Enhanced Care Management
Enhanced Care Management (ECM) is a Medi-Cal care management benefit. ECM offers extra services to members with complex needs that make it difficult to improve their health. This could include health conditions or challenges such as not having a place to live.
Working with an ECM care team
Qualified members who enroll in ECM are paired with a care team. The care team works with the member to make a care plan. This can include connecting members with core community and social services.
Who can get ECM?
Members must be enrolled in a Medi-Cal managed care health plan. They must meet eligibility requirements to receive ECM services. If they qualify, using ECM services is their choice.
People who qualify
ECM is for Medi-Cal members with the most complex medical and social needs. It is available to select “Populations of Focus.” It will address the clinical and non-clinical needs of the highest-need members. Members that qualify will receive help with health-related services.
How to request Enhanced Care Management
Members can talk to their doctor or call Blue Shield Promise Customer Care in Los Angeles at (800) 605-2556 or San Diego at (855) 699-5557, Monday through Friday from 8 a.m. to 6 p.m.
To check if a member qualifies for ECM services, email Blue Shield Promise Enhanced Care Management: ECM@blueshieldca.com
To contact the Justice Involved Managed Care Plan Liaison:
Phone: (800) 393-1542
Email: ECM@blueshieldca.com
In alignment with the Justice Involved Reentry program, please accept appointments from justice-involved individuals as a way to help them reintegrate into our communities and become healthy, productive citizens.
Read the APL 23-030 Justice Involved FAQ (PDF, 440 KB)
Blue Shield of California Promise Health Plan offers the following ECM services to eligible Medi-Cal members in Los Angeles and San Diego Counties:
| Enhanced Care Management Populations of Focus for Adults |
|
|---|---|
| Adult nursing facility residents transitioning to the community | Adults and their families experiencing homelessness |
| Adults at risk for avoidable hospital or emergency department (ED) utilization | Adults living in the community and at risk for Long Term Care (LTC) Institutionalization |
| Individuals transitioning from incarceration | Adults without dependent children/youth living with them experiencing homelessness |
| Adults with serious mental health or substance use disorder (SUD) needs | Pregnant or postpartum adults in racial and ethnic groups experiencing disparities in care for maternal morbidity and mortality |
| Enhanced Care Management Populations of Focus for Youth |
|
|---|---|
| Children and youth at risk for avoidable hospital or ED utilization | Children and youth enrolled in California Children’s Services (CCS) or CCS Whole Child Model (WCM) with additional needs beyond the CCS condition |
| Children and youth involved in child welfare | Homeless families or unaccompanied children/youth experiencing homelessness |
| Children and youth with serious mental health and/or SUD needs | Pregnant or postpartum youth in racial and ethnic groups experiencing disparities in care for maternal morbidity and mortaility |
| Youth transitioning from incarceration | |
For additional information or to refer members to Enhanced Care Management, email ECM@blueshieldca.com.
Important documents
LA MCP Adult ECM Assessment (PDF, 471 KB)
LA MCP Children and Youth ECM Assessment (PDF, 407 KB)
Referral forms
Online form
Download PDF form
Adult ECM Referral Form (PDF, 370 KB)
Under 21 ECM Referral Form (PDF, 284 KB)