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Testimonials - Scott Gary

ct training to work at IEHP? “It’s all about the mission,” said Scott Gary, a lead instructional designer in Learning & Development who served 10 years in the Army. “That’s what’s most important. That’s what motivates you.” A shared IEHP mission enables Team Members to focus on a common goal and work toward achieving it together. It also emphasizes collaboration rather than competition – unlike other corporate workplaces. Scott says that spirit of collaboration also fosters true employee engagement. It’s one of the main reasons why he enjoys works at IEHP. “The culture here is really unique,” Scott said. “The emphasis on a work-life balance shows that our leaders care about our well-being and that makes you feel good about what you do here. You feel valued.” High engagement is an important driver of quality as well, he added.  If a quality issue or concern is raised, the immediate question that comes after that is, “How can we do better?” He credits that responsiveness and dedication to a supportive and engaged team culture. “In my work with other departments, I see firsthand how committed Team Members are to improving quality and to their best,” Gary said. “It’s because they care.”

Healthy Living - Smoking Cessation

right medicine to help you quit, and stress management. Below are resources that will assist you in quitting smoking.  By clicking on the links below you will be leaving the IEHP website. Community Resources Kick it California Ready to take the next steps to quit smoking, chewing, or vaping now? The CA Smokers’ Helpline has all you need to reach your goal! They have many free services such as phone counseling, texting, and referrals to other local programs. They can also give step-by-step help on making a quit plan, tips on dealing with triggers, and support to help you stay quit. Call 1-800-300-8086 and give promo code 84 to get started! Or visit their website at https://kickitca.org/ Arrowhead Regional Medical Center 400 N. Pepper Avenue, Colton Click here to visit their website.  909-580-6167 Kaiser Permanente 2055 Kellogg Avenue, Corona Click here to visit their website.  (866) 883-0119 (No cost for Kaiser Members only) Rim Family Services 28545 Highway 18, Skyforest Click here to visit their website.  (909) 336-1800 Beaver Medical Group 1150 Brookside Avenue, Redlands Click here to visit their website. (909) 335-4131 Kaiser Permanente 17296 Slover Avenue, Fontana Click here to visit their website.  (909) 609-3000 (No cost for Kaiser Members only) Loma Linda University Health - Center for Health Promotion 24785 Stewart Street, Loma Linda Click here to visit their website. (909) 558-4594 Websites By clicking on the links below you will be leaving the IEHP website. American Heart Association  A step-by-step guide to smoke-free living, knowing the benefits, making a plan, dealing with urges, and staying quit.  Center for Disease Control and Prevention (CDC) Featuring all you need to set up a quit plan, this site also links you to social media for ongoing support through the quitting process. Plus, you’ll be able to view videos of past smokers, hear their stories and learn through their experiences.  Smokefree.gov Support and tools to help you or someone you love to quit. You can also opt for versions geared to veterans, women, seniors, and teens.  Mobile Apps iOs Apps Smoke Free QuitNow! Quit Guide Kwit no butts No Vape Android Apps Quit Now Quit Guide Kwit no butts No Vape Interactive Tool Stop Smoking You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. Click here to download a free copy by clicking Adobe Acrobat Reader.   

Leadership Team - Michelle Rai, MS

2020. She oversees IEHP’s communications and marketing programs and guides the development of long-term communication and marketing strategies. In addition, Ms. Rai oversees the strategic execution of IEHP’s community relations, media relations, internal communications, digital and social media. Ms. Rai has over 20 years of experience in public relations, communications, marketing, and media relations. Prior to joining IEHP, Ms. Rai served as Chair of the Communication Department at Pacific Union College in Napa Valley, Calif. Before her role as Chair, Ms. Rai acted as the College’s Public Relations Director and Public Information Officer. Ms. Rai holds a master’s degree in integrated marketing communications from Golden Gate University. She earned bachelor’s degrees in journalism and communications from Pacific Union College, where she received the prestigious Educator of the Year award in 2016. Ms. Rai’s leadership enables IEHP to increase its brand reach and social media presence, while enhancing perception of the organization and strengthening its place as an industry thought leader.

Speakers Bureau - Tiffany Thompson

ng During Crisis Media Relations Strategy   Telehealth Interoperability   Finding your Corporate Voice   Community Health   Women's Health   Data Exchange   Testing starts here... Request a Speaker

Special Programs - Independent Living and Diversity Resources

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: Information on the Americans with Disabilities Act (ADA) 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). Read the Full Article: HTM PDF 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, 2006 Get the facts on common ADA misconceptions. ADA Myths & Facts  PDF Text 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 PDF Text  Download the Attorney General's information packet: Website 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 Standards - PDF Standards - HTM Download Special Application 6 (Health Care Facilities) Access to Medical Care for Individuals with Mobility Disabilities (PDF) Access to Medical Care for Individuals with Mobility Disabilities (HTM) 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 Checklist - PDF Checklist - HTM ADA Regulations for Health Care Providers Nondiscrimination on the Basis of Disability U.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).  DOJ article - PDF DOJ article - HTM 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. See the Full DOJ Article Practical Guidance for ADA Compliance Title III Technical Assistance Manual  U.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  Read the full Manual Read the Supplement 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.   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. Policies, Practices, and Procedures Communicating with Customers Who Have Disabilities New Buildings, Additions, and Remodeling Removing Barriers in Buildings That Are Not Being Remodeled Providing Access When Removing Barriers Is Not Readily Achievable Maintaining Accessibility Transporting Customers ADA Compliance Costs and Tax Incentives Enforcement of the ADA 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) Reminder: Community-Based Adult Center (PDF) 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) Community Resources Community Resources Guide (PDF) Disability Competency and Sensitive Training Disability Etiquette Guide (PDF) You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

