A wide range of entities may operate as Enhanced Care Management (ECM) providers, including but not limited to:

• Counties.
• Behavioral health providers.
• Primary care physicians (PCPs).
• Federally Qualified Health Centers (FQHCs).
• Community Health Centers.
• Hospitals or hospital-based physician groups or clinics (including public hospitals and district and/or municipal public hospitals).
• Rural Health Clinics.
• Indian Health Service Programs.
• Local health departments.
• Behavioral health entities.
• Community mental health centers.
• Substance use disorder (SUD) treatment providers.
• Organizations serving individuals experiencing homelessness.
• Managed care plans.
• Organizations serving justice-involved individuals.
• California Children’s Services (CCS) providers.
• Other Community-Based Organizations.

To become an ECM provider, the ECM provider must be experienced in serving the ECM Population(s) of Focus it will serve and have the experience and expertise with the ECM services it will provide. The ECM provider will be able to communicate in culturally and linguistically appropriate and accessible ways. The ECM provider will have the capacity to provide culturally appropriate and timely in-person care management activities including accompanying members to critical appointments when necessary. The ECM provider should have formal arrangements and processes in place to engage and cooperate with area hospitals, primary care practices, behavioral health providers, specialists, and other entities, including Community Supports providers, to coordinate care as appropriate to each member. The ECM provider will use a care management documentation system or process that supports the documentation and integration of physical, behavioral, social service, and administrative data and information from other entities to support the management and maintenance of a member care plan that can be shared with other providers and organizations involved in each member’s care. Other providers and organizations could include, but are not limited to, primary care doctors, participating physician groups (PPGs), specialists, etc. Care management documentation systems could include certified electronic health record technology, or other documentation tools that can:

• Document member goals and goal attainment status.
• Develop and assign care team tasks.
• Define and support member care coordination and care management needs.
• Gather information from other sources to identify member needs and support care team coordination and communication.
• Support notification regarding member health status and transitions in care (e.g., discharges from hospital or long-term care facility, housing status).