Enhanced Care Management
Enhanced Care Management (ECM) is a new, statewide Medi-Cal benefit available to eligible members with complex medical and social needs.
The goal of ECM is to provide a whole-person approach to care that addresses the clinical and non-clinical needs of CenCal Health members in San Luis Obispo County.
ECM provides comprehensive care services to specific populations of focus through systemic coordination that is collaborative, interdisciplinary, community-based, high-touch, and person-centered.
The overall goal of the ECM benefit is to provide comprehensive care and achieve better health outcomes.
The seven core services are:
- Outreach and engagement
- Comprehensive assessment and care management plan
- Enhanced care coordination
- Health promotion
- Comprehensive transitional care
- Member and family supports
- Coordination of and referral to community and social support services
Who qualifies for Enhanced Care Management?
San Luis Obispo County’s Enhanced Care Management program is currently available to SLO County residents including:
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Individuals and families experiencing homelessness
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Individuals who are at risk for avoidable hospital or emergency department care
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Adults and youth transitioning from jail, prison or juvenile correctional facility within the past 12 months.
To be eligible for ECM, members must be enrolled in CenCal Health (San Luis Obispo County’s Medi-Cal managed care health plan) and fit into at least one of the populations mentioned. ECM will provide these members with long-term help coordinating their services across delivery systems to address their needs.
The ECM Program provides extra services to help individuals get the care they need to stay healthy at no cost by coordinating the care received from various doctors and services.
How to enroll into the ECM Program for interested individuals
If you are a service provider for San Luis Obispo County, click the link here to fill out the ECM referral form for clients you believe are ECM eligible. All types of social services, non-profit and medical providers can refer clients by completing this form.
Note it may take up to ten business days to confirm ECM eligibility and be assigned a Provider.
If you qualify for San Luis Obispo County’s ECM Program, you will be contacted by an ECM Provider also known as the ECM Lead Care Manager. This person will coordinate care between:
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You
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Our doctors
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Specialists
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Pharmacists
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Case Managers
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Social services providers
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Other additional resources and services
Your ECM Lead Care Manager will make sure everyone works together to get the care you need and can help you find and apply to other services in your community.
Through the Enhanced Care Management Program, the Health Agency hopes to improve population health, enhance the care experience for Members, and improve care coordination between providers.
For more information, please visit the Enhanced Care Management guide provided by the California Department of Health Care Services here.
Contact us
If you would like to speak to someone about your eligibility for this program, contact us by phone at 805-781-4838. You can also email us at [email protected].