Coronavirus (COVID-19) Announcements

of Phase 1A of its vaccination roadmap, vaccines will be distributed to caregivers with In-Home Support Services (IHSS), intermediate care centers, and public and community health centers, including facilities for mental health. Click here to learn more. 1/12/21: San Bernardino County introduces a coronavirus quarantine and isolation calculator. This tool allows people to determine how long they should self-isolate after testing positive for COVID-19, being sick with COVID-19, or being exposed to someone with COVID-19. Click here for more info. 12/7/20: The governor announced a stay at home order for Southern California regions, including Riverside and San Bernardino County, for a minimum of three weeks. This order is in response to a rapid growth in COVID-19 cases and a substantial increase in hospitalizations and ICU admissions. Click here to learn more.  9/11/20: To continue to help slow the spread of COVID-19, Riverside County is urging residents to get tested. In addition, increased testing will help the county move into the next level of the state’s reopening plan. For testing locations, visit gettested.ruhealth.org.   8/21/20: Health officials urge Riverside County residents to get tested for COVID-19, whether or not they are experiencing symptoms. For testing locations, visit gettested.ruhealth.org.  8/21/20: To stop the spread of COVID-19, San Bernardino County Public Health Director urges all residents to get tested. Watch this video to learn more.  7/24/20: Fraud reports have increased due to uncertainty surrounding COVID-19, leaving many San Bernardino residents unsure how to avoid scams or report them to authorities. Scams include fake at-home COVID-19 testing kits or vaccinations, IRS impersonators, illegal robocalls and fake charities. For more information visit the San Bernardino County Public Website. 6/29/20: San Bernardino County is encouraging all residents, including those who have not experienced symptoms of COVID-19, to be testing for the Coronavirus. Click here for testing locations.  6/19/20: Governor Newsom requires California residents to wear face coverings while in public. Click here to learn more. For information on how to wear a proper face covering, watch this short video. 6/12/20: A COVID-19 testing site returns to Blythe. Testing started on June 10th and will continue for two weeks. In addition, a testing site opens at the Edgemont Women’s Club in Moreno Valley and will operate June 17 through June 19th. Click here for more information.  5/29/20: Cooling Centers open throughout Riverside County, offering residents an escape from extreme heat and are open to the public at no cost. The centers will be available through October. Click here for more information.  5/29/20: New COVID-19 testing sites open in San Bernardino County. They are scheduled to run through June with appointment registrations opening weekly. For a complete list of testing locations click here: Click here for a complete list of testing locations.  5/27/20: A drive up COVID-19 testing site will be opened at the old Sears parking lot in Riverside, replacing the testing location at Harvest Christian Fellowship that is closing. Click here for a complete list of testing.   5/22/20: Riverside County added three new COVID-19 testing sites in Corona, San Jacinto and Temecula. Click here for a complete list of testing locations.  4/30/20: Riverside County’s Public Health Officer is extending his order requiring residents to wear face coverings when outside and to continue practicing social distancing through June 19. Residents are still required to remain in their primary residence under Governor Newsom’s existing “stay at home” order unless they are engaged in an essential business or activity, such as grocery shopping or visiting the doctor.  Click here for more information. 4/28/20: San Bernardino County opens up criteria for COVID-19 testing. Beginning April 30th, residents 65 and older, healthcare workers, emergency responders, and law enforcement can get tested without displaying symptoms of COVID-19. For testing information, visit the San Bernardino County website.  4/24/20: In response to an increasing number of requests for resources, Riverside County released an online map to connect residents to local food resources. Resources include senior meal sites, school district meal sites and food pantries. Click here to find food resources.  4/20/20: Testing for COVID-19 has been expanded to all Riverside County residents, including those who do not have any COVID-19 symptoms.  In addition, a fifth COVID-19 testing site will be established at the Blythe Fairgrounds on April 22nd. All residents interested in testing must call 800-945-6171 for an appointment. Click here for more information. 4/13/20: A fourth drive-up COVID-19 testing site opens in Riverside County on Tuesday, April 14th. The site has been established at the Perris Fairgrounds, located at 18700 Lake Perris Drive. Perris, California. Residents who want to get tested must have symptoms to make an appointment, symptoms include fever, cough, sore throat, runny nose or cough. Residents must call 800-945-6171 to make an appointment. For more information on testing locations, visit the Riverside County Public Health website.  4/13/20: San Bernardino County Public Health will conduct a community drive-through event for COVID-19 testing in Montclair on Tuesday, April 14. This event is open to San Bernardino County residents by appointment only. Residents can make an appointment online at http://wp.sbcounty.gov/dph/coronavirus/ at 2 p.m. on Monday, April 13 or by calling (909) 387-3911. Additional community drive-through events are scheduled throughout this month in Yucaipa, Big Bear Lake, Joshua Tree, and Rancho Cucamonga, California. For more information visit the San Bernardino County website.  4/8/20: Arrowhead Regional Medical Center will begin a COVID-19 drive-thru testing site on Thursday, April 9th. Appointments are required. To make an appointment call 855-422-8029. For more information visit Arrowhead Regional Medical Center.   4/7/20: CalWORKs and CalFresh renewals and SAR 7 status reports do not need to be submitted for March, April or May. This does not apply to Transitional CalFresh or Transitional Nutrition benefits. To access your benefits, visit: c4youself.com or call 877-410-8829 (San Bernardino County) 877-410-8827 (Riverside County).  4/7/20: The San Bernardino County’s Acting Health Officer ordered everyone in San Bernardino County to wear face coverings when leaving home and interacting with other people. Face coverings may include homemade cloth ear loop covers, bandannas and handkerchiefs, and neck gaiters. Also, orders all religious services to be done electronically, including upcoming Easter celebrations.Click here for more information. 4/4/20: The Riverside County Public Health Officer orders the public to stay home and cover their face when leaving and interacting with other people, including essential workers. Face coverings can be bandanas, scarves, neck gaiters or other clothing that does not have visible holes. Click here to learn more. 4/4/20: The Small Business Association (SBA) is offering forgivable loans that help businesses keep their workforce employed during the Coronavirus (COVID-19) crisis. The Paycheck Protection Program is a loan designed to provide a direct incentive for small businesses to keep their workers on the payroll. The loan application period opens on Friday, April 3, 2020. For more information visit the SBA website.   3/31/20: San Bernardino County will conduct a drive-thru sample collection event for COVID-19 in the High Desert on April 2nd. This event is open to San Bernardino County residents only. Residents can request an appointment online at sbcovid19.com or by calling (909) 387-3911. For more information on this event visit: http://www.sbcounty.gov/main/default.aspx 3/30/20 – A third drive-up COVID-19 testing site opens in Riverside County on April 1st. The site has been established at Harvest Christian Fellowship church in Riverside.  Residents must have symptoms to make an appointment, which include fever, cough, sore throat, runny nose or cough.  Residents must call 800-945-6171 to make an appointment. For more information on testing locations, visit the Riverside County Public Health website. 3/30/20 – A COVID-19 testing site in Indian Wells will be relocated to the Riverside County Fairgrounds in Indio. The first day of testing at the fairgrounds is Tuesday (March 31). Residents must have symptoms to make an appointment, which include fever, cough, sore throat, runny nose or cough. Appointments must be scheduled by calling 800-945-6171. For more information on testing locations, visit the Riverside County Public Health website. 3/27/20: San Bernardino County Public Health will conduct a drive-thru specimen collection for COVID-19 on Friday, March 27. The specimen collection for COVID-19 testing will be available for the public by appointment only. Appointment sign-up and details will be available on the county website. 3/25/20: COVID-19 testing for IEHP Members is now available at SAC Health Systems in San Bernardino. IEHP Members must call (909) 771-2911 to schedule a telephone appointment with a Doctor. The Doctor will evaluate the Member and determine if they need COVID-19 testing and will provide details on how to obtain testing. 3/20/2020: Gov Gavin Newsom announces a California statewide order for residents to “stay at home,” excluding essential entities which include grocery stores, take-out and delivery and health care organizations. IEHP is an essential entity and will continue operations to support our Members and Providers through telephonic contact only. OUR BUILDINGS ARE CLOSED TO NON-EMPLOYEES. We highly encourage you (our Members and Providers) to call us if you need any services or have any questions. Continue to visit our website for frequent updates and news from Gov Gavin Newsom. 3/19/2020: IEHP Chief Medical Officer, Dr. Hansberger, has an important message for our Members in the Coachella Valley region about the COVID-19 situation and ways for them to protect their health. Click here.  3/18/2020: To help our IEHP Members stay home and avoid public places, we encourage Members to use mail order delivery service for both new and refill prescriptions. By using this service, Members can get medicines mailed to their home at no cost by using standard shipping. 3/13/2020: We are requesting when you (including Members, Providers, Community Partners, Vendors, and all Visitors) need IEHP services, please call IEHP or your IEHP contact directly to get the help you need. If you must visit IEHP in person, please ensure that you do not have a fever, cough or breathing problem. 3/13/2020: All classes and events at IEHP’s Community Resource Centers are canceled until further notice for the protection and safety of our community during the Coronavirus (COVID-19) situation. We apologize for any inconvenience and expect to resume classes as soon as possible.

