CAL AIM/ECM Foundations
The federally-approved waiver that created the framework for ECM.
What is CalAIM
Within how many business days must an LCM reach out after receiving a Member Information File (MIF)?
What is five (5) business days?
The LCM provides this letter when welcoming a member.
What is the ECM Welcome Letter?
All referral activities must be documented in this system.
What is ORCHID?
The main staff member responsible for ECM coordination with members.
What is the Lead Care Manager (LCM)?
This initiative provided funding for LA DPH CMS ECM.
What is PATH-CITED?
Who may submit a Microsoft ECM Referral Form?
What is MTU or CMS staff (or member/caregiver)?
The LCM updates the Individualized Care Plan (ICP) on this schedule.
What is quarterly, or more frequently as needed?
This process ensures referrals are tracked from initiation to outcome.
What is the Closed-Loop Referral (CLR) process?
This team brings together professionals across disciplines.
What is the Multidisciplinary Care Team (MDCT)?
DPH ECM aims to serve children/youth enrolled in this statewide program first.
What is the CCS Medical Therapy Program (MTP)?
The preferred method for member engagement.
What is in-person contact?
Members may change this key staff role at any time.
What is the Lead Care Manager (LCM)?
Who maintains and updates the ECM Resource Database?
What are LCMs and Senior Typist Clerks (STCs)?
The electronic health record system used by LA County.
What is ORCHID?
Name two goals of ECM.
What are reducing barriers and preventing unnecessary ER visits?
Name at least three outreach modalities required over 90 days.
What are phone calls, texts, in-person visits, emails, USPS mail, secure messages?
Three core responsibilities of the LCM when implementing the ICP.
What are assessment, coordination, and updating/sharing the ICP?
Name two types of referrals LCMs may make.
What are internal CMS/CCS, external CBOs, behavioral health, or MCP Community Supports (CS)?
Part of the ECM clinical staff that includes an MD, PHN, and LVNs.
What is the Medical Consultant Team (MCT)?
The four health plans that reimburse ECM services.
What are Health Net, Kaiser, LA Care, and Molina?
This standard guides culturally appropriate communication.
What are the CLAS Standards?
This form ensures information can be shared between providers and the ECM team.
What is the Release of Information (ROI) form?
Within how many business days must LCMs confirm receipt of a referral?
What is ten (10) business days?
This document combines medical, behavioral, and social service needs.
What is the Individualized Care Plan (ICP)?