Enhanced
Care Management

Enhanced Care Management provides
7 core services

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

What will I gain as a member of Enhanced Care Management?

You will have a personalized care team – including a Care Manager – that works together to help you get the care you need.

Your care team and Care Manager will work with you to develop an individualized Health Action Plan. A Health Action Plan will help you to meet your goals and objectives in hopes of better overall health and wellness.

You receive extra services at no cost as part of your Medi-Cal benefits, including help with:

Making and following-through with appointments
Transportation to-and-from doctors’ appointments (coordination of insurance provided
transportation services)
Understanding your prescription medications
Medication reminders
Coordination of Specialty referrals and visits
Getting follow-up services after you leave the hospital
Connecting to and applying for community programs and services

Who qualifies for Enhanced Care Management?

To be eligible for Enhanced Care Management services, patients must be enrolled in a Medi-Cal Health Plan (Elica Health Centers are contracted to provide Enhanced Care Management Services in the Sacramento County to Molina, Health Net and Anthem Members), and meet criteria for 1 of 3 current Populations of Focus as indicated below:

Adult Experiencing Homelessness AND have at least one complex physical, behavioral, or developmental health need
Children or Youth Experiencing Homelessness: Sharing the housing of other persons (i.e., couch surfing), or Living in motels, hotels, trailer parks or camping grounds, or Living in emergency or transitional shelters or Are abandoned in hospitals(in hospital without a safe place to be discharged to).
Adult High Utilizers who in the last six months have had 5 or more ER visits OR 3 unplanned hospital admissions OR 3 or more short-term SNF stays
Children or Youth who in the last twelve months have had 3 or more ER visits OR 2 unplanned hospital admissions OR 2 or more short-term SNF stays
Adult with Serious Mental Illness or Substance Use Disorder and other health needs are individuals who are working with the County Specialty Mental Health (SMH) System or the Drug Medi-Cal Organization Delivery System (DMC-ODS) AND at risk of institutionalization OR experiencing a complex social factor affecting their health
Children or Youth with Serious Mental Illness or Substance Use Disorder and other health needs who are working with the County Specialty Mental Health (SMH) System or the Drug Medi-Cal Organization Delivery System (DMC-ODS)

How can I receive additional information?

For more general information regarding the Enhanced Care Management Program, please view the Member Toolkit.

For more information regarding Elica's Enhanced Care Management Program, please contact ecm@elicahealth.org.

You may also inquire about a referral by calling your health plan or asking your Elica primary care provider to submit a Social Care Department referral.

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Open Payments Information

For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.

The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. It can be found at https://openpaymentsdata.cms.gov