Enhanced Care Management (ECM) is a statewide Medi-Cal benefit offered at no cost to select members with complex needs to support your health and well-being. This could involve taking care of your health conditions and outside struggles that make it hard to take care of your health, such as not having a place to live.
What Services Are Covered by ECM
If you qualify for ECM, you will get comprehensive care management from a Lead Care Manager, who will serve as your main point of contact. The Lead Care Manager can meet you where you are - on the street, in a shelter, in your doctor's office, or at home to meet your needs. Your Lead Care Manager will work with you, your doctors and others to get you the care you need. The Lead Care Manager can help link you to other non-health services, such as housing, food and childcare in your community.
ECM Services May Involve:
- Coordinating care based on your needs
- Helping you understand and manage your medication
- Helping you plan visits with the doctor
- Working with you and your family to improve your health
Who Can Get ECM
ECM is for members, regardless of age, who have Medi-Cal with a Managed Care health plan such as L.A. Care and meet at least one of these groups (called “Populations of Focus”):
- Individuals and families experiencing homelessness
- Individuals who have been to the ER, nursing facilities or the hospital many times
- Individuals who need help with mental health or drug or alcohol use
- Individuals who have been released from a correctional facility, such as prison, jail, or youth correctional facility
- Adults living in the community who are at risk for long-term care
- Adults living in a nursing home who want to transition to the community
- Children and youth enrolled in California Children’s Services (CCS) or CCS Whole Child Model (WCM) with additional needs
- Children and youth who are or have been involved in child welfare (foster care)
- Black, American Indian or Alaska Native, or Pacific Islander who is pregnant or has had a baby in the past 12 months
What Is the Cost
None. ECM is at no cost to you if you have Medi-Cal.
Stopping ECM Services
If you would like to stop ECM at any time, please let your ECM provider know or call L.A. Care Member Services at 888-839-9909 (TTY 711). The L.A. Care Member Services is available 24 hours a day, 7 days a week.
Changing ECM Provider and/or Lead Care Manager
If you would like to change ECM provider and/or Lead Care Manager at any time, please call L.A. Care Member Services at 888-839-9909 (TTY 711). L.A. Care Member Services is available 24 hours a day, 7 days a week.
How Can I Learn More about ECM
There are three ways to learn more about ECM:
- Call L.A. Care Member Services at 888-839-9909 (TTY 711). The L.A. Care Member Services is available 24 hours a day, 7 days a week.
- An ECM provider may reach out to you directly to offer ECM services if you qualify.
- Talk to your health care provider about ECM.
You can also visit our Frequently Asked Questions web page.
Community Supports
Through ECM, you may also be connected to Community Supports services. L.A. Care Medi-Cal members have the choice to use Community Supports. If you qualify, there are 14 types of services that can help you with your health and well-being.
You do not have to pay for Community Supports, and they do not replace benefits that you already get under Medi-Cal. These services are available to Medi-Cal members regardless of whether you qualify for ECM. If you would like to learn more about Community Supports, please call 888-839-9909 (TTY 711) or talk to your doctor.
You can also visit L.A. Care’s Community Health Services web page for more information.