Changing the way you
receive healthcare

  • Enhanced Care Management (ECM)
    & Community Supports

    Enhanced Care Management (ECM)

    PHC California covers Enhanced Care Management (ECM) services for members with highly complex needs. ECM provides extra services to help you get the care you need to stay healthy. ECM coordinates primary and preventive care, acute care, behavioral health, developmental, oral health, community-based long-term services and supports (LTSS), and referrals to available community resources.

    Learn more about PHC California offered Enhanced Care Management (ECM):

    If you qualify for ECM, you will have your own care team, including a Lead Care Manager. This person will talk to you and your doctors, specialists, pharmacists, case managers, social services providers, and others to make sure everyone works together to get you the care you need. A Lead Care Manager can also help you find and apply for other services in your community.

    ECM includes:

    • Outreach and engagement
    • Comprehensive assessment and care management
    • Enhanced coordination of care
    • Health promotion
    • Comprehensive transitional care
    • Member and family support services
    • Coordination and referral to community and social supports

    Cost to Member
    There is no cost to the member for ECM services.  PHC California’s ECM team contact members who qualify for ECM services to get consent to receive services. Members must opt-in to receive ECM services.

    Community Supports

    Community Supports are optional, medically appropriate and cost-effective alternative services or settings to those covered under the Medi-Cal State Plan. If you qualify, these services might help you live more independently. They do not replace benefits you already get under Medi-Cal.

    PHC California offers the following Community Supports:

    Environment accessibility adaptations (EAA) are home modifications to ensure a member’s health, welfare and safety. EAA help a member function independently in the home and avoid being institutionalized.  Examples of EAA are ramps, grab-bars, doorway widening for members who require a wheelchair, stair lifts, etc.

    Housing deposits help members who are homeless or at risk of becoming homeless set up a basic household by paying for items such as security deposits, first and last months’ rent, set up/deposit fees for utilities, and other services.

    Housing transition navigation services help members who are homeless or at risk of becoming homeless find housing.

    Housing tenancy and sustaining services help formerly homeless members maintain safe and stable tenancy once housing is secured.

    Meals and medically-tailored meals for members who are homebound and not able to grocery shop and/or prepare nutritious meals for themselves. This includes members who have been discharged from hospital or skilled nursing facility and members who have a chronic health condition.

    Personal care and homemaker services for members who are not able to bathe, groom and/or dress themselves or perform basic housework.

    Community transition services/nursing facility transition to a home help members live in the community at home and avoid further institutionalization. This Community Support includes set up expenses for a basic household and any needed home modifications or medically-necessary services or items.

    Nursing facility transition/diversion to an assisted-living facility help members move from a nursing facility into an assisted-living facility.  This Community Support also prevents a nursing facility admission in favor of moving to an assisted-living facility for members who otherwise would be admitted into a nursing facility. This Community Support will become available July 1, 2024.

    If you need help or want to find out what Community Supports might be available for you, call 1-800-263-0067 (TTY 711). Or call your health care provider.

     

    DHCS MMDDYY PHC FR Form 1.0