COVID-19 - Resources

19. Below you will find resources and information on how to protect yourself and your loved ones during this time.  How vaccines build immunity While the COVID-19 vaccines are relatively new - the technology and science behind the vaccines have been in development for decades. In the video below, we demonstrate how years of vaccine research and advanced technology allowed researchers and scientists worldwide to be prepared to develop an mRNA vaccine that could help fight the spread of a global infectious disease. COVID-19: Home isolation tips If you or someone in your household has been diagnosed with COVID-19, there are necessary steps you can take to reduce the risk of it spreading to those you live with. COVID-19: What to do when you're sick IEHP Chief Medical Officer, Dr. Karen Hansberger, is here to discuss what you need to do if you find yourself sick from COVID-19. Face Mask Resources Proper use of face coverings (CDC)  How to make a homemade mask How to make your own face mask (whether or not you know how to sew) Refer to the following resources for information on self isolation during COVID-19.  Riverside County COVID-19 Self Isolation Recommendations  For IEHP DualChoice Members A healthcare fraud alert has been issued in relation to COVID-19 complaints. Scammers are giving COVID-19 tests to Medicare Members in trade for personal details. They are reaching out to Medicare Members by sales calls, social media platforms, and door to door visits. The personal details taken may be used to falsely bill Federal health care programs and the COVID-19 test kits may cause harm to Members. If you suspect COVID-19 fraud, call IEHP right away at: Compliance Hotline: (866) 355-9038 Fax: (909) 477-8536 E-mail: compliance@iehp.org Mail: IEHP Compliance Officer P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 Click here to report a compliance issue online. Refer to the following websites/resources for more information on coronavirus (COVID-19). Centers for Disease Control and Prevention (CDC) Riverside County Public Health  San Bernardino Public Health   State of California Coronavirus (COVID-19) Updates CA COVID-19 Rent Relief Portal California Workplace Rights Immigrant Eligibility for Public Programs during COVID-19  Protections for Housing and Utility Shutoff Order ConnectIE Below you will find resources and information on local food pantries in your area.  Riverside County Pantries: A list of food pantries in Riverside County San Bernardino County Pantries: A list of food pantries in San Bernardino County Connect IE: A free website that provides community resources 24/7. It can connect you to housing services, job training's, food pantries and more.  High Desert Food Distribution:The High Desert is hosting a food distribution on the last Thursday of every month.

