When CalAIM was first introduced, much of the conversation centered on implementation. Organizations across California have worked diligently to understand new requirements, evaluate funding opportunities, establish contracts, and prepare for significant changes in how care would be delivered. For many, the initial focus was appropriately placed on building the operational capacity needed to participate in a rapidly evolving healthcare landscape.

Today, those conversations are beginning to change. As we continue working alongside counties, Managed Care Organizations (MCOs), community-based organizations, and behavioral health providers throughout California, we’re noticing that the questions leaders are asking have become increasingly strategic.

The conversation is no longer simply about how to implement CalAIM. Instead, organizations are asking how they can build systems, partnerships, and leadership structures that will allow them to thrive as the Health & Human Services landscape continues to evolve.

This shift is important because successful CalAIM implementation is no longer the distinguishing factor it once was. Increasingly, what separates organizations is not whether they have implemented new programs, but how they have strengthened their organization in the process. While every organization’s circumstances are unique, we’ve noticed several characteristics that consistently emerge among those navigating this work particularly well.

These observations are not intended to serve as a checklist or formula for success. Rather, they reflect patterns we’ve seen across organizations that continue to adapt thoughtfully, strengthen their impact, and position themselves well for whatever comes next.

1. Let Strategy Drive Opportunity

One of the clearest differences we observe among organizations thriving with CalAIM is their ability to remain anchored in strategy, even as new opportunities emerge. While funding announcements, new service models, and evolving county priorities naturally create excitement, successful organizations resist the temptation to pursue every opportunity simply because it exists.

Instead, they begin with a different set of questions. Does this opportunity align with our mission? Does it strengthen the populations we are uniquely positioned to serve? Does it move our organization closer to where we ultimately want to be?

This approach often requires saying “not yet” or even “no” to opportunities that don’t align with long-term priorities. While that can feel difficult in a rapidly changing environment, organizations that consistently make strategic decisions tend to build stronger foundations over time. Their growth feels intentional rather than reactive, allowing CalAIM implementation to become part of a broader organizational vision instead of dictating it.

2. Become Indispensable Partners, Not Just Service Providers

CalAIM was designed around the idea that better outcomes require greater collaboration. As a result, organizations that are thriving rarely operate in isolation. Instead, they become trusted partners within the broader Health & Human Services ecosystem.

Over time, these organizations earn a reputation for being collaborative, dependable, and solution oriented. Counties begin engaging them earlier in planning conversations. Managed Care Organizations seek their perspective. Healthcare providers, schools, and community-based organizations view them as valued collaborators rather than simply another contracted provider.

These relationships are rarely built through formal agreements alone. They develop through consistent communication, shared problem-solving, and a willingness to work across systems in support of whole-person care. As those relationships deepen, organizations often discover that trust becomes one of their greatest strategic assets, creating opportunities that extend well beyond any single contract or initiative.

3. Stay Grounded While the Landscape Continues to Evolve

Few sectors experience change as consistently as California’s Health & Human Services system. Policy updates, funding shifts, regulatory changes, workforce challenges, and evolving community needs have become part of the environment leaders navigate every day.

Organizations that continue to thrive have developed enough organizational clarity to respond without losing their direction. Leadership teams share a common understanding of their mission, values, and priorities, allowing them to evaluate new opportunities through a consistent strategic lens instead of reacting to each new development independently.

This type of organizational readiness creates stability during periods of uncertainty. Rather than being pulled in multiple directions, leaders can make thoughtful decisions that balance immediate needs with long-term sustainability. In many ways, this steadiness becomes a competitive advantage because it allows organizations to adapt without sacrificing the culture, relationships, and purpose that define their work.

4. Learn Faster Than the System Changes

Another characteristic we consistently observe is a commitment to continuous learning. Organizations thriving with CalAIM recognize that implementation is not a destination; it is an ongoing process of refinement, evaluation, and adaptation.

Rather than assuming new systems are complete once they are launched, these organizations remain curious. They gather feedback from staff, partners, and the communities they serve. They evaluate workflows, strengthen care coordination, improve operational infrastructure, and continuously look for opportunities to deliver more effective integrated care.

This mindset extends beyond compliance. While meeting regulatory expectations remains essential, thriving organizations also ask whether their systems are truly supporting people, strengthening partnerships, and improving outcomes. They understand that organizational sustainability depends not only on meeting today’s requirements, but also on developing the capacity to learn, evolve, and improve as the system itself continues to mature.

5. Invest in Foundations That Will Outlast CalAIM

Perhaps the strongest pattern we see is that successful organizations recognize CalAIM as one important chapter within a much larger transformation taking place across California’s Health & Human Services landscape.

Alongside CalAIM, organizations are simultaneously navigating initiatives such as Enhanced Care Management (ECM), Community Supports, the Behavioral Health Services Act (BHSA), the Children and Youth Behavioral Health Initiative (CYBHI), expanding behavioral health services, workforce development, and changing county priorities. While each initiative brings its own opportunities and complexities, organizations that continue to thrive rarely build their strategy around any single program.

Instead, they invest in the foundational capabilities that strengthen the organization regardless of what policy or funding changes come next. Strong leadership. Healthy organizational culture. Operational readiness. Strategic partnerships. Clear governance. Workforce development. Sustainable systems.

These investments may not always be the most visible, but they are often the ones that create the greatest long-term impact. They allow organizations to respond confidently to change because the strength of the organization does not depend on any one initiative alone.

Looking Beyond CalAIM

As CalAIM continues to mature, one observation has become increasingly clear. The organizations creating the greatest long-term impact are not distinguished solely by their ability to implement new programs or respond to changing regulations. They are distinguished by the strength of the organizations they are intentionally building every day.

Across California, we continue to see leaders making thoughtful investments in strategy, relationships, organizational learning, and sustainable systems. Those investments strengthen not only their ability to navigate today’s challenges, but also their capacity to respond to whatever tomorrow may bring.

Perhaps that is the broader lesson emerging as CalAIM evolves. Implementation remains essential, but it is no longer the defining measure of success. Increasingly, organizations that are thriving have shifted their attention toward something deeper: building resilient, adaptable organizations capable of delivering meaningful impact through changing policies, evolving partnerships, and the continued transformation of California’s Health & Human Services system.

While the future will undoubtedly continue to bring new initiatives, new expectations, and new opportunities, organizations that invest in these foundational characteristics today will be better positioned to serve their communities for years to come.