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.

Eligibility Providers Connect to ECM

Learn More

Review San Diego’s List of CalAIM Providers

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

Adults Transitioning from Incarceration

Adults with Intellectual or Developmental Disabilities (I/DD)

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

Adult Nursing Facility Residents Transitioning to the Community

Children and Youth

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)

Children and Youth Transitioning from Incarceration

Birth

Pregnant or postpartum individuals (up to 12 months postpartum) with other identifiers as defined by California public health data on maternal morbidity and mortality across.

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

For more information about each Population of Focus and the qualifying criteria, please review the DHCS Enhanced Care Management Policy Guide.

To review San Diego County’s Universal Referral form with eligibility criteria, click here.

Who are San Diego County’s ECM Providers?

To review a list of active Enhanced Care Management providers, review the 211/CIE database of ECM providers.

There are 50+ providers in San Diego County providing ECM services.

* Listed in 211/CIE database

** CIE Direct Referral Partner

211 San Diego

Access TLC

American True Care

Americare

Amity Foundation

Be There San Diego

Borrego Health*

Casa Pacifica Adult Day Health Center

Choice Medical Group

Community Health Systems Inc*

CRF – Healthy Connect San Diego**

Dr. Gelen Del Rosario dba Bridge Prenatal

Exodus Recovery**

Family Health Centers of San Diego*

Fried Finch Youth Centers

Global Communities

Greentree

Happy Mama

Healthcare in Action**

Imperial Beach Clinic

Independent Living Systems

Jewish Family Services*

Koinonia Foster Homes, Inc.

La Maestra Community Health Centers*

Lightbridge*

Meals On Wheels Orange County

MedZed

Mental Health America of San Diego

Merakey

Neighborhood Healthcare*

North County Lifeline

Nurturing Care

Pacific Clinics

Pair Team

Partners in Care Foundation*

Presidium Medical Group

Rady Children’s Hospital**

Rooted Life*

San Diego Center for Children

San Diego Family Care*

San Diego Wellness Collaborative**

San Ysidro Health Centers*

Serene Health**

Star Nursing

Sterling Hospitalist Medical Group, Inc

TITANIUM*

Truecare*

Vista Community Clinic*

Vista Hill

Volunteers of America Southwest**

Walden Family Services

Whole Person Care Clinic

How to Connect with an Enhanced Care Management (ECM) 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.

To download the San Diego County Universal Referral form to Enhanced Care Management and/or to review eligibility criteria for each Population of Focus, please click here.

Enhanced Care Management

Learn More

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

Adults Transitioning from Incarceration

Adults with Intellectual or Developmental Disabilities (I/DD)

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

Adult Nursing Facility Residents Transitioning to the Community

Children and Youth

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)

Children and Youth Transitioning from Incarceration

Birth

Pregnant or postpartum individuals (up to 12 months postpartum) with other identifiers as defined by California public health data on maternal morbidity and mortality across.

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

Who are San Diego County’s ECM Providers?

How to Connect with an Enhanced Care Management (ECM) provider:

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