Healthcare Scholarship Fund - Our Scholars

group of students from the Inland Empire. More than 30 recipient students grew up in the Inland Empire and more than 50% are first generation medical students and grew up in low-income households. Through the scholarship fund, aspiring healthcare professionals will be guided through the system and connected to the health plan’s provider network. This allows students to pursue successful careers in healthcare immediately after graduation to help support the region’s growing population. Loma Linda University School of Medicine Inland Empire Medical Community Service Awardees Class of 2022 Ye Jin Jeon Ye Jin's Why: “I applied for the Inland Empire Medical Community Service Award because the goal and priority to expand access to care and healthcare provider options for the Southern California region aligns with my calling. As a child growing up in the San Bernardino County, I saw the economic disproportion within my own neighborhood, and this compelled me…God has led me pursue my medical career” Class of 2024 Edwin Choque Edwin's Why: “Simply put, my heart lies in the Inland Empire. This community of individuals have fostered me and loved me since I was a child and all I can hope is to pay that love and care forward. . . . My dream is to be on the front lines as a representative for these individuals who frequently become marginalized…” University of California, Riverside Dean's Mission Recipients Four Year Award Elizabeth Celaya-Ojeda Elizabeth's Why: “I want to work particularly with the underserved in this area because I truly believe that being a physician is a privilege and with that there is a responsibility to be an advocate for those who are facing health disparities. I am particularly interested in providing care to underserved Native American and Hispanic communities. Not many healthcare providers are aware of the disparities these two communities face and I want to be an advocate for them, especially in the Inland Empire.” Alfonso Parocua Alfonso's Why: “Growing up, my family lacked meaningful access to healthcare and relied on a local free clinic as our only means of interacting with a physician. Through my personal experience with the free clinic, I developed a passion for service to the underserved communities who lack meaningful access to basic healthcare amenities due to low socioeconomic status. I sought opportunities that would allow me to pay my gratitude forward by becoming part of the solution to healthcare disparities in Inland Southern California. Through my volunteer efforts in free clinics and other community involvement programs, I witnessed the passion and dedication that health care providers and volunteers in the area have towards the underserved community. This realization deepened my connection to Inland Southern California because I was reminded so much of the health care professionals that helped my family when they couldn't help themselves.” Two Year Award Cesar Fortuna Cesar's Why: “A San Bernardino native, I have had the opportunity to volunteer in my community as a Spanish language translator for free clinics. Most patients I have spoken with fell into the category of uninsured, underinsured, or undocumented. It became clear the extent of need in this region when I would translate to the providers that this was the first-time dozens of our patients had ever seen a medical professional; however, this wasn’t uncommon. To these patients and their stories, I thank them because they inspire me to pursue Emergency Medicine where I can become a valuable player in providing care, providing resources, or providing comfort.” Lavinia Mitroi Lavinia's Why: “My goal of pursuing a career at the intersection of medicine and public health is driven by a desire to put patients and communities at the center of our health care system in the U.S. This desire was sparked most poignantly by my own experiences as an IEHP patient growing up in the Inland Empire. As I prepare for a future career as a pediatrician in this region, I hope to serve as an advocate for children and families, providing direct health services but also creating systems change.” Armando Navarro Armando's Why: “The earliest memory of my grandfather is him telling me, “Mijo, tienes que aprender Español para ayudar tu comunidad, you have to learn how to speak Spanish to help your community”. These words were often repeated to me by my grandfather who lamented the fact that he only spoke Spanish. I witnessed the health disparities affecting my community; doctors who did not speak Spanish, parents who could not afford a trip to the doctors’ office, and a healthcare system that was not inclusive of my community’s culture. I have a duty to give back to a school, a community, that has given me so much.” Christ Ordookhanian Christ's Why: “I see the medical profession through the lens of an individual who had lived through challenging times and witnessed how one individual provider can make such and impact when their heart is in the right place. My dedication to our underserved community stems from that of a lifelong mission I have set for myself which is to ensure I give back to a community that I am deeply associated with, they are my founding roots in the United States, and I vow to be at the forefront of the next generation of physicians that care and give the underserved hope.” University of California, Riverside Dean's Mission Recipients Daphne Du Daphne's Why: “I spent most of my life in underprivileged areas and saw firsthand how difficult healthcare access could be through inadequate financial resources, transportation, or translation services. Thanks to this investment in my studies, there is less stress in my life. I can focus on my studies and eventually give back to the community by becoming a physician who will advocate for patients without meaningful access to health care.” Judith Gonzales Judith's Why: “As a first-generation college student, there have always been many barriers in my path to higher education. I am the eldest daughter of an immigrant family, and it is truly an honor to be able to reach this point in my education and in my career, and to give back to my parents who have sacrificed so much for me and my sisters. Growing up in an underserved community showed me the long-lasting impacts of health inequities and strengthened my resolve to pursue a career in medicine. Working in the Inland Empire, I hope to not only address, but actively work towards combating the health inequity present in our communities.” Jordan Hough Jordan's Why: “Despite disadvantages encountered when living in a low-income community, I am grateful for the privilege I had in meeting physicians dedicated to their practice and willing to share that love through mentorship. These individuals have served as exemplary medical professionals and have encouraged me to follow in their footsteps. As a future physician, I aspire to empathetically care for patients by allowing my past experiences to enhance my understanding of their needs. I also plan to incorporate teaching into patient care by presenting opportunities for students to shadow and be mentored for a career in medicine.” Diana Martinez Diana's Why: “I am the daughter of Mexican Immigrants and grew up in Compton, California where I unfortunately was quickly desensitized to violence and was able to tell the difference between a firework and a gun shot. My mother had to travel a significant distance to ensure we had adequate healthcare. Despite these conditions, my parents always stressed education and did their best to give me what I needed. These life circumstances ignited my passion to serve those in disadvantaged communities, which I interacted with throughout my educational career. The Inland Empire Health Program Scholarship means I can achieve my dream –by practicing medicine in a community that deserves adequate, equitable, and accessible healthcare. I will serve as a bilingual physician in the Inland Empire that can serve families like my own and many more.”

