Enhanced Case Management Form

Thank you for your interest in becoming a Community-Based Care Management Entity (CB-CME) with L.A. Care's Health Homes Program.  

To become a CB-CME, your organization must be one of the following:

  • Behavioral health entity
  • Community health center
  • Community mental health center
  • Federally qualified health center
  • Hospital or hospital-based physician group or clinic
  • Indian health center
  • Indian health clinic
  • Local health department
  • Primary care provider (PCP) or specialist physician or physician group
  • Provider serving individuals experiencing homelessness
  • Rural health center
  • Substance Use Disorder (SUD) treatment provider
  • Other entities that meet certification
     
Point of Contact Phone Number
Specialty Type & Services (Check all that apply)
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