This page is used by staff working with Healthy San Diego, the Medi-Cal managed care system in San Diego. The staff can obtain resources to assist and inform Medi-Cal members about their health care choices.
Healthy San Diego
HSD Behavioral Health Operations Quarterly Meeting Schedule
CY2024 | Date | Time | Location | Materials(s) |
Q1 | March 7, 2024 | 1:00 p. m. - 3:00 p. m. | Virtual | HSD BH Operations Quarter 1 Meeting Summary Notes |
Q2 | June 6, 2024 | 1:00 p. m. - 3:00 p. m. | Virtual | HSD BH Operations Quarter 2 Meeting Summary Notes |
Q3 | September 19, 2024 | 1:00 p. m. - 2:30 p. m. | Virtual | HSD BH Operations Quarter 3 Meeting Summary Notes |
Q4 | December 19, 2024 | 1:00 p. m. - 2:30 p. m. | Virtual |
CY2025 | Date | Time | Location | Material(s) |
Q1 | March 20, 2025 | 1:00 p. m. - 3:00 p. m. | Virtual | |
Q2 | June 12, 2024 | 1:00 p. m. - 3:00 p. m. | Virtual | |
Q3 | ||||
Q4 |
HSD Behavioral Health Quality Improvement Projects Meeting Schedule
Date | Time | Location | Materials |
July 25, 2024 | 10:00 a.m. - 11:30 a.m. | Virtual | July 25, 2024 Meeting Summary Notes |
August 1, 2024 | 1:00 p.m. - 2:30 p.m. | Virtual | August 1, 2024 Meeting Summary Notes |
August 22, 2024 | 10:00 a.m. - 11:30 a.m. | Virtual | August 22, 2024 Meeting Summary Notes |
September 5, 2024 | 1:00 p.m. - 2:30 p.m. | Virtual | September 5, 2024 Meeting Summary Notes |
September 26, 2024 | 10:00 a.m. - 11:30 a.m. | Virtual | September 26, 2024 Meeting Summary Notes |
October 3, 2024 | 1:00 p.m. - 2:30 p.m. | Virtual | October 3, 2024 Meeting Summary Notes |
November 7, 2024 | 10:00 a.m. - 11:30 a.m. | Virtual | November 7, 2024 Meeting Summary Notes |
December 26, 2024 | 10:00 a.m. - 11:30 a.m. | Virtual | Meeting going dark due to holiday |
Training / Education
For Provider | San Diego BHP-MOU Resource.Training.10.2024 (pdf)
|
Revised 10/2024 | 2024-10-31 |
Screening and Transition of Care for Mental Health Services
The Screening and Transition of Care Tools for Medi-Cal Mental Health Services aim to ensure that Medi-Cal members receive timely and coordinated specialty and non-specialty mental health services (SMHS/NSMHS).
Process Maps
Screening Tool Process Map – Calls to ACL
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04/06/2023 | 2024-07-24 |
Screening Tool Process Map – Calls to MCP
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04/06/2023 | 2024-07-24 |
Transition of Care Process Map - MCP identifies a member
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12/10/2024 | 2024-12-12 |
Transition of Care Process Map – County Provider identifies a member
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09/26/2023 | 2024-07-24 |
Resources
MCP Foster Care Liaisons
Blue Shield | CHG | Kaiser | Molina |
---|---|---|---|
Erika Osuna (562) 613-5479 |
Sal Tapia (619) 240-8855 |
Olatokunbo Ajibola-Stott Olatokunbo.X.Ajibola-Stott@kp.org (510) 987-4423 |
Marlene Grosch marlene.grosch@molinahealthcare.com (562) 456-4410 |
Data Exchange
Provider Network Search Link | Blue Shield Provider Search | CHG Provider Search | Molina Provider Search | County of San Diego Behavioral Health Services Provider Directory | |
API Provider Directory | CHG Provider Directory API | County of San Diego Behavioral Health Services Provider Directory API | |||
Patient Portal | Blue Shield Patient Portal | CHG Patient Portal | Molina Patient Portal | TBD | |
General Info / Plan Home Page | Blue Shield Home Page | CHG Home Page | Molina Home Page | County of San Diego Behavioral Health Services | |
Behavioral Health Landing Page | Blue Shield BH Page | CHG BH Page | County of San Diego Behavioral Health Services |
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
- Confirm the individual has active Medi-Cal and identify their Managed Care Plan (MCP).
- Ensure the individual meets the eligibility criteria for ECM in the ECM Policy Guide.
- 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.
Blue Shield Promise | ECM Referral Form (blueshieldca.com) | Email: ECM@blueshieldca.com | 1-855-699-5557 |
Community Health Group | ECM Referral Form (chgsd.com) | Email: ecm-cs@chgsd.com | 1-800-224-7766 |
Kaiser | ECM Referral Form (kaiserpermanente.org) | Email: RegCareCoordCaseMgmt@KP.org | 1-800-464-4000 |
Molina | ECM Referral Form (molinahealthcare.com) | Email: MHC_ECM@Molinahealthcare.com | 1-888-665-4621 |
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:
- Housing Transition Navigation Services
- Housing Deposits
- Housing Tenancy and Sustaining Services
- Short-Term Post-Hospitalization Housing
- Recuperative Care (Medical Respite)
- Day Habilitation Programs
- Caregiver Respite Services
- Personal Care and Homemaker Services
- Nursing Facility Transition/Diversion to Assisted Living Facilities
- Community Transition Services/Nursing Facility/Transition to a Home
- Environmental Accessibility Adaptations (Home Modifications)
- Medically Tailored Meals/Medically-Supportive Food
- Sobering Centers
- 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:
- Confirm the individual has active Medi-Cal and identify their Managed Care Plan (MCP).
- Ensure the individual meets the eligibility criteria for Community Supports in the Community Supports Policy Guide.
- 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.
Blue Shield Promise | Communit Supports Referral Form (blueshieldca.com) | Email: Email: SDCommunitySupports@blueshieldca.com | 1-855-699-5557 |
Community Health Group | Community Supports Referral Form (chgsd.com) | Email: Email: ecm-cs@chgsd.com | 1-800-224-7766 |
Kaiser Permanente | Community Supports Referral Form (kaiserpermanente.org) | Email: Email: RegCareCoordCaseMgmt@KP.org | 1-800-464-4000 |
Molina | Community Supports Referral Forms (molinahealthcare.com) | Email: Email: MHC_CS@MolinaHealthcare.com | 1-888-665-4621 |
For additional information and resources, please visit: San Diego Advancing and Innovating Medi-Cal (SDAIM)
Agreements (MOUs)
Blue Shield | ||
CHG | ||
Kaiser | ||
Molina |
Policies and Procedures
Training & Education | ||
Assessment and Referral | ||
Care Coordination | ||
Quarterly Meetings and QI Activities | ||
Dispute Resolution |
Annual Report
This webpage was last updated on: 08/22/2024