Healthcare Scholarship Fund - About the Healthcare Scholarship Fund

p Fund is the health plan’s partnership with local academic institutions to help remove the barrier of debt for medical students and develop a growing workforce for healthcare professionals to care for the Inland Empire’s growing Medi-Cal population. Why is the Healthcare Scholarship Fund needed? According to the California Healthcare Foundation, the Inland Empire has one of the lowest ratios of Primary Care Physicians (PCPs) and specialty physicians per 100,000 people in California. In addition, the Inland Empire lacks adequate Specialty and Behavioral Health practitioner capacity to serve the current growing population. With the average cost of a four-year medical degree standing firm at $276,800, pursuing a career in the medical field is out of reach for more and more each year. The HSF will aid students by helping to remove the financial burden of medical school that often restricts the choices of many aspiring healthcare professionals and allow recipients to immediately pursue careers in healthcare. I am a student and am interested in becoming a Doctor, what should I do? Students interested in the IEHP Healthcare Scholarship Fund are encouraged to contact the academic institutions below for more information on how apply. While each institution may have differing eligibility requirements, all Healthcare Scholarship Fund scholarships require students commit to practicing in the Inland Empire for 5 years after graduation. Participating schools and programs include: Loma Linda University Medical School University of California Riverside California University of Science and Medicine

Medi-Cal Behavioral Health Treatment

ed benefit solely for Members Diagnosed with Autism Spectrum Disorder. The coverage criteria have been expanded to include IEHP Members who meet ALL the below: Under 21 years of age Have a recommendation from a licensed physician and surgeon or a licensed psychologist that evidence based BHT services are medically necessary. Be medically stable Not need 24-hour medical/nursing monitoring or procedures provided in a hospital or intermediate care facility for persons with intellectual disabilities. Behavioral Health Treatment (BHT) is the design, implementation and evaluation of environmental modifications, using behavioral stimuli and consequences, to produce socially significant improvement in human behavior, including the direct observation, measurement and functional analysis of the relations between environment and behavior. BHT services teach skills using behavioral observation and reinforcement, or through prompting to teach each step of targeted behavior. BHT services are based on reliable evidence and are not experimental. Treatment may or may not include Applied Behavioral Analysis (ABA). BHT is medically necessary after the Provider has completed a comprehensive developmental surveillance and screening, and have recommended BHT services is clinically warranted to treat persistent developmentally inappropriate behavior and/or diagnoses that may be able to be corrected or ameliorated with BHT services. Aberrant behaviors include but are not limited to self-injury, aggression, and deficits in language skills, daily living skills, and social skills. PCPs will continue to referral a Member directly to IEHP Behavioral Health for any BHT services and/or diagnostic needs regardless of IPA. If you have any questions or ask your PCP for screening, diagnosis and treatment, you can call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347. Cost to Member There is no cost to the Member for these services. Visit IEHP's Mental Health page for general mental health information.   

