Medi-Cal programs

ECM services help to coordinate your care. You’ll have a lead care manager who works with your care teams. This includes doctors, specialists, and mental health providers. They make sure everyone works together and you get the care you need. Your lead care manager can also help you find services near you to help you stay healthy.

ECM services may include:

• Coordinating care for your medical and social needs
• Helping you manage medications
• Helping you schedule appointments
• Finding and applying for services
• Helping you and your family improve your health

If you’re already enrolled in ECM, you can request a different ECM provider or lead care manager. Call one of our contracted ECM providers, Monday through Friday from 8:30 a.m. to 4 p.m.

• Full Circle Health Network: 1-888-749-8877
• Independent Living Services: 1-844-320-5182
• Partners in Care Foundation: 1-818-463-0734

Adults are eligible if: ¹

• You and your family are homeless or don’t have a stable place to live
• You had 5 or more emergency visits, or 3 or more unplanned hospital or short-term skilled nursing facility (SNF) stays in the last 6 months
• You have a serious mental health condition or struggle with drug or alcohol use
• You’re transitioning from incarceration (such as jail or prison)
• You’re at risk of entering a nursing home
• You’re staying in a nursing home and need help to transition back to the community
• You’re pregnant or had a baby in the last year and are Black, American Indian, Alaska Native, or Pacific Islander
  

Children or youth under 21 are eligible if: ¹

• You’re homeless or don’t have a stable place to live
  
• You had 3 or more emergency visits, or 2 or more unplanned hospital or short-term SNF stays in the last 12 months
• You have a serious mental health condition or struggle with drug or alcohol use
• You’re part of California Children’s Services (CCS) or Whole Child Model (WCM). And you have more social needs. This may include food, stable housing, or transportation. Or you’re having a mental health or substance use crisis. Or you had recent contact with police
  
• You’re in foster care or have a history of being in a child welfare program or foster care
  
• You’re transitioning from incarceration (such as a camp or detention facility)
• You’re pregnant or had a baby in the last year and are Black, American Indian, Alaska Native, or Pacific Islander

^{1 Members may not be enrolled in ECM and any of the following programs at the same time: Hospice, Program for All-Inclusive Care for the Elderly (PACE), Complex Care Management (CCM), County-based Targeted Care Management (TCM), Community Health Worker (CHW), California Community Transitions (CCT), and 1915 (c) Home and Community-Based Services Waiver (HCBS) -- including Medi-Cal Waiver Program (HIV/AIDS), Home and Community-Based Alternatives (HCBA), Assisted Living Waiver (ALW), Home and Community-Based Services Waiver for the Developmentally Disabled (HCBS-DD), Multipurpose Senior Services Program (MSSP), and Self-Determination Program (ICF-DD)}

Qualifying for Community Supports depends on the service. You can request services on your own. Your provider can also refer you. To learn which supports you can get and how to qualify, call us at the phone numbers listed below. Services usually start within 14 days after approval.

Kaiser Permanente offers CHW services at no cost to Medi-Cal members who qualify. A CHW is a non-clinical health worker. This means they’re not a doctor, nurse, or social worker. You may also know them as promotores, navigators or community health representatives. They are a trusted member of your community. They can help guide you through the healthcare system. They can also offer you support to reach your health goals.

CHWs provide a wide range of support services. Here are some examples of how they can help:

• Provide cultural or language support to understand your healthcare options
• Share details about your health condition
• Guide you to government programs and local resources, like food or transportation
• Go with you to doctor’s appointments
• Support you with issues related to domestic or community violence

CHW services do not include:

• Clinical services or other services that require a license
• Childcare
• Chores like shopping, cooking, or driving
• Social visits or companion services
• Employment services
• Delivering medication, medical equipment, or medical supplies
  

Most Medi-Cal members may qualify for CHW services. If you need non-clinical support to reach your health goals, you may qualify.

You don’t qualify for CHW services if you’re enrolled in ECM.