WE CARE 

AND ASSURE RESPECT, PERSONAL CHOICE, PRIVACY AND DIGNITY

Welcome to Love Focus International Association ECM-CS Website! 

We are a Community-Based Organization(CBO). Our Agency is an enrolled California Department of Health Care Services (DHCS) Medi-Cal Fee For Service Provider (PRIVATE NON-PROFIT PROPRIETARY AGENCY)
We provide Access to Health Services free of charge to the Population of Focus (Homeless Individuals, Families and Individuals with disability). 

Our services and supports includes: Enhanced Care Management (ECM). Community Supports (CS) and Community Health Worker (CHW) Services to Medi-Cal beneficiaries with disabilities including persons with developmental disabilities, regardless of age or degree of disability, and at each stage of life and to support their integration into the mainstream life of the community. Our services and supports follow an individualized and person-centered plan of care.

WE FOLLOW CALAIM ENHANCED CARE MANAGEMENT AND COMMUNITY SUPPORTS POLICY GUIDES

The Issue

In California 

Over half of Medi-Cal spending is attributable to the 5 percent of enrollees with the highest-cost needs.

Medi-Cal Enrollees

Medi-Cal enrollees typically have several complex health conditions involving physical, behavioral, and social needs. 

Complex Needs

Enrollees with complex needs must often engage several delivery systems to access care, including primary and specialty care, dental, mental health, substance use disorder, and long-term services and supports.

Disabled

California introduced community-based care management with promising results in many counties through the Health Homes Program and Whole Person Care Pilots. CalAIM is California’s first statewide effort to address complex care management. For more follow this link Review of Provider Roles & Requirements for ECM & ILOS.

For more follow this link Review of Provider Roles & Requirements for ECM & ILOS

Faces of CalAIM: Meet Frank!

Frank has struggled with opioid addiction while living on the streets of San Francisco for the past four years. Frank visited the emergency department seven times in the last two years because of overdoses and he returns to the streets after brief stays in shelters. In 2020, Frank contracted COVID-19 and continues to experience long-term symptoms. CalAIM’s Enhanced Care Management connects Frank with a care manager. They can meet at a nearby food bank to make plans for him to see his mental health provider to get his medication adjusted, and to follow up with his primary care doctor. The case manager can also connect Frank to a local Community Supports provider who will help him secure safe, supportive housing.

At-Risk-Youth

Key CalAIM Initiatives to Advance Enhanced Care Management

CalAIM will improve Medi-Cal for people with complex needs and who are facing difficult life and health circumstances. It is focused on breaking down the traditional walls of health care – extending beyond hospitals and health care settings into communities. As a key part of CalAIM, Enhanced Care Management will be a new statewide Medi-Cal benefit available to “populations of focus,” including:

  1. Individuals and families experiencing homelessness.
  2. Adults, youth, and children who are high utilizers of avoidable Emergency department, hospital, or short-term skilled nursing facility services.
  3. Adults with serious mental illness or substance use disorder.
  4. Children and youth with serious emotional disturbance, identified to be at clinical high risk for psychosis or experiencing a first episode of psychosis.
  5. Adults and youth who are incarcerated and transitioning to the community.
  6. Adults at risk of institutionalization and eligible for long-term care.
  7. Adult nursing facility residents transitioning to the community.
  8. Children and youth enrolled in California Children’s Services (CCS) with additional needs beyond CCS.
  9. Children and youth involved in child welfare (including those with a history of involvement in welfare, and foster care up to age 26).

Improve Quality of Life!

Enhanced Care Management will address clinical and non-clinical needs of the highest-need enrollees through intensive coordination of health and health-related services. It will meet enrollees wherever they are – on the street, in a shelter, in their doctor’s office, or at home.

Additionally, enrollees will have connections to Community Supports to meet their social needs, including medically supportive foods or housing supports. Enrollees will have a single Enhanced Care Manager who will coordinate care and  services among the physical, behavioral, dental, developmental, and social services delivery systems,  making it easier for them to get the right care at the right time.

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Positive Impact of CalAIM’s Enhanced Care Management

Benefits of the Enhanced Care Management pilots expanded to a statewide program.
During the pilots, emergency department and inpatient utilization rates decreased, and indicators of preventative care and engagement increased.

Justice-involved individuals saw a 29 percent improvement in control of high blood pressure. In 2022, about 95,000 Medi-Cal enrollees will be able to use Enhanced Care Management, including those experiencing homelessness, high utilizers, and adults with serious mental illness or substance use disorders. California expects to see positive impacts on outcomes and total costs when comprehensive, community-based care coordination is available to those with the highest needs across the state.

Community Health Worker (CHW) Services

Our CHW Services program aligns with Medi-Cal community health worker (CHW) services, pursuant to 42 CFR Section 440.130(c), as preventive services and on the written recommendation of a physician or other licensed practitioner of the healing arts within their scope of practice under state law.

CHW services may address issues that include, but are not limited to, the control and prevention of chronic conditions or infectious diseases; mental health conditions and substance use disorders; need for preventive services, perinatal health conditions; and reproductive health; environmental and climate-sensitive health issues; child health and development; oral health; aging; injury; domestic violence; and violence prevention.

Definition:
Community health worker (CHW) services are preventive health services to prevent disease, disability, and other health conditions or their progression; to prolong life; and promote physical and mental health.

Our Community health workers may include individuals known by a variety of job titles, including promotores, community health representatives, navigators, and other non-licensed public health workers, including violence prevention professionals, with the qualifications. 

How Will CalAIM Help to Address California’s Homelessness Crisis? Medi-Cal plays an instrumental role in coordinating medical and non-medical services, as unmet social needs have been shown to significantly affect health outcomes. In particular, CalAIM plays a critical role in addressing California’s homelessness crisis. DHCS has the opportunity through coordinated CalAIM initiatives to address housing needs in innovative ways, such as offering housing related services, including transition and navigation services and tenancy sustaining supports, and integrating those services with members’ other needed health and social services.


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