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Enhanced Care Management  

Enhanced Care Management (ECM) is a new statewide Medi-Cal benefit available to select “Populations of Focus” that will address clinical and non-clinical needs of the highest-need enrollees through intensive coordination of health and health-related services. It will meet beneficiaries wherever they are – at home, in their doctor’s office, in a shelter, or on the street.   

Clients who enroll in ECM will have a single Lead Care Manager who will coordinate care and services among the physical, behavioral, dental, developmental, and social services delivery systems, making it easier for them to get the right care at the right time.  

Learn More

Download CalAIM Provider Matrix

Download CalAIM Provider Contact Sheet

 

Who is Eligible?

The following populations of focus are currently eligible for Enhanced Care Management:

Adults and their Families Experiencing Homelessness

Adults At Risk for Avoidable Hospital or Emergency Department (ED) Utilization (formerly “High Utilizers”)

Adults with Serious Mental Health and/or Substance Use Disorder (SUD) Needs

Individuals Transitioning from Incarceration

Adults with Intellectual or Developmental Disabilities (I/DD)

Pregnant or Postpartum Adults

Adults Living in the Community and At Risk for Long Term Care (LTC) Institutionalization

Adult Nursing Facility Residents Transitioning to the Community

 

  

On July 1, 2023, Children and Youth will be eligible to also receive Enhanced Care Management if they meet any of the following criteria:

Homeless Families or Unaccompanied Children/Youth Experiencing Homelessness

Children and Youth At Risk for Avoidable Hospital or ED Utilization

Children and Youth with Serious Mental Health and/or SUD Needs

Children and Youth Enrolled in California Children’s Services (CCS) or CCS Whole Child Model (WCM) with Additional Needs Beyond the CCS Condition

Children and Youth Involved in Child Welfare

Children and Youth with Intellectual or Developmental Disabilities (I/DD)

Pregnant or Postpartum Youth

Do you want to find out if you’re eligible?  Call 2-1-1 to Learn More!

 

 

Enhanced Care Management Providers 

2-1-1 San Diego
Borrego Health 
Community Health Systems Inc 
Community Research Foundation 
Exodus Recovery 
Family Health Centers of San Diego
Healthcare in Action
Imperial Beach Clinic 
INDEPENDENT LIVING SYSTEMS 
Jewish Family Services 
La Maestra Community Health Centers
Lightbridge Hospice and Palliative Care
Neighborhood Healthcare 
North County Lifeline 
Partners in Care Foundation
San Diego Family Care 
San Diego Wellness Collaborative 
San Ysidro Health Centers
Serene Health 
TITANIUM 
Truecare 
Vista Community Clinic 
Volunteers of America Southwest 

How to connect with an Enhanced Care Management (ECM) or Community Supports (CS) provider:  

Visit your healthcare provider below to call your Medi-cal Managed Care Plan to learn more.

 

If you are unsure of which managed care plan you are enrolled with, call State Health Care Options to learn more.

Review the list of Enhanced Care Management Providers and check to see if they are accepting referrals directly to their organization.