Enhanced Care Management in San Diego, CA
Enhanced Care Management (ECM) is a statewide Medi-Cal program providing comprehensive, person-centered care for Medi-Cal beneficiaries with complex health and social needs. It provides whole-person, coordinated care, including help with medical appointments, housing navigation, behavioral health support, community resources, and care planning. The goal is to improve health outcomes by addressing both clinical and non-clinical needs and factors, such as behavioral health, social determinants of health, and other non-medical risks and circumstances that impact a person’s well-being. OpSam Health provides support for enhanced care management for San Diego, CA patients. Below, you’ll find more information about the ECM program and how it may benefit you.
Who is Eligible for the ECM Program?
The Enhanced Care Management program is intended for individuals or families who belong to one or more of its “Populations of Focus.” To qualify, you must be enrolled in a Medi-Cal managed care health plan. You or your family members may be eligible to receive benefits from the ECM if:
- You are homeless, houseless, or trying to secure housing.
- You have been admitted to the emergency room, hospital, or nursing home multiple times.
- You have or are currently seeking help for mental health or drug or alcohol use.
- You have recently been released from prison, jail, or a correctional facility.
- You live in a nursing home and want to transition to a new community.
What the ECM Program Includes
ECM covers and provides relief for a wide range of routine and complex care management and health and medical services, including the following:
- Whole‑Person Care Services: Care that addresses not just medical needs but also behavioral, social, and environmental factors that impact a person’s health.
- Care Coordination Services: Organizing and managing a person’s care across multiple providers and systems to ensure they receive care at the right time.
- Behavioral Health Care Coordination: Coordinating care for individuals with mental health disorders or substance abuse disorders, such as therapy and psychiatric treatment.
- Social Needs Care Management: Care that addresses social and external factors in health, such as housing, food security, transportation, and employment.
How OpSam Health’s Care Team Supports You
OpSam Health is a Federally Qualified Health Center (FQHC), a local, community-based healthcare provider that serves underserved individuals and patients throughout the San Diego, CA area. One of our primary goals is to provide care coordination for low-income individuals and families, or those who are uninsured or underinsured. Some of the health and medical care services we can coordinate and connect you with include the following:
Why Choose OpSam Health for ECM
Patients have chosen us for their health care and medical needs for many years. Here are the reasons why:
- Little to No Wait Time: The patients we serve often don’t have to wait long to receive care. The chances of receiving same-day care or no-wait appointments are high.
- Decades of Experience: We have helped uninsured, underinsured, and underserved individuals and families receive high-quality health care since 1973, connecting them with their doctors and medical providers.
- Connections to Comprehensive Care: The services that we connect patients with are varied, ranging from mental health to substance abuse treatment. Whether you need care for yourself or your child, we can help.
