ECM Basics
A whole-person, interdisciplinary approach that coordinates care for Medi-Cal members with complex medical and social needs.
What is Enhanced Care Management (ECM)?
The date ECM first launched for adult populations that were part of Whole Person Care or Health Homes.
What is January 1, 2022?
Adults and families without a fixed, regular, and adequate nighttime residence fall into this ECM population.
Who are individuals experiencing homelessness?
The first step in ECM involves assessing this to tailor the member’s care plan.
What are the member’s clinical and non-clinical needs?
Vanessa Valenzuela, Nhi Bui, Katia Arciga Duarte, Jessica Bautista
The initiative under which ECM was launched to reform Medi-Cal delivery, payment, and quality systems.
What is CalAIM (California Advancing and Innovating Medi-Cal)?
The statewide rollout date for children and youth populations of focus.
What is July 1, 2023?
A population defined by high use of emergency or hospital services that could be avoided with better outpatient care.
Who are individuals at risk for avoidable hospital or ED utilization?
This key document outlines member goals, interventions, and the interdisciplinary care team.
What is the individual care plan?
Services that are preventive health services to prevent disease, disability, and other health conditions or their progression; to prolong life; and promote physical and mental health and well-being which is a program excluded from ECM.
What is Community Health Worker Benefit/Program?
This previous Medi-Cal program’s lessons formed the foundation for ECM, along with the Health Homes Program.
What were the Whole Person Care Pilots?
This State entity/department provides ECM operational oversight and updates via official guidance.
What is the Department of Health Care Services (DHCS)?
Individuals who have schizophrenia, severe bipolar disorder, severe major depression, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).
Who are members with serious behavioral health conditions?
This service helps members access housing, food, and transportation resources.
What is linkage to community and social supports?
Platform built by SCFHP to refer members into ECM program for SCFHP staff and others who have access to platform.
What is the provider portal?
One of ECM’s main goals is to reduce this by ensuring better coordination and prevention.
What is inappropriate utilization or duplication of services?
Each Managed Care Plan (MCP) must develop this detailed plan describing its program build.
What is a Model of Care (MOC)?
This population includes individuals who receive services prior to enrolling in ECM such as behavioral health screening, medication screening, and care planning that are conducted by county and State prisons.
Who are justice-involved individuals?
This coordination ensures alignment across physical health, behavioral health, and social services.
What is care coordination and system navigation?
Current enrollment count for ECM.
What is 8,290?
The DHCS vision for ECM emphasizes this kind of care, centered on the member’s overall well-being rather than just illness.
What is person-centered, whole-person care?
SCFHP supports and provides oversight to this many providers as of October 2025?
What is 39 ECM contracted providers?
Youth enrolled a State program for children with certain diseases or health problems. Through this program, children up to 21 years old can get the health care and services they need.
Who are children/youth with CCS or CCS WCM needs beyond their CCS condition?
ECM providers are expected to deliver care primarily in this setting.
What is the community, through in-person engagement?
QNXT-> Attributes-> ECM Engagement Status