WHAT IS ENHANCED CARE MANAGEMENT?

Enhanced Care Management (ECM) is a benefit for Medi-Cal members. This benefit helps Central California Alliance for Health (CCAH) individuals with complex needs coordinate their care. ECM offers extra services to individuals with complex needs that make it difficult to improve their health. This could include health conditions or challenges such as not having a place to live.

If you qualify for ECM, you will be assigned a care team from one of our qualified providers. This team includes a lead care manager. Your care team will talk with doctors, mental health providers, specialists, pharmacists, case managers, social services providers and others. They will make sure everyone works together to get you the care you need. The care team can also help you find and apply for other services in the community.  

ECM can help you:

• Find doctors or specialists
• Schedule appointments for health-related services.
• Manage medications.
• Set up a ride to go to the doctor or pharmacy.
• Find and apply for community-based services that you need. These services include support with housing or medically nutritious food.
• Set up follow-up care after the hospital.

WHY CHOOSE COUNTY OF MONTEREY ECM? WHAT MAKES COUNTY OF MONTEREY ECM UNIQUE?

County of Monterey Health Department ECM program is a team-based approach to care. Led by a Public Health Nurse, the care team may consist of Licensed Vocational Nurses, Community Service Aides and a Behavioral Health Aide. All of these providers work together to support your individual needs and goals. Our case management services are primarily through in-person interaction where members, their families and support networks live, seek care, and prefer to access services. ECM services are voluntary, and you may choose to end services or switch providers at any time.

 WHO IS ELIGIBLE FOR ECM? 

County of Monterey Health populations served include:

a. Perinatal (pregnant or post-partum up to 12 months) and identify with the following ethnicities: 
          • Pacific Islander 
          • American Indians/Alaskan Native/Indigenous 
          • African American 
b. Pregnant or post-partum up to 12 months and target another Population of Focus below (c-e)

To make a referral for Perinatal or Birth Equity, click here

c. Homeless, at risk for homelessness, marginally housed (this includes couch surfing etc.) 
d. Using the Emergency Room for visits or staying in the hospital for chronic conditions 
e. Mental health and substance use disorder

The ECM program is committed to serving the Medi-Cal population with the most complex health care and social service needs by providing intensive and comprehensive care management. Each enrollee will work with a Lead Care Manager and a team of support staff to address the clinical and non-clinical needs of the client. 

HOW ARE ELIGIBLE INDIVIDUALS IDENTIFIED/REFERRED?

Member identification can happen in one of three (3) ways:

1. Central California Alliance for Health (CCAH) uses claims and/or other data available to identify individuals presumed eligible for ECM.

2. Providers can identify and refer an individual as a potential ECM beneficiary.

3. The Individual or the Individual's representative can refer them(selves) to the program.

To refer an individual to ECM, contact County of Monterey Enhanced Care Management Program at 831-755-4950 or contact Central California Alliance for Health (CCAH) Directly at 831-430-5512.