Helpline Youth Counseling, Inc. 

                                                     

           Program Details

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Enhanced Care Management (ECM) is a free statewide benefit available to eligible members within the Medi-Cal program in California. The program focuses on addressing the clinical and non-clinical needs of high-need individuals through the coordination of services and comprehensive care management.

 

Eligible Medi-Cal Providers:

 

Individuals with Medi-Cal coverage through the following providers are eligible:

 

- Anthem Blue Cross Blue Shield

- HealthNet

- Kaiser Permanente

- LA Care

- Molina Healthcare

 

 

Qualifying Groups for ECM:

 

- SPA 7

- Adults and children/youth experiencing homelessness, with at least one complex physical, behavioral, or developmental health need.

- Adults at risk for avoidable hospital or emergency department (ED) utilization, with specific conditions in the last six months: five or more ED visits, three or more unplanned hospital admissions, or short-term skilled nursing facility stays.

- Children/youth at risk for avoidable hospital or ED utilization, with specific conditions in the past 12 months.

- Adults and children/youth with serious mental health or substance use disorders.

- Children and youth involved in child welfare.

 

Services Offered by ECM:

 

- Outreach and member engagement.

- Comprehensive assessment and care plan.

- Coordination of care across all member's providers.

- Health promotion.

- Comprehensive transitional care in and out of hospitals or treatment facilities.

- Education and inclusion of member and family supports.

- Coordination and referral to community and social support services.