Alcohol Misuse Screening and Counseling
To comply with APL 18-014 (PDF), Alcohol Misuse Screening and Counseling (AMSC) formerly known as Screening, Brief Intervention & Referral for Treatment (SBIRT), IEHP has updated the requirements for Primary Care Physicians (PCPs) with Members whose alcohol and substance use may be negatively impacting their health and quality of life. Helpful resources:- Correspondence (PDF)
- Training Guide (PDF)
- AUDIT-C (PDF)
- Brief Addiction Monitor (BAM) (PDF)
- Alcohol Misuse Addendum Tool (PDF)
- Pamphlets
Baby-N-Me
To improve maternity health outcomes, IEHP launched a new prenatal app, Baby-N-Me, in June of 2018. This free app provides expectant mothers with clinically approved information and access to exclusive content based on their due date. IEHP Members can download this app in Google Play or Apple App stores.
Flyers for Members:
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.Incentive Program Update - 06/02/2020
Attention VBP BHIIP Applicants,
DHCS has announced to IEHP that per the May Budget Revision, Proposition 56 adjustments have been proposed. The May Budget Revision proposes to shift funding from many programs to support growth in the Medi-Cal program compared to the 2016 Budget Act. Considering these circumstances, the Behavior Health Integration program is on hold until further notice.
If you have any questions, please do not hesitate to reach out to the BHIIP@iehp.org mailbox.
Behavioral Health Integration Incentive Program (BHIIP)
The California Department of Health Care Services (DHCS) is providing Proposition 56 funding to incentivize managed care health plans (MCPs) to promote behavioral health integration in their provider networks. The behavioral health integration incentive program (BHIIP) aims to improve physical and behavioral health outcomes, care delivery efficiency, and patient experience by establishing or expanding fully integrated care in IEHP’s network using culturally and linguistically appropriate teams with expertise in primary care, substance use disorder conditions, and mental health conditions who deliver coordinated comprehensive care for the whole patient.
Goals include increasing IEHP network integration for providers at all levels of integration, focus on new target populations or health disparities, and improve provider’s level of integration or impact.
If you have programmatic questions, please submit them to BHIIP@iehp.org.
- Behavioral Health Integration (BHI) Incentive Program Update (PDF) - June 06, 2020
- Behavioral Health Integration (BHI) Incentive Program Application (PDF)
- Behavioral Health Integration (BHI) Incentive Program FAQs (PDF)
- Behavioral Health Integration (BHI) Incentive Program Overview Presentation Slides (DHCS) (PDF)
- Behavioral Health Integration (BHI) Incentive Program Overview Presentation Slides (IEHP) (PDF)
- Behavioral Health Integration (BHI) Incentive Program Process Guide (PDF)
- Behavioral Health Integration (BHI) Incentive Program Project Selection Criteria (PDF)
- Behavioral Health Integration (BHI) Incentive Program Webex Recording (IEHP)
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
California Children Services (CCS)
Welcome to IEHP's California Children Services (CCS) information page.
What is CCS?
CCS is a statewide program that enables children with qualifying conditions to receive specialized services related to that condition independent from IEHP. These conditions are generally physical or congenital handicaps or malformations, not cognitive in nature (i.e. autism).
Specifically, CCS will provide medical care, equipment, rehabilitation and case management services related to that child's qualifying condition. For example, if a CCS-paneled Provider orders a continuous glucose monitoring system (CGM) for a child active with CCS for type I diabetes, their office would submit it directly to CCS for approval and bypass IEHP.
Who Qualifies?
CCS is specifically for children and young adults with physically handicapping medical conditions under 21 years of age, who have CCS-eligible conditions and whose families are unable to provide all or part of their care.
Examples of CCS-eligible conditions include:
- Chronic medical conditions such as cystic fibrosis,
- Hemophilia,
- Cerebral palsy,
- Congenital heart defects,
- Cancer,
- Traumatic injuries, and
- Infectious diseases producing major sequelae.
Examples of CCS-ineligible conditions include:
- Closed fractures,
- Pyloric stenosis,
- Failure to thrive,
- Down’s syndrome,
- Laryngomalacia,
- Plagiocephaly without craniosynostosis, and
- Minor orthopedic impediments such as knock knees and flat feet.
