Some of the hardest obstacles have nothing to do with medicine for families managing a child’s complex medical needs. When a San Diego mother’s son with Down syndrome and autism turned 18, she faced a flood of legal and medical paperwork. Thankfully, a care manager at Rady Children’s Health used the hospital’s Enhanced Care Management (ECM) program to guide the Spanish-speaking mother through the conservatorship process, securing food and utility assistance, and working with the son’s school so he could graduate and transition smoothly into adulthood. The ECM program is a state-funded model built for the most vulnerable kids on Medicaid: Those with complex medical, behavioral, and social needs, often all at once. Each family is paired with a care manager who coordinates across specialties and supports the day-to-day challenges that often derail treatment, from benefits paperwork to rides to the food bank. What began four years ago with three staff serving five children now supports more than 800 children at any given time. Because of the program, emergency department visits have decreased by up to a fourth, inpatient admissions by nearly half, and well-child visits have climbed past 67%. To put kids first, we must invest in models that treat the whole child and protect the Medicaid funding that keeps them running. At Rady Children’s Health, that work is already changing lives.