place to live, a care manager’s phone call, or a home modification that keeps someone out of a nursing facility.
The Department of Health Care Services has released its newest quarterly report on Enhanced Care Management and Community Supports, covering July through September 2025, and the data show a fast-growing piece of California’s Medi-Cal transformation moving deeper into everyday life. Nearly 453,000 Medi-Cal members have received Enhanced Care Management, known as ECM, since the program launched in 2022. In Q3 2025 alone, nearly 227,500 members were served, a 59% increase from the same quarter a year earlier.
That growth matters because Medi-Cal is not a small program on the edge of the health system. DHCS data show California had 14,603,440 certified Medi-Cal people eligible in September 2025, and 14,325,495 by January 2026. More than 5.2 million certified people eligible in January were ages 0 to 20, making children and youth a major part of the state’s safety-net health system.
The biggest jump is among children and youth
The new report shows participation among children and youth grew 90% from Q3 2024. ECM enrollment also rose 56% among adults living in the community and at risk of long-term care, while youth at risk of avoidable hospital or emergency department use saw an 83% increase.
ECM is California’s highest level of Medi-Cal care management. It pairs eligible members with a Lead Care Manager who helps coordinate physical health, behavioral health and social services. The idea is plain: a person with complex needs should not have to navigate doctors, housing supports, mental health care, food help and long-term care risks alone.
“The continued growth of ECM and Community Supports reflects the strength of our statewide partnerships,” DHCS Director Michelle Baass said. She added that the services are “strengthening stability, dignity, and health” for members across California.
Food and housing remain the front door
Community Supports have also expanded sharply. More than 528,000 Medi-Cal members have used the services since launch, with more than 1.5 million services delivered statewide. Nearly 191,000 members used Community Supports in Q3 2025, up 40% from the prior year.
The most used supports remain Medically Tailored Meals/Medically Supportive Food and the “Housing Trio”: Housing Navigation, Housing Deposits and Tenancy Support. Statewide access has widened as well, with 94% of Medi-Cal members having access to at least 10 Community Supports and 78% having access to all 15.
One of the clearest signals came from Assisted Living Facility Transitions, which saw the largest increase in use to date, rising 74% in the quarter as more members received help moving into community living.
The cost argument is getting stronger
The latest cost-effectiveness data give the program another layer of importance. DHCS’ In Lieu of Services report found that 10 of 12 studied Community Supports are already demonstrating cost-effectiveness across categories such as emergency department visits, hospital stays and nursing facility stays. Environmental Accessibility Adaptations showed a 51.4% net cost reduction, Respite Services 19.9%, Housing Deposits 15.2%, Medically Tailored Meals/Medically Supportive Food 10.5%, Assisted Living Facility Transitions 9.7%, and Community or Home Transition Services 9.1%.
A 2026 DHCS fact sheet added that Personal Care and Homemaker Services were associated with a 79.9% net cost reduction when compared with long-term care, while all studied Community Supports were linked to reductions in inpatient and/or emergency department use.
Built to last, not built as a pilot
The deeper message is that California is no longer treating these services as temporary experiments. DHCS says ECM is a statewide Medi-Cal managed care benefit for members with the most complex needs, while Community Supports are built into managed care contracts and federal Medicaid managed care rules. The department says it will continue overseeing implementation, expanding provider networks and supporting long-term stability.
For Medi-Cal members, that means the next stage of health care may look less like a hospital hallway and more like a coordinated network: a care manager, a housing worker, a meal delivery, a caregiver break, a safer home. California’s bet is that those smaller interventions, delivered earlier, can prevent bigger crises later.