Unfortunately, there is not an established list of CCS-eligible diagnosis available, but the parameters can be viewed on the CCS website at (by clicking this link, you will be leaving the IEHP site.): https://www.dhcs.ca.gov/services/ccs.
Additionally, there are printable diagnosis resources available on this page for quick reference. When in doubt, the IEHP CCS team is available for assistance. Many CCS-eligible conditions are not identified, unfortunately, and we encourage referrals if in doubt!
Provider Responsibilities
Primary Care Physicians (PCPs), Specialty Providers, and IPA/Medical Groups are responsible for performing appropriate baseline health assessments and diagnostic evaluations sufficient to identify children and young adults with potential CCS-qualifying conditions and refer them to CCS for consideration.
CCS requests consult notes from a CCS-paneled Specialty Provider that would manage the qualifying condition when approving enrollment. After identifying a possible diagnosis, please try to refer to a CCS-paneled specialist for consult to speed up the patient’s approval.
This link is a searchable list of CCS-paneled Specialty Providers (by clicking this link, you will be leaving the IEHP site.): https://cmsprovider.cahwnet.gov/prv/ppc.pdf
Benefits of CCS Enrollment
CCS is an underutilized resource! Once a Service Authorization Request (SAR) has been approved by CCS for designated medical care, equipment, or rehabilitation, the primary barrier between the patient and appropriate care has been removed. To assist our valued Providers, every Member active with CCS will have an alert in their online Patient Profile with their active SARs to reduce unnecessary duplicate efforts (i.e. submitting a request to IEHP for DME that is already approved by CCS).
To assist our valued Providers, every Member active with CCS has a distinct red “CCS” widget in the Provider Portal. Opening that widget enables you to view the diagnosis being treated and any Specialists and their treatment authorization range.
For any questions about your Member’s CCS care or management, please don’t hesitate to contact IEHP’s CCS Team at: (800) 706-4347.
Additional Resources (By clicking on the links below, you will be leaving the IEHP site.)
IEHP is committed to improving the coordination of care for our Members with suspected or confirmed CCS conditions, as well as the Providers caring for them. Please refer to information below, and feel free to contact the CCS team!
CCS Program Overview: https://www.dhcs.ca.gov/services/ccs
CCS Program Application: https://www.dhcs.ca.gov/formsandpubs/forms
CCS Brochure (English/Spanish):
If you would like more information on how to become a CCS Provider:
https://www.dhcs.ca.gov/services/ccs
To search CCS-paneled Providers by Type within an Interactive Map, please see the following link and instructions (by clicking on this link, you will be leaving the IEHP website): DHCS - CA Children Services Providers. IEHP has developed this web page in order to help Providers access information that may aide with the coordination of care for Medi-Cal Managed Care in children with suspected or confirmed CCS conditions. By clicking on these links, you will be leaving the IEHP website. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.The IEHP Health Homes Program
The IEHP Health Homes Program (HHP) is a no-cost Medi-Cal benefit that helps eligible IEHP Members with certain complex chronic health conditions - like diabetes, hypertension or substance use disorder - and who meet other specific criteria get the health care and community services they need.
The HHP provides these vulnerable Members an additional care team to help coordinate and manage their care. The care team consists of a Nurse Care Manager, a Behavioral Health Care Manager, a Care Coordinator, and a Community Health Worker These specially trained professionals collaborate with IEHP Members' Primary Care Physicians, Specialists, and family support systems to create a personalized plan of care.
Beginning January 1, 2019, please direct eligible IEHP Members who need the HHP services to call IEHP Member Services at (800) 440-4347, Monday - Friday, 8am - 5pm. TTY users should call (800) 718-4347.
If you have programmatic questions, please submit them to healthhomes@iehp.org.
- Health Homes Program Year 1 Implementation Report – 2019 (PDF)
- The IEHP Health Homes Program Member Brochure (PDF)
- Medi-Cal Health Homes Program Guide (PDF)
- BHICCI Sites and Health Homes Program FAQs (PDF)
IEHP Gender Health
For education and training on gender health care, please access the following resources:
- IEHP Transgender-Gender Health Center of Excellence Program Guidelines (PDF)
- IEHP Gender Health Brochure (PDF)
- Adult (PDF) (For IEHP Members 18+)
- Child (PDF) (For Parents and Children under 18)
- IEHP Social Health Survey (PDF)
- Questionnaire - Providers for Transgender Members (PDF)
ADA and Beyond
By clicking on the links below, you may be leaving the IEHP website.ADA and Beyond: A resource for health providers, IPAs and others interested in the Americans with Disabilities Act, California law as it related to accessibility and Universal Design.
