NEW! Medi-cal Benefits

ECM Purpose

Enhanced Care Management will address clinical and non-clinical needs of the highest-need enrollees

through intensive coordination of health and health-related services. It will meet enrollees wherever they

are – on the street, in a shelter, in their doctor’s office, or at home. Additionally, enrollees will have

connections to Community Supports to meet their social needs, including medically supportive foods or

housing supports. Enrollees will have a single Enhanced 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.

Who is Eligible?

Medi-cal health plan.

Re-entry individuals.

Individuals and families experiencing homelessness.

Adults, youth, and children who are high utilizers of avoidable emergency department, hospital, or

Short-term skilled nursing facility services.

Adults with serious mental illness or substance use disorder.

Children and youth with serious emotional disturbance, identified to be at clinical high risk for

Psychosis or experiencing a first episode of psychosis.

Adults and youth who are incarcerated and transitioning to the community.

Adults at risk of institutionalization and eligible for long-term care.

Adult nursing facility residents transitioning to the community.

Children and youth enrolled in California Children’s Services (CCS) with additional needs beyond

CCS.

Children and youth involved in child welfare (including those with a history of involvement in welfare, and foster care up to age 26).