IEHP DualChoice - Problems with Part C

ng appeals with problems related to your benefits and coverage. It also includes problems with payment. You are not responsible for Medicare costs except for Part D copays. How to ask for coverage decision coverage decision to get medical, behavioral health, or certain long-term services and supports (MSSP, CBAS, or NF services)  To ask for a coverage decision, call, write, or fax us, or ask your representative or doctor to ask us for an coverage decision.  You can call us at: (877) 273-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays, TTY (800) 718-4347.  You can fax us at: (909) 890-5877  You can to write us at: IEHP DualChoice P.O. Box 1800 Rancho Cucamonga, CA 91729-1800. How long does it take to get a coverage decision coverage decision for Part C services? It usually takes up to 14 calendar days after you asked. If we don’t give you our decision within 14 calendar days, you can appeal. Sometimes we need more time, and we will send you a letter telling you that we need to take up to 14 calendar more days. The letter will explain why more time is needed. Can I get a coverage decision faster for Part C services? Yes. If you need a response faster because of your health, you should ask us to make a “fast coverage decision.”  If we approve the request, we will notify you of our coverage decision coverage decision within 72 hours. However, sometimes we need more time, and we will send you a letter telling you that we need to take up to 14 more calendar days. Asking for a fast coverage decision coverage decision: If you request a fast coverage decision coverage decision, start by calling or faxing our plan to ask us to cover the care you want.  You can call IEHP DualChoice at (877) 273-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY users should call (800) 718-4347 or fax us at (909) 890-5877. You can also have your doctor or your representative call us. Here are the rules for asking for a fast coverage decision coverage decision:  You must meet the following two requirements to get a fast coverage decision coverage decision:  You can get a fast coverage decision coverage decision only if you are asking for coverage for care or an item you have not yet received. (You cannot get a fast coverage decision coverage decision if your request is about payment for care or an item you have already received.) You can get a fast coverage decision only if the standard 14 calendar day deadline could cause serious harm to your health or hurt your ability to function.  If your doctor says that you need a fast coverage decision, we will automatically give you one. If you ask for a fast coverage decision, without your doctor’s support, we will decide if you get a fast coverage decision.  If we decide that your health does not meet the requirements for a fast coverage decision, we will send you a letter. We will also use the standard 14 calendar day deadline instead. This letter will tell you that if your doctor asks for the fast coverage decision, we will automatically give a fast coverage decision. The letter will also tell how you can file a “fast appeal” about our decision to give you a fast coverage decision instead of the fast coverage decision you requested. If the coverage decision is Yes, when will I get the service or item? You will be able to get the service or item within 14 calendar days (for a standard coverage decision) or 72 hours (for a fast coverage decision) of when you asked. If we extended the time needed to make our coverage decision, we will provide the coverage by the end of that extended period. If the coverage decision is No, how will I find out?  If the answer is No, we will send you a letter telling you our reasons for saying No. If we say no, you have the right to ask us to change this decision by making an appeal. Making an appeal means asking us to review our decision to deny coverage. If you decide to make an appeal, it means you are going on to Level 1 of the appeals process. Appeals What is an Appeal? An appeal is a formal way of asking us to review our decision and change it if you think we made a mistake. For example, we might decide that a service, item, or drug that you want is not covered or is no longer covered by Medicare or Medi-Cal. If you or your doctor disagree with our decision, you can appeal. In most cases, you must start your appeal at Level 1. If you do not want to first appeal to the plan for a Medi-Cal service, in special cases you can ask for an Independent Medical Review. If you need help during the appeals process, you can call the Cal MediConnect Ombuds Program at (855) 501-3077. The Cal MediConnect Ombuds Program is not connected with us or with any insurance company or health plan. What is a Level 1 Appeal for Part C services? A Level 1 Appeal is the first appeal to our plan. We will review our coverage decision to see if it is correct. The reviewer will be someone who did not make the original coverage decision. When we complete the review, we will give you our decision in writing. If we tell you after our review that the service or item is not covered, your case can go to a Level 2 Appeal.  Can someone else make the appeal for me for Part C services? Yes. Your doctor or other provider can make the appeal for you. Also, someone besides your doctor or other provider can make the appeal for you, but first you must complete an Appointment of Representative Form. The form gives the other person permission to act for you. If the appeal comes from someone besides you or your doctor or other provider, we must receive the completed Appointment of Representative form before we can review the appeal. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. Click here to download a free copy by clicking Adobe Acrobat Reader. How do I make a Level 1 Appeal for Part C services? To start your appeal, you, your doctor or other provider, or your representative must contact us. You can call IEHP DualChoice Member Services at (877) 273-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY should call (800) 718-4347. For additional details on how to reach us for appeals, see Chapter 9 of the IEHP DualChoice Member Handbook. You can ask us for a “standard appeal” or a “fast appeal.” If you are asking for a standard appeal or fast appeal, make your appeal in writing: IEHP DualChoice P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 Fax: (909) 890-5748 You may also ask for an appeal by calling IEHP DualChoice Member Services at (877) 273-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY should call (800) 718-4347. We will send you a letter within 5 calendar days of receiving your appeal letting you know that we received it. How much time do I have to make an appeal for Part C services? You must ask for an appeal within 60 calendar days from the date on the letter we sent to tell you our decision. If you miss this deadline and have a good reason for missing it, we may give you more time to make your appeal. Examples of a good reason are: you had a serious illness, or we gave you the wrong information about the deadline for requesting an appeal. Can I get a copy of my case file? Yes. Ask us for a copy by calling Member Services at (877) 273-IEHP (4347). TTY (800) 718-4347. Can my doctor give you more information about my appeal for Part C services? Yes, you and your doctor may give us more information to support your appeal. How will the plan make the appeal decision?  We take a careful look at all of the information about your request for coverage of medical care. Then, we check to see if we were following all the rules when we said No to your request. The reviewer will be someone who did not make the original decision. If we need more information, we may ask you or your doctor for it.  When will I hear about a “standard” appeal decision for Part C services? We must give you our answer within 30 calendar days after we get your appeal. We will give you our decision sooner if your health condition requires us to. However, if you ask for more time, or if we need to gather more information, we can take up to 14 more calendar days. If we decide to take extra days to make the decision, we will tell you by letter. If you believe we should not take extra days, you can file a “fast complaint” about our decision to take extra days. When you file a fast complaint, we will give you an answer to your appeal within 24 hours. If we do not give you an answer within 30 calendar days or by the end of the extra days (if we took them), we will automatically send your case to Level 2 of the appeals process if your problem is about a Medicare service or item. You will be notified when this happens. If your problem is about a Medi-Cal service or item, you will need to file a Level 2 Appeal yourself. Please see below for more information.  If our answer is Yes to part or all of what you asked for, we must approve or give the coverage within 30 calendar days after we get your appeal. If our answer is No to part or all of what you asked for, we will send you a letter. If your problem is about a Medicare service or item, the letter will tell you that we sent your case to the Independent Review Entity for a Level 2 Appeal. If your problem is about a Medi-Cal service or item, the letter will tell you how to file a Level 2 Appeal yourself. Please see below for more information. What happens if I ask for a fast appeal? If you ask for a fast appeal, we will give you your answer within 72 hours after we get your appeal. We will give you our answer sooner if your health requires us to do so. However, if you ask for more time, or if we need to gather more information, we can take up to 14 more calendar days. If we decide to take extra days to make the decision, we will tell you by letter. If you believe we should not take extra days, you can file a “fast complaint” about our decision to take extra days. When you file a fast complaint, we will give you an answer to your appeal within 24 hours. If we do not give you an answer within 72 hours or by the end of the extra days (if we took them), we will automatically send your case to Level 2 of the appeals process if your problem is about a Medicare service or item. You will be notified when this happens. If your problem is about a Medi-Cal service or item, you will need to file a Level 2 Appeal yourself. Please see below for more information. If our answer is Yes to part or all of what you asked for, we must authorize or provide the coverage within 72 hours after we get your appeal.  If our answer is No to part or all of what you asked for, we will send you a letter. If your problem is about a Medicare service or item, the letter will tell you that we sent your case to the Independent Review Entity for a Level 2 Appeal. If your problem is about a Medi-Cal service or item, the letter will tell you how to file a Level 2 Appeal yourself. Please see below for more information. Will my benefits continue during Level 1 appeals? If we decide to change or stop coverage for a service or item that was previously approved, we will send you a notice before taking the action. If you disagree with the action, you can file a Level 1 Appeal and ask that we continue your benefits for the service or item. You must make the request on or before the later of the following in order to continue your benefits: Within 10 days of the mailing date of our notice of action; or The intended effective date of the action. If you meet this deadline, you can keep getting the disputed service or item while your appeal is processing. Level 2 Appeal If the plan says No at Level 1, what happens next? If we say no to part or all of your Level 1 Appeal, we will send you a letter. This letter will tell you if the service or item is usually covered by Medicare or Medi-Cal. If your problem is about a Medicare service or item, we will automatically send your case to Level 2 of the appeals process as soon as the Level 1 Appeal is complete. If your problem is about a Medi-Cal service or item, you can file a Level 2 Appeal yourself. The letter will tell you how to do this. Information is also below. What is a Level 2 Appeal? A Level 2 Appeal is the second appeal, which is done by an independent organization that is not connected to the plan.   