Healthy San Diego

HSD Behavioral Health Operations Quarterly Meeting Schedule

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Managed Care Plan (MCP) Enhanced Care Management (ECM) Referral Forms and Contact Information

Enhanced Care Management (ECM) is available for select Medi-Cal members with complex needs. Enrolled members receive comprehensive case management from a lead care manager who coordinates health and social services.

To connect an individual to EMC

1. Confirm the individual has active Medi-Cal and identify their Managed Care Plan (MCP).
2. Ensure the individual meets the eligibility criteria for ECM in the ECM Policy Guide.
3. Complete the universal or plan specific ECM referral form linked below and email the form to the assigned MCP's designated email address. The Universal ECM Referral Form is accepted by all plans.

Note that the MCP should authorize ECM services within 5 working days for routine authorizations and within 72 hours for expedited requests. If you have not received a response, email or call the MCP for an update.

Managed Care Plan (MCP) Community Supports Referral Forms and Contact Information

Community Supports are medically appropriate and cost-effective services provided by MCPs to help members address their health-related social needs.

The 14 services are:

1. Housing Transition Navigation Services
2. Housing Deposits
3. Housing Tenancy and Sustaining Services
4. Short-Term Post-Hospitalization Housing
5. Recuperative Care (Medical Respite)
6. Day Habilitation Programs
7. Caregiver Respite Services
8. Personal Care and Homemaker Services
9. Nursing Facility Transition/Diversion to Assisted Living Facilities
10. Community Transition Services/Nursing Facility/Transition to a Home
11. Environmental Accessibility Adaptations (Home Modifications)
12. Medically Tailored Meals/Medically-Supportive Food
13. Sobering Centers
14. Asthma Remediation

Community Supports are available to a wide range of members, including those with complex needs and those who are enrolled in ECM. However, members do not need to be enrolled in ECM to access Community Supports.

To connect an individual to Community Supports:

1. Confirm the individual has active Medi-Cal and identify their Managed Care Plan (MCP).
2. Ensure the individual meets the eligibility criteria for Community Supports in the Community Supports Policy Guide.
3. Complete the plan specific Community Supports referral form linked below for each service needed and email the form(s) to the assigned MCP's designated email address.

For additional information and resources, please visit: San Diego Advancing and Innovating Medi-Cal (SDAIM)

Agreements (MOUs)

Policies and Procedures

Annual Report