San Ysidro Health offers services to eligible members through Enhanced Care Management (ECM). This program helps people with complex health issues and people who need help setting up their medical care. Our goal is to help you get healthy and stay healthy.
Through ECM, individuals may qualify for additional Community Supports which can help with resources such as housing and food, as well as support for those who have experienced or are experiencing homelessness.
Enhanced Care Management (ECM) is a new benefit for Medi-Cal members. It comes from a new Medi-Cal program called California Advancing and Innovating Medi-Cal, also called CalAIM. This benefit helps members with complex needs coordinate their care.
If you qualify for ECM, you will be assigned a lead case manager. Your lead case manager 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. A lead case manager can also help you find and apply for other services in the community.
An ECM lead case manager can help you:
To get ECM services, you must be:
1. Enrolled in a Medi-Cal managed care health plan
2. Meet certain eligibility requirements
The following members can get ECM services starting January 1, 2022:
Community Supports are support services tht help address health issues often caused or made worse by lack of food, housing, or transportation. Community Supports are available to Medi-Cal members through a referral, as part of the Enhanced Care Management program.
Community Supports include:
Your Enhanced Care Management (ECM) Case Manager can refer you to Community Supports. You or your family may also ask to get Community Supports.
If you are already enrolled in Enhanced Care Management (ECM), you will be assigned with a case manager who will assist and provide you with all the information including what will be required to receive Community Supports directly from your health plan.
To learn more, call us at (833) 503-5910, option #2 or email us at ECM@syhealth.org. You can also call your Medi-Cal health plan for additional information.