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Program: Enhanced Care Management - Lutheran Social Services of Northern California

Agency: Lutheran Social Services of Northern California


Resource Number: 86982702
Alternate name: CalAIM, ECM

Description

Provides case management for Medi-Cal enrollees with complex needs. Enrollees are assigned a Lead Care Manager who will work with their doctors, specialists, mental health providers, and other care staff to ensure necessary care is provided.

Enhanced Care Management services may include:

  • Coordinating care based on the individual's specific medical and social needs
  • Helping individuals understand and manage medications
  • Helping individuals schedule appointments
  • Finding and applying for services in the individual's community
  • Working with individuals and their families to improve their health

The program is supported by CalAIM, also known as the Medi-Cal Transformation Initiatives. To learn more about CalAIM, click here.




Program Phones:
No phone access - online only

Website: www.lssnorcal.org/what_we_do/mct.html

Location information
Sites offering this program
+ Sacramento Office ->
Sacramento Office  
Location: 2450 Alhambra Boulevard, Suite 101
Sacramento, CA 95817
(Map)
Program Hours:
Website: Seven days a week, 24-hours
Description: Located near the intersection of Broadway and Alhambra Boulevard.
Bus Service: SacRT Bus 67.
Disabilities Access: Fully accessible to individuals using mobility aids. Designated, accessible parking spaces.
Mailing Address: 2450 Alhambra Boulevard, Suite 101, Sacramento, CA 95817
Service Area:

Program Delivery
Eligibility: An individual must:
- Be a Medi-Cal recipient with either Anthem, Molina Healthcare, Partnership Healthplan of California, Kaiser Permanente, or Health Net.
- Live in a County within the service area.

Adults are eligible if they meet one or more of the following criteria:
- Are homeless or don’t have a stable place to live
- Are at risk for avoidable hospital or emergency department care.
- Have a serious mental health condition or struggle with drug or alcohol use
- Are transitioning from incarceration
- Are at risk of entering a nursing home or facility
- Are staying in a nursing home or facility and need help to transition back to the community
- Are pregnant or have 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 they meet one or more of the following criteria:
- Are homeless or don’t have a stable place to live
- Are at risk for avoidable hospital or emergency department care.
- Have a serious emotional or mental health condition or struggle with drug or alcohol use
- Are part of California Children’s Services (CCS) or Whole Child Model (WCM) and have additional social needs. This can include, but is not limited to, food, stable housing, or transportation. Or they are having a mental health or substance use crisis, or have had recent contact with police.
- Are in foster care now or have a history of being in a child welfare program or foster care
- Are transitioning from incarceration
- Are pregnant or have had a baby in the last year and are Black, American Indian, Alaska Native, or Pacific Islander

At risk of homelessness is generally defined as those who will lose primary residence within 14 days, have nowhere else to go, and have no resources or support networks to obtain permanent housing. Individuals are encouraged to share their FULL Housing History and Current Housing Status in the application to ensure the reviewer can accurately assess eligibility.
Languages: Spanish, English
Application Process: Interested individuals may complete the LSS Medi-Cal Transformation Referral Form on the LSS website. A person may also refer another individual but will need the name, medical record number, and birthdate of that individual.
Payment methods: Accepts Medi-Cal
Program Fees: No fee.
Documents Required: Medi-Cal ID and Health Plan Member information.
Normal Wait Time: Approximately 2 weeks for healthcare plan approval.
Service Area:
Defined coverage area:
CA-Sacramento County
CA-San Joaquin County
CA-Shasta County
CA-Siskiyou County
CA-Solano County
CA-Stanislaus County
CA-Yolo County


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