Monterey County’s Whole Person Care pilot program (WPC) transitioned to Enhanced Care Management (ECM) under CalAIM on January 1, 2022. CalAIM is a program for Medi-Cal enrollees that coordinates access to services to address physical, behavioral, developmental, dental, and long-term care needs in an equitable manner.
We appreciated the opportunity to serve our community through our participation in the WPC. Previously, we accepted referrals for WPC directly from community partners and members, however this process and the eligibility requirements have changed with ECM. Central California Alliance for Health (CCAH), the Medi-Cal Managed Care Program serving Monterey County, will assign clients directly to an ECM provider, including Monterey County Health Department, Public Health Bureau. To refer someone to ECM, please contact CCAH directly at 831-430-5512.
ECM clients will partner with a nurse case manager to actively participate in improving their health outcomes. Some of these services include:
- Conducting a comprehensive assessment, care plan, and discharge plan
- Working with the client and care team to reach client’s health goals
- Making referrals to community partners and CCAH for community supports, such as housing and sobering center
- Accompanying client to medical visits
- Providing health education around medical diagnosis
- Assisting in obtaining medications and provide instruction on how to take correctly
- Assisting in arranging for transportation
There will be three populations of focus served beginning January 2022:
- Individuals experiencing homelessness who have multiple chronic diseases.
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High utilizers of the hospital emergency and inpatient services.
- Adults who have a serious mental health condition or have a hard time with drug or alcohol use.
We look forward to continued community service through ECM.
More information about CalAIM and ECM can be found here: https://www.dhcs.ca.gov/CalAIM/Pages/calaim.aspx
