Provider Alerts

Starting in 2022, new benefits and services called Enhanced Care Management (ECM) and Community Supports will be available to Medi-Cal members. ECM and Community Supports will be available for transitioning and select populations starting January 1, 2022 in San Joaquin County and July 1,2022 in Stanislaus County. ECM and Community Supports will be implemented in phases and additional populations will become eligible over time.

ECM offers extra care management services at no cost to qualifying members who have complex needs and challenges that make it difficult to improve their health.

ECM provides coordination services, including a dedicated care manager that that functions as a central point for the member and develops a care plan, coordinates with providers, and offers an added layer of support to assist members to:

• Find doctors and make appointments
• Keep all your doctors updated on member health needs and wishes
• Understand medication needs and how to access refills
• Connect members to needed community and social services such as food
  and in-home support

Community Supports are optional services that Medi-Cal health plans may offer to their members as a substitute for other services, such as hospital care or emergency department visits. Community Supports can be an important part of care for members enrolled in ECM who need additional support in the community.

Community Supports can help members with things like transitioning between care settings, navigating housing, and getting healthy meals. The specific Community Supports available may vary by health plan. Medi-Cal health plans have the option to offer Community Supports from a list of services preapproved by California’s Department of Health Care Services (DHCS). 

HPSJ will begin by offering community supports such as:

• Housing navigation and transition services
• Housing deposits
• Housing tenancy and sustaining services
• Short-term post hospitalization housing
• Recuperative care
• Meals/medically tailored meals
• Sobering centers

Some important points for hospitals and facilities are:

• Whole Person Care transitioning members will be:
  • Automatically authorized for ECM and Community Supports.
  • Reassessed within a six-month period to ensure appropriateness of
    care.
  • Receiving member notices from multiple points to advise of the
    transition and provide access to important phone numbers.
• Hospitals and facilities may work with their HPSJ assigned concurrent review nurse manager to schedule an appointment with the member’s PCP to refer for ECM services.
• Hospitals and facilities may work with their assigned concurrent review nurse manager to refer the member to Community Support services.

If you have questions, please contact the Customer Services team at 1.888.936.PLAN (7526).