Kern Health Systems (KHS) offers the Enhanced Care Management (ECM) benefit for eligible Kern Family Health Care (KFHC) Members. These services help coordinate the Member's physical, behavioral, developmental, oral health, long term services and supports (LTSS), and services that address social determinants of health.
If you would like more information or to find out the KFHC Member qualifies please call us at 1.800.391.2000. You or the eligible KHFC Member may also be contacted by KHS or our contracted ECM providers to see if they are interested in enrolling into an ECM Program.
Who is eligible for ECM?
KFHC Members may qualify for ECM if they are within one (1) or more of the following Populations of Focus.
Adults experiencing homelessness
- Lacking adequate nighttime residence
- Living in a shelter
- Imminently losing housing in next 30 days
- Victims fleeing domestic violence
Adults who have been admitted to the hospital three (3) or more times in the past six (6) months or have visited the Emergency Department five (5) or more times in the past six (6) months
Adults experiencing a serious mental illness or suffering from a substance use disorder.
- The individual is receiving services through County Specialty Mental Health or Drug Medi-Cal and meets one (1) or more of the following:
- Uses the emergency department, urgent care, or inpatient hospital as sole source of care
- Is at high risk of hospital or skilled nursing facility admission, overdose, and/or suicide
- Had two (2) or more emergency department visits, or two (2) or more hospitalizations due to SMI or SUD in past 12 months
- Is pregnant or is less than 12 months post-partum
Adults who are transitioning from incarceration
- The individual transitioned from incarceration within the last 12 months and has at least one (1) of the following:
- Chronic mental illness
- Substance use disorder
- Chronic disease
- Intellectual or developmental disability
- Traumatic brain injury
- HIV
- Pregnancy
Who is not eligible to receive ECM services?
- Individuals receiving hospice services.
What services does ECM provide?
ECM provides care coordination services lead by a care team. The ECM care team will work together with the individual's health care providers including their doctors, specialists, pharmacists, case managers, and others, to coordinate the needed care and services.
Individuals enrolled in ECM will receive services including:
- A Comprehensive Assessment and Care Management Plan
- Enhanced Coordination of Care
- Health Promotion Services
- Comprehensive Transitional Care
- Member and Family Supports
- Coordination and Referral to Community and Social Support Services
Is there a cost?
There is no cost to the Member for ECM services.
Resources
- Department of Health Care Services Enhanced Care Management.
- KFHC Enhanced Care Management Brochure (English/Spanish).