Enhanced Care Management & Community Supports Housing Navigation Referral Form

To submit a referral for Enhanced Care Management (ECM) and/or Community Supports (CS) Housing Navigation to Neighborhood Networks, please complete the form below.

• Referrals will be reviewed and assessed for eligibility within 48 hours of receipt and referred clients will be contacted within 5-10 business days.
• Anything with an asterisk is required upon submission.
• Referral forms should be filled out for one individual at a time.
• ECM and CS services are not designed for urgent needs.
• ECM and CS services are not duplicative, and members can be referred for both services at a time
• Referral notes should include information on member’s needed support and any additional contextual information helpful to serving the referred member.