About HPSM

Enhanced Care Management (ECM)

CalAIM’s Enhanced Care Management (ECM) aims to stabilize the health of the highest-need “Populations of Focus" who have multiple chronic conditions. The program addresses these Medi-Cal members' clinical and non-clinical needs not only at the doctor's office but wherever they need help: whether that's in their home, in a shelter or on the street.

Each member in ECM has a Care Manager who talks with them as well as their care team. The care team can include their doctors, mental health providers, specialists, pharmacists, case managers, social services providers and others. This makes sure everyone works together to get the member the care they need. A member’s Care Manager can also help them:

  • Find doctors and get appointments for health-related services they may need.
  • Better understand and keep track of their medications.
  • Set up rides to and from health care visits.
  • Find and apply for community-based services based on their needs. This includes housing supports or meals to fit health needs.
  • Get follow-up care after they leave the hospital.

ECM currently serves HPSM'a most at-risk Medi-Cal members who fall into at least one of the following categories:

  • Adults, unaccompanied youth and children, and families experiencing homelessness.
  • Adults, youth, and children who are at risk for avoidable hospital or emergency department care.
  • Adults, youth, and children with serious mental health and/or substance use disorder needs.
  • Adults living in the community and at risk for long-term care institutionalization.
  • Adult nursing facility residents transitioning to the community.
  • Children and youth enrolled in California Children’s Services (CCS) or CCS Whole Child Model with additional needs beyond their CCS condition(s).
  • Children and youth involved in child welfare (foster care).

Note:  "Children and youth" refers to members under the age of 21

HPSM contracts with the following agencies to provide ECM to our members:

For additional details, see the Enhanced Care Management and Community Supports Provider List.