Enhanced Care Management - Info for Members
L.A. Care covers Enhanced Care Management (ECM) services for members with highly complex needs. ECM is a benefit that provides extra services to help you get the care you need to stay healthy. It coordinates the care you get from different doctors.
ECM helps coordinate primary care, acute care, behavioral health, developmental, oral health, community-based long-term services and supports (LTSS), and referrals to available community resources.
If you qualify, you may be contacted about ECM services. You can also call L.A. Care to find out if and when you can receive ECM. Or talk to your health care provider who can find out if you qualify for ECM and when and how you can receive it.
Covered ECM services
If you qualify for ECM, you will have your own care team, including a care coordinator. This person will talk to you and your doctors, specialists, pharmacists, case managers, social services providers and others to make sure everyone works together to get you the care you need. A care coordinator can also help you find and apply for other services in your community. ECM includes:
- Outreach and engagement
- Comprehensive assessment and care management
- Enhanced coordination of care
- Health promotion
- Comprehensive transitional care
- Member and family support services
- Coordination and referral to community and social supports
To find out if ECM may be right for you, talk to your L.A. Care representative or health care provider.
Cost to member
There is no cost to the member for ECM services.
Community Supports may be available under your Individualized Care Plan. Community Supports is medically appropriate and cost-effective alternative services or settings to those covered under the Medi-Cal State Plan. These services are optional for Members to receive.
If you qualify, these services may help you live more independently. They do not replace benefits that you already get under Medi-Cal. Community Supports may include help finding or keeping housing, medically-tailored meals, or other help for you or your caregiver.
If you need help or would like to find out what Community Supports may have available for you, call 1.888.839.9909 (TTY 711) or call your health care provider.