Enhanced Care Management

Enhanced Care Management (ECM)

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

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

Want to Learn More About ECM?

Read the official DHCS overview of Enhanced Care Management and In Lieu of Services (ILOS) to understand how the benefit works statewide.

Visit DHCS →

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See If You Qualify Find a Provider Connect With Your Health Plan

Who Is Eligible?

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

Doctor assisting a patient with paperwork

Adults

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

Birthing Population

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

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, review the full policy guide.

Read the DHCS ECM Policy Guide →

San Diego County’s Universal Referral form includes the eligibility criteria for each Population of Focus.

Download the Referral Form →

Who Are San Diego County’s ECM Providers?

Review San Diego’s List of CalAIM Providers

To review a live, up-to-date list of active Enhanced Care Management providers, visit 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

Connect with an ECM Provider

Download CalAIM Provider Contact Sheet

Contact your Medi-Cal Managed Care Plan below to learn more:

Blue Shield California Community Health Group Kaiser Permanente Molina Healthcare

Not sure which managed care plan you’re enrolled with?

Contact State Health Care Options →

See if a provider is accepting direct referrals to their organization.

Review ECM Providers →

The San Diego County Universal Referral form includes eligibility criteria for each Population of Focus.

Download the Referral Form →

Enhanced Care Management