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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
- 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
- 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
- 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
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 email@example.com.
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.