Description: Offers care management services to Medi-Cal Health Plan of San Joaquin members with complex medical and social needs. Provides support to coordinate care between Doctors, Specialists, Pharmacists, Social Services Providers, and HPSJ Members. Also help find and apply for other services in your community.Services include:Regular doctor visits for preventative care when you are sickSpecialty Care VisitsHelp with housing or shelterBehavioral health and mental health servicesSubstance use disorder treatmentDevelopmental healthOral health (dental)Long-term services and supports (LTSS)Referrals to community resources in your areaServices covered under ECM include:Outreach and engagementComprehensive assessment and care managementEnhanced coordination of careHealth promotionComprehensive transitional careMember and family support servicesCoordination and referral to community and social supports
Eligibility: To qualify, must be an active Medi-Cal Health Plan of San Joaquin member and meet one of the following requirements:. Adults and their Families Experiencing Homelessness. Adults At Risk for Avoidable Hospital or Emergency Department (EDO) Utilization (formerly "High Utilizers). Adults with Serious Mental Health and/or Substance Use Disorder (SUD) Needs. Individuals Transitioning from Incarceration (some Whole Person Care (WPC) counties). Adults with Intellectual or Developmental Disabilities (I/DD). Pregnant or Postpartum Adults. Adults Living in the Community and At Risk for Long Term Care (LTC) Institutionalization. Adults Nursing Facility Residents Transitioning to the Community. Adults without Dependent Children/Youth Living with Them Experiencing Homelessness. Children and Youth Populations of Focus: ? Homeless Families or Unaccompanied Children/Youth Experiencing Homelessness ? Children and Youth At Risk for Avoidable Hospital or ED Utilization ? Children and Youth with Serious Mental Health and/or SUD Needs ? Children and Youth Enrolled in California Children's Services (CCS) or CCS Whole Child Model (WCM) with Additional Needs Beyond the CCS Condition ? Children and Youth Involved in Child Welfare ? Pregnant or Postpartum Youth. Pregnant and Postpartum Individuals At Risk for Adverse Perinatal Outcomes who are subject to racial and ethnic disparities. Individuals Transitioning from Incarceration
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