In partnership with our Provider Network, IEHP strives to break down barriers to medical care and promote health and wellness for Members with disabilities.
With accessibility issues often cited as an obstacle to care, we publish this site to help all stakeholders in the health care system understand the barriers and in some cases the solutions. We invite you to browse these topics:
Accessibility of Doctor's offices, clinics, and other health care providers is essential in providing medical care to people with Disabilities. Find out more by following the link to the ADA's Access Guide (PDF).
The Federal Americans with Disabilities Act (ADA) of 1990 prohibits discrimination on the basis of disability and sets national standards for accessibility. Each page in this section gives you a summary of ADA related documents and a link to the actual Federal resource.
By clicking on this link, you will be leaving the IEHP website.View the full text of the law at the ADA Website.
Enforcement
Lawsuits for ADA Violations
U.S. Department of Justice (DOJ)
1994
Status reports, briefs, and settlement information will help you stay up-to-date on precedent-setting ADA litigation. Unsuccessful negotiations or mediation may lead to federal lawsuits. Courts can order compensatory damages, back pay, or civil penalties up to $55,000 for the first violation and $110,000 for any subsequent one.
Read more about DOJ Litigation
Alternative to Litigation
U.S. Department of Justice (DOJ) Mediation Program Established: 1994
Mediation, which is confidential and voluntary, can resolve some ADA disputes quickly and satisfactorily – without the expense and delay of formal investigation and litigation.
Read more about DOJ Mediation
Facts and Information
Diagnosing & Treating Members with Auditory Disability
Communicating with People Who Are Deaf or Hard of Hearing in Hospital Settings
U.S. Department of Justice (DOJ) Disability Rights Section, Civil Rights Division
Published 2003
Interactive doctor-patient discussions with individuals who are deaf or hard-of-hearing may require an interpreter to ensure proper diagnosis and treatment. DOJ’s brief outlines the types of interpreter services including sign language, oral interpretation, cued speech, and Computer Assisted Real-time Transcription (CART).
Phone Calls & Auditory/Speech Disabilities
Phone Calls & Auditory/Speech Disabilities - Technology Breaks Communication Barriers
Created by IEHP, 2006
Learn about FREE options for effective telephone communication with individuals who have auditory and/or speech disabilities:
- National Telecommunication Relay Service (TRS) – two-way translation between individuals using a TTY and a standard telephone
- Speech-to-Speech (STS) Relay Service – assistance for individuals with speech disabilities by repeating their message verbatim.
Read the Full Article
- Fact Sheet - PDF
- Fact Sheet - TXT
Dispelling ADA Myths
Just the Facts on the ADA
Adapted from 1995 DOJ fact sheet
IEHP, 2006Get the facts on common ADA misconceptions. ADA Myths & Facts
Accessibility Pays Off at Tax Time
Tax Incentives for ADA Compliance
Take advantage tax incentives that help eligible businesses comply with the Americans with Disabilities Act. The Federal and California state governments offer Tax Credits and/or Deductions for improving accessibility and/or employing persons with disabilities.
Attorney General’s ADA Tax Incentives Packet
Your practice/health care facility may be eligible for tax credits and/or deductions to help offset the costs of improving accessibility for patients and employees with disabilities. The Attorney General’s packet includes a fact sheet and Internal Revenue Service (IRS) form and instructions.
Download IEHP's Fact Sheet
Download the Attorney General's information packet
Legal Obligations
Standards for Accessible Design
ADA Accessibility Guidelines
U.S. Department of Justice (DOJ)
1991
The ADA Accessibility Guidelines (ADAAG) include stringent criteria for health care Providers as well as additional requirements based on building use (special application 6 – Medical Care Facilities). The Standards for Accessible Design apply to the architecture and construction of new buildings/facilities as well as alterations to existing structures.
Download the Standards
Download Special Application 6 (Health Care Facilities)
Removing Existing Barriers
Checklist for Readily Achievable Barrier Removal
Adaptive Environments Center, Inc. and Barrier Free Environments, Inc.
