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Healthy San Diego

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.

HSD Behavioral Health Operations Quarterly Meeting Schedule

CY2024Date TimeLocationMaterials(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

 
CY2025DateTimeLocationMaterial(s)
Q1March 20, 20251:00 p. m. - 3:00 p. m.Virtual 
Q2June 12, 20241:00 p. m. - 3:00 p. m.Virtual 
Q3    
Q4    

HSD Behavioral Health Quality Improvement Projects Meeting Schedule

DateTimeLocation
Materials
July 25, 202410:00 a.m. - 11:30 a.m.VirtualJuly 25, 2024 Meeting Summary Notes 
August 1, 20241:00 p.m. - 2:30 p.m.VirtualAugust 1, 2024 Meeting Summary Notes
August 22, 202410:00 a.m. - 11:30 a.m.VirtualAugust 22, 2024 Meeting Summary Notes
September 5, 20241:00 p.m. - 2:30 p.m.VirtualSeptember 5, 2024 Meeting Summary Notes
September 26, 202410:00 a.m. - 11:30 a.m.VirtualSeptember 26, 2024 Meeting Summary Notes
October 3, 20241:00 p.m. - 2:30 p.m.VirtualOctober 3, 2024 Meeting Summary Notes
November 7, 202410:00 a.m. - 11:30 a.m.VirtualNovember 7, 2024 Meeting Summary Notes
December 26, 202410:00 a.m. - 11:30 a.m.VirtualMeeting 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
04/06/2023 2024-07-24
Screening Tool Process Map – Calls to MCP
04/06/2023 2024-07-24
Transition of Care Process Map - MCP identifies a member
12/10/2024 2024-12-12
Transition of Care Process Map – County Provider identifies a member
09/26/2023 2024-07-24

Resources

Community Supports for Medi-Cal Members (pdf) Revised 09/13/2024 2024-10-11
Enhanced Care Management for Medi-Cal Members (pdf) Revised 09/13/2024 2024-10-11
HSD CMCBH Quick Guide Matrix (doc) Revised 02/06/2024 2024-02-08
HSD Drug Medi-Cal Quick Guide (pdf) Revised 02/06/2024 2024-02-08
HSD Medi-Cal BH IP Guide Plus (pdf) Revised 02/06/2024 2024-02-08
HSD Medi-Cal EDO Quick Guide Screening Tool (docx) Revised 02/06/2024 2024-02-08
HSD Medi-Cal Quick VID Tool (pdf) Revised 02/06/2024 2024-02-08
HSD Pharmacy Benefit Quick Guide (pdf) Revised 02/06/2024 2024-02-08
HSD Transportation FAQs (pdf) Revised 01/22/2024 2024-01-24
Health Plan Contact Card (docx) Revised 05/30/2024 2024-05-31
MOU Care Coordination Form (docx) Revised 06/18/2024 2024-06-18
Medi-Cal Options (pdf) Revised 09/13/2024 2024-09-30
Screening and Transition of Care Contact Card (docx) Revised 06/06/2024 2024-06-06
Transportation for Medi-Cal Members (pdf) Revised 09/10/2024 2024-10-11
For Provider | Care Coordination Toolkit (pdf) Revised 10/2024 2024-10-31

MCP Foster Care Liaisons

Blue Shield CHG Kaiser Molina

Erika Osuna

Erika.Osuna@blueshieldca.com

(562) 613-5479

Sal Tapia

STapia@chgsd.com

(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 , Opens In New Window CHG Provider Search , Opens In New Window Molina Provider Search , Opens In New Window County of San Diego Behavioral Health Services Provider Directory , Opens In New Window
API Provider Directory CHG Provider Directory API, Opens In New Window County of San Diego Behavioral Health Services Provider Directory API , Opens In New Window
Patient Portal Blue Shield Patient Portal , Opens In New Window CHG Patient Portal , Opens In New Window Molina Patient Portal , Opens In New Window TBD
General Info / Plan Home Page Blue Shield Home Page , Opens In New Window CHG Home Page , Opens In New Window Molina Home Page , Opens In New Window County of San Diego Behavioral Health Services , Opens In New Window
Behavioral Health Landing Page Blue Shield BH Page , Opens In New Window CHG BH Page , Opens In New Window County of San Diego Behavioral Health Services , Opens In New Window

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.

Blue Shield Promise 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:

  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.

Blue Shield Promise 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