Peach Tree Healthcare, a PATH Capacity and Infrastructure Transition, Expansion, and Development (CITED) awardee, shares how one of their clients was referred to the Enhanced Care Management (ECM) benefit by her primary care physician (PCP) because of her many visits to the emergency room, multiple chronic conditions, and socio-economic barriers to accessible, equitable care.
The Medi-Cal member’s name has been changed to protect confidentiality.
Amy consistently missed appointments and had her behavioral health services discontinued because she didn’t access services. She was unable to take care of her health because of the stress brought on by financial burdens and a lack of transportation to health providers.
The assigned case manager built a rapport with Amy to navigate priorities and create a care plan addressing health and socio-economic barriers. She was connected with a transportation provider and worked with the case manager to learn how to schedule appointments. The case manager provided Amy with a pocket agenda and showed her how to efficiently use the calendar to write down appointments and tasks, reducing no-show appointments.?
The case manager counseled Amy on how to prepare for appointments and accompanied her to doctor appointments to ensure she was learning to advocate for herself and understand what was discussed, improving adherence to treatment. In addition to ensuring Amy was prioritizing her health, the case manager assisted her with calling the Social Security office and provided tips on how to speak with the representative and what to ask to resolve an issue.
Once the issue was resolved, Amy was assigned to a payee to ensure her rent and bills were paid on time. Since she was discharged from county behavioral health services, the case manager connected her with another therapist and psychiatrist.
Thanks to the ECM benefit, Amy now has all the tools she needs to manage her chronic conditions, resolve issues through efficient communication, and utilize available resources.?
Have you applied for funding to support your organization’s workforce, vendor contracting, IT, community assessment and other Medi-Cal needs necessary to deliver ECM and Community Supports?