1995
Identify accessibility problems and solutions for eliminating physical/architectural and communication barriers. Use this informal checklist as a guide to meet your obligations under the ADA (for existing facilities only, not new construction or alterations).
Download the checklist for readily achievable barrier removal
ADA Update: Barrier Removal vs. New Construction
U.S. Department of Justice (DOJ) Disability Rights Section, Civil Rights Division
1996
DOJ answers common questions about barrier removal and how it differs from requirements for new construction and alterations.
ADA Regulations for Health Care Providers
Nondiscrimination on the Basis of DisabilityU.S. Department of Justice (DOJ)
1991
Federal regulations for accessibility at Health care facilities include standards for the architecture of buildings, alterations, and new construction (ADA, Title III).
Basic ADA Requirements for Health Care Providers
ADA Title III Highlights
U.S. Department of Justice (DOJ) Disability Rights Section, Civil Rights Division
Published 1990
This functional outline of the ADA’s Title III (section covering health care providers) helps you become familiar with key requirements that impact you and your patients. DOJ’s overview provides details in bullet format for quick reference.
Practical Guidance for ADA Compliance
Title III Technical Assistance ManualU.S. Department of Justice (DOJ)
1993 and 1994
This manual (with supplement) outlines ADA requirements for businesses to ensure access to goods, services, and facilities. The reader-friendly format offers:
- Lay terms and practical examples (limited legalese)
- Focused, systematic description of requirements
- Questions/answers and illustrations
Technical Assistance
DOJ ADA
Information and Technical Assistance on the Americans with Disabilities Act
The official ADA website of the U.S. Department of Justice (DOJ) offers the most up-to-date information and practical guidance on design, construction, and operation:
- Regulations and standards impacting Providers and Members
- Accessibility and reasonable accommodations guidelines
- Solutions for ensuring access within your budget
- Tax credits and incentives
- Technical assistance and materials/publications
Visit DOJ's ADA Homepage
Avoid Costly Building Mistakes
Common ADA Errors and Omissions in New Construction and Alterations
U.S. Department of Justice (DOJ) Disability Rights Section, Civil Rights Division
Published 1997
Incorporating ADA Standards into initial building/alteration plans helps ensure patient safety as well as cost-effectiveness. Review some of the most common accessibility errors/omissions identified through DOJ’s ongoing enforcement efforts. Following each error/omission, you’ll find an explanation of its significance and reference to the appropriate requirement under the ADA Standards for Accessible Design.
Read the full DOJ article
Online ADA Course
Reaching Out to Customers with Disabilities
U.S. Department of Justice (DOJ) with Representatives of Business and Disability Communities
2005
Learn about ADA compliance in an online course with 10 short lessons.
1. Policies, Practices, and Procedures
2. Communicating with Customers Who Have Disabilities
3. New Buildings, Additions, and Remodeling
4. Removing Barriers in Buildings That Are Not Being Remodeled
5. Providing Access When Removing Barriers Is Not Readily Achievable
6. Maintaining Accessibility
7. Transporting Customers
8. ADA Compliance Costs and Tax Incentives
9. Enforcement of the ADA
10. Information Sources
Take the ADA online course
Pacific Region ADA Technical Assistance
Disability Business Technical Assistance Center (DBTAC) Region IX
National Institute on Disability and Rehabilitation Research U.S. Department of Education
1995
Get information on your compliance obligations, problem-solving assistance, and referrals from ADA experts – without the high cost of a consultant. The 10 regional ADA & IT Technical Assistance Centers serve strictly as educational entities to help you understand your rights and responsibilities and have no enforcement or advocacy responsibilities. Federal Region IX, Pacific, serves: Arizona, California, Hawaii, Nevada, and the Pacific Basin.
Visit Pacific ADA Center
Visit DBTAC Homepage
Visit NIDRR
Community Based Adult Services (CBAS)
SPD Awareness Training
By clicking on these links, you may be leaving the IEHP website.
By making your facilities accessible you convey a sense of welcome for people with disabilities. Most of all, you comply with the requirements set by the Americans with Disabilities Act (ADA) of 1990. This is a civil rights law that prohibits discrimination against persons with disabilities on the basis of their disability in programs and services that receive federal financial assistance. Please see the resources below for more detailed information.