My problem is about a Medi-Cal service or item. How can I make a Level 2 Appeal? There are two ways to make a Level 2 appeal for Medi-Cal services and items: 1) Independent Medical Review or 2) State Hearing. 1)    Independent Medical Review You can ask for an Independent Medical Review (IMR) from the Help Center at the California Department of Managed Health Care (DMHC). An IMR is available for any Medi-Cal covered service or item that is medical in nature. An IMR is a review of your case by doctors who are not part of our plan. If the IMR is decided in your favor, we must give you the service or item you requested. You pay no costs for an IMR. You can apply for an IMR if our plan: Denies, changes, or delays a Medi-Cal service or treatment (not including IHSS) because our plan determines it is not medically necessary. Will not cover an experimental or investigational Medi-Cal treatment for a serious medical condition. Will not pay for emergency or urgent Medi-Cal services that you already received. Has not resolved your Level 1 Appeal on a Medi-Cal service within 30 calendar days for a standard appeal or 72 hours for a fast appeal. You can ask for an IMR if you have also asked for a State Hearing, but not if you have already had a State Hearing, on the same issue. In most cases, you must file an appeal with us before requesting an IMR. If you disagree with our decision, you can ask the DMHC Help Center for an IMR. If your treatment was denied because it was experimental or investigational, you do not have to take part in our appeal process before you apply for an IMR. If your problem is urgent and involves an immediate and serious threat to your health, you may bring it immediately to the DMHC’s attention. The DMHC may waive the requirement that you first follow our appeal process in extraordinary and compelling cases. You must apply for an IMR within 6 months after we send you a written decision about your appeal. The DMHC may accept your application after 6 months if it determines that circumstances kept you from submitting your application in time. To ask for an IMR: Fill out the Independent Medical Review/Complaint Form available at: http://www.dmhc.ca.gov/FileaComplaint/SubmitanIndependentMedicalReviewComplaintForm.aspx or call the DMHC Help Center at (888) 466-2219. TDD users should call (877) 688-9891. If you have them, attach copies of letters or other documents about the service or item that we denied. This can speed up the IMR process. Send copies of documents, not originals. The Help Center cannot return any documents. Fill out the Authorized Assistant Form if someone is helping you with your IMR. You can get the form at http://www.dmhc.ca.gov/FileaComplaint/SubmitanIndependentMedicalReviewComplaintForm.aspx Or call the DMHC Help Center at (888) 466-2219. TDD users should call (877) 688-9891. Mail or fax your forms and any attachments to:  Help Center Department of Managed Health Care 980 Ninth Street, Suite 500 Sacramento, CA 95814-2725 FAX: 916-255-5241 If you qualify for an IMR, the DMHC will review your case and send you a letter within 7 calendar days telling you that you qualify for an IMR. After your application and supporting documents are received from your plan, the IMR decision will be made within 30 calendar days. You should receive the IMR decision within 45 calendar days of the submission of the completed application. If your case is urgent and you qualify for an IMR, the DMHC will review your case and send you a letter within 2 calendar days telling you that you qualify for an IMR. After your application and supporting documents are received from your plan, the IMR decision will be made within 3 calendar days. You should receive the IMR decision within 7 calendar days of the submission of the completed application. If you are not satisfied with the result of the IMR, you can still ask for a State Hearing.  If the DMHC decides that your case is not eligible for IMR, the DMHC will review your case through its regular consumer complaint process. 2)    State Hearing You can ask for a State Hearing for Medi-Cal covered services and items. If your doctor or other provider asks for a service or item that we will not approve, or we will not continue to pay for a service or item you already have and we said no to your Level 1 appeal, you have the right to ask for a State Hearing. In most cases you have 120 days to ask for a State Hearing after the “Your Hearing Rights” notice is mailed to you.  NOTE: If you ask for a State Hearing because we told you that a service you currently get will be changed or stopped, you have fewer days to submit your request if you want to keep getting that service while your State Hearing is pending. Read “Will my benefits continue during Level 2 appeals” in Chapter 9 of the Member Handbook for more information. There are two ways to ask for a State Hearing: You may complete the "Request for State Hearing" on the back of the notice of action. You should provide all requested information such as your full name, address, telephone number, the name of the plan or county that took the action against you, the aid program(s) involved, and a detailed reason why you want a hearing. Then you may submit your request one of these ways: To the county welfare department at the address shown on the notice. To the California Department of Social Services: State Hearings Division P.O. Box 944243, Mail Station 9-17-37 Sacramento, California 94244-2430 To the State Hearings Division at fax number 916-651-5210 or 916-651-2789. You can call the California Department of Social Services at (800) 952-5253. TDD users should call (800) 952-8349. If you decide to ask for a State Hearing by phone, you should be aware that the phone lines are very busy. Will my benefits continue during Level 2 appeals? If your problem is about a service or item covered by Medicare, your benefits for that service or item will not continue during the Level 2 appeals process with the Independent Review Entity. If your problem is about a service or item covered by Medi-Cal and you ask for a State Fair Hearing, your Medi-Cal benefits for that service or item will continue until a hearing decision is made. You must ask for a hearing on or before the later of the following in order to continue your benefits: Within 10 days of the mailing date of our notice to you that the adverse benefit determination (Level 1 appeal decision) has been upheld; or The intended effective date of the action. If you meet this deadline, you can keep getting the disputed service or item until the hearing decision is made. How will I find out about the decision? If your Level 2 Appeal was a State Hearing, the California Department of Social Services will send you a letter explaining its decision.  If the State Hearing decision is Yes to part or all of what you asked for, we must comply with the decision. We must complete the described action(s) within 30 calendar days of the date we received a copy of the decision. If the State Hearing decision is No to part or all of what you asked for, it means they agree with the Level 1 decision. We may stop any aid paid pending you are receiving.  If your Level 2 Appeal was an Independent Medical Review, the Department of Managed Health Care will send you a letter explaining its decision.  If the Independent Medical Review decision is Yes to part or all of what you asked for, we must provide the service or treatment. If the Independent Medical Review decision is No to part or all of what you asked for, it means they agree with the Level 1 decision. You can still get a State Hearing. If your Level 2 Appeal went to the Medicare Independent Review Entity, it will send you a letter explaining its decision. If the Independent Review Entity says Yes to part or all of what you asked for, we must authorize the medical care coverage within 72 hours or give you the service or item within 14 calendar days from the date we receive the IRE’s decision.  If the Independent Review Entity says No to part or all of what you asked for, it means they agree with the Level 1 decision. This is called “upholding the decision.” It is also called “turning down your appeal.” If the decision is No for all or part of what I asked for, can I make another appeal? If your Level 2 Appeal was a State Hearing, you may ask for a rehearing within 30 days after you receive the decision. You may also ask for judicial review of a State Hearing denial by filing a petition in Superior Court (under Code of Civil Procedure Section 1094.5) within one year after you receive the decision.  If your Level 2 Appeal was an Independent Medical Review, you can request a State Hearing.  If your Level 2 Appeal went to the Medicare Independent Review Entity, you can appeal again only if the dollar value of the service or item you want meets a certain minimum amount. The letter you get from the IRE will explain additional appeal rights you may have. Payment Problems We do not allow our network providers to bill you for covered services and items. This is true even if we pay the provider less than the provider charges for a covered service or item. You are never required to pay the balance of any bill. The only amount you should be asked to pay is the copay for service, item, and/or drug categories that require a copay. If you get a bill that is more than your copay for covered services and items, send the bill to us. You should not pay the bill yourself. We will contact the provider directly and take care of the problem. How do I ask the plan to pay me back for the plan’s share of medical services or items I paid for? Remember, if you get a bill that is more than your copay for covered services and items, you should not pay the bill yourself. But if you do pay the bill, you can get a refund if you followed the rules for getting services and items.  If you are asking to be paid back, you are asking for a coverage decision. We will see if the service or item you paid for is a covered service or item, and we will check to see if you followed all the rules for using your coverage. If the service or item you paid for is covered and you followed all the rules, we will send you the payment for our share of the cost of the service or item within 60 calendar days after we get your request. Or, if you haven’t paid for the service or item yet, we will send the payment directly to the provider. When we send the payment, it’s the same as saying Yes to your request for a coverage decision. If the service or item is not covered, or you did not follow all the rules, we will send you a letter telling you we will not pay for the service or item and explaining why. What if the plan says they will not pay? If you do not agree with our decision, you can make an appeal. Follow the appeals process. When you are following these instructions, please note: If you make an appeal for reimbursement, we must give you our answer within 60 calendar days after we get your appeal. If you are asking us to pay you back for medical care you have already received and paid for yourself, you are not allowed to ask for a fast appeal.  If we answer “no” to your appeal and the service or item is usually covered by Medicare, we will automatically send your case to the Independent Review Entity. We will notify you by letter if this happens. If the IRE reverses our decision and says we should pay you, we must send the payment to you or to the provider within 30 calendar days. If the answer to your appeal is Yes at any stage of the appeals process after Level 2, we must send the payment you asked for to you or to the provider within 60 calendar days. If the IRE says No to your appeal, it means they agree with our decision not to approve your request. (This is called “upholding the decision.” It is also called “turning down your appeal.”) The letter you get will explain additional appeal rights you may have. You can appeal again only if the dollar value of the service or item you want meets a certain minimum amount. If we answer “no” to your appeal and the service or item is usually covered by Medi-Cal, you can file a Level 2 Appeal yourself (see above). IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan) is a Health Plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. Information on this page is current as of October 08, 2021. H5355_CMC_22_2246727 Accepted

