Enhanced Care Management

Accessing ECM for CenCal Eligible Members Transitioning from Incarceration

As a provider, correctional facility, or community organization, facilitating access to Enhanced Care Management (ECM) for CenCal Health members who are transitioning or have transitioned from incarceration within the last 12 months is essential. ECM helps connect members to important services outlined in their discharge plans, including housing, transportation, and follow-up care with primary healthcare providers.

Who Qualifies for ECM Justice-Involved Population of Focus?

• Mental illness
• Substance Use Disorder (SUD)
• Chronic or non-chronic clinical conditions (e.g., hepatitis C, diabetes)
• Intellectual or developmental disability
• Traumatic brain injury
• HIV/AIDS
• Pregnancy or postpartum

CenCal Health members under 21 who have transitioned from incarceration within the last 12 months are automatically eligible for ECM services without additional requirements.

What is ECM?

ECM provides intensive, in-person care management through a Lead Care Manager, who coordinates members’ physical and behavioral health, long-term services, oral health, and social determinants of health. CenCal Health collaborates with community-based organizations and healthcare providers experienced in serving these populations.

How Do I Refer to ECM?

To refer a CenCal Health member to ECM services, complete the ECM Adult (21+) Referral Form or ECM Children/Youth Referral Form and select the appropriate populations of focus. You can submit the referral through the methods listed on the form. The referral will be reviewed, and if eligible, the member will be assigned to an ECM provider for outreach. Members have the right to enroll in or decline ECM services at any time.

CenCal Health has a dedicated team available Monday to Friday, from 8 AM to 5 PM, to assist with phone referrals, answer questions about the referral process, and provide updates on ECM provider assignments. The ECM team can be reached at 805-562-1698. Additionally, a dedicated Justice-Involved Liaison is available to support care coordination efforts.

What is the Justice-Involved Liaison?

The Justice-Involved Liaison is CenCal Health’s primary contact for correctional facilities, care managers, and ECM providers supporting the justice-involved population. They assist with inquiries regarding CenCal Health services, including prior authorization, Community Supports, non-emergency medical transportation, PCP assignments, and network providers.

CenCal Health’s Justice-Involved Point of Contact:
Heather Te, LMFT, LPCC, CCM
ECM Manager and Justice Involved Liaison
Phone: (805) 685-9525 x5427
Email: hte@cencalhealth.org
Available during business hours (8 AM – 5 PM) and will respond to after-hours or weekend requests within one business day.

Justice Involved contact cards for BH linkages (Counties that have gone live)

CalAIM Provider Micro Training Resources

• CalAIM CenCal Health Website Overview
• CenCal Health Member Eligibility Overview
• CalAIM Program Member Capacity Change Request
• Enhanced Care Management Helpful Reminders & Tips
• Enhanced Care Management January 2025 Updates
• Enhanced Care Management New Provider Orientation Training Video