Office Accessibility- How to Make Your Medical Office More Accessible (PDF)
- Guidebook: How to Safely Transfer Patients with Disabilities to an Exam Table (PDF)
- Video #1: How to Safely Transfer Patients with Disabilities to an Exam Table
- Video #2: Using an Accessible Scale to Weigh Patients with Disabilities
- Accessibility Checklist (PDF)
- Primary and Specialty Care Practitioners - Front Office
- Primary and Specialty Care Practitioners - Medical Office Staff
- Disability Etiquette Guide (PDF)
My Path Palliative Care
My Path is IEHP’s palliative care program that provides Member and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. My Path addresses the Member’s needs, including physical, emotional and spiritual, while facilitating Member autonomy, access to information, and choice. The My Path program consists of: a palliative care assessment and consultation; advanced care planning; individualized written plan of care; pain and symptom management; mental health and medical social services; care coordination; and a palliative care team.
- My Path Program Brochure (PDF)
- My Path Program Guidelines (PDF)
- My Path Program FAQs (PDF)
- My Path - A Palliative Care Approach (PDF)
- Certification of Advanced Disease (PDF)
Services for Teen Patients
Help your teen patients get the services they need!
The online teen resource guide will help direct teens to community resources - from abuse and domestic violence counseling, to birth control and pregnancy testing, to job training and recreation.
By clicking on this link, you will be leaving the IEHP website.
Tobacco Cessation Services
By clicking on these links, you may be leaving the IEHP website.- Training: Comprehensive Tobacco Cessation Services for Medi-Cal Members (PDF)
- The Smoking Cessation Leadership Center's (SCLC) latest webinar recordings eligible for CME/CE credit. Register Here (PDF)
- Webinar Materials: New and Emerging Tobacco Products: An Ever-Changing Market. Download Here
- California Smoker's Helpline Free Recorded Webinar and 1.0 CE Credit, "How to Talk with Patients about Smoking Cessation and Anxiety". Start Here
- 5 Major Steps to Intervention - http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/5steps.html
- Tobacco Cessation CPT Codes for Identification
- ACA Facts Sheets and Resources (American Lung Association) - http://www.lung.org/our-initiatives/tobacco/cessation-and-prevention/aca-factsheets-and-resources.html
- Helpline:
- https://www.nobutts.org/ (also available in Spanish, Chinese, Korean and Vietnamese)
- http://www.nobutts.org/free-training
- http://www.nobutts-catalog.org/collections/health-care-provider-resources
- Continuing Medical Education California courses offered through UC Schools of Medicine - https://cmecalifornia.com/Education.aspx
- Centers for Disease Control Coverage for Tobacco Use Cessation Treatments - http://www.cdc.gov/tobacco/quit_smoking/cessation/coverage/pdfs/coverage_tobacco_508_new.pdf
- Patients Not Ready to Make a Quit Attempt Now (The “5 R’s”) - http://www.ahrq.gov/sites/default/files/wysiwyg/professionals/clinicians-providers/guidelines-recommendations/tobacco/5rs.pdf
- Smokefree.gov - http://smokefree.gov/health-care-professionals
- University of California San Francisco’s Smoking Cessation Leadership Center’s tools and resources - http://smokingcessationleadership.ucsf.edu/resources
- USPSTF-Tobacco Smoking Cessation in Adults, Including Pregnant Women: Behavioral and Pharmacotherapy Interventions - https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions1
- USPSTF-Tobacco Use in Children and Adolescents: Primary Care Interventions - https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/tobacco-use-in-children-and-adolescents-primary-care-interventions?ds=1&s=adolescentsandsmoking
Total Fracture Care Program
The Total Fracture Care Program allows IEHP Members to be seen by a participating Orthopedist for global fracture care without a prior authorization. This Program ensures that Members in need of fracture care by an Orthopedist, as determined by an Emergency Department Physician, Urgent Care Physician or Primary Care Provider, will receive timely access to care.
Correspondence
- Total Fracture Referral Protocols (PDF) - May 4, 2015
Total Fracture Care Providers
- Arrowhead Orthopaedics
- For more information and locations, please visit:https://www.arrowheadortho.com/
- Orthopaedic Medical Group of Riverside Inc.
- For more information and location, please visit:https://omgnet.com/
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.