IEHP DualChoice - Making Complaints

he kinds of problems related to: Quality of your medical care Respecting your privacy Disrespect, poor customer service, or other negative behaviors Physical accessibility Waiting times Cleanliness Information you get from our plan Language access Communication from us Timeliness of our actions related to coverage decisions or appeals How to file a Grievance with IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan) 1. Contact us promptly – call IEHP DualChoice at (877) 273-IEHP (4347), 8am - 8pm, 7 days a week, including holidays.TTY users should call 1-800-718-4347. You can make the complaint at any time unless it is about a Part D drug. If the complaint is about a Part D drug, you must file it within 60 calendar days after you had the problem you want to complain about. If you do not wish to call (or you called and were not satisfied), you can put your complaint in writing and send it to us. If you put your complaint in writing, we will respond to your complaint in writing.  You can use our "Member Appeal and Grievance Form." All of our Doctor’s offices and service providers have the form or we can mail one to you. You can file a grievance online. You can give a completed form to our Plan provider or send it to us at the address listed below or fax the completed form to the fax number listed below. This form is for IEHP DualChoice as well as other IEHP programs. IEHP DualChoice  P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 Fax: (909) 890-5877 Whether you call or write, you should contact IEHP DualChoice Member Services right away. 2. We will look into your complaint and give you our answer If possible, we will answer you right away. If you call us with a complaint, we may be able to give you an answer on the same phone call. If your health condition requires us to answer quickly, we will do that. Most complaints are answered in 30 calendar days. If we need more information and the delay is in your best interest or if you ask for more time, we can take up to 14 more days (44 days total) to answer your complaint. If we do not agree with some or all of your complaint or don’t take responsibility for the problem you are complaining about, we will let you know. Our response will include our reasons for this answer. We must respond whether we agree with the complaint or not. Fast Grievances If you are making a complaint because we denied your request for a “fast coverage determination” or fast appeal, we will automatically give you a “fast” complaint. If you have a “fast” complaint, it means we will give you an answer within 24 hours. Who may file a grievance? You or someone you name may file a grievance. The person you name would be your “representative.”  You may name a relative, friend, lawyer, advocate, doctor, or anyone else to act for you. Other persons may already be authorized by the Court or in accordance with State law to act for you. If you want someone to act for you who is not already authorized by the Court or under State law, then you and that person must sign and date a statement that gives the person legal permission to be your representative. To learn how to name your representative, you may call IEHP DualChoice Member Services. External Complaints You can tell Medicare about your complaint You can send your complaint to Medicare. The Medicare Complaint Form is available at: https://www.medicare.gov/MedicareComplaintForm/home.aspx. Medicare takes your complaints seriously and will use this information to help improve the quality of the Medicare program. If you have any other feedback or concerns, or if you feel the plan is not addressing your problem, please call (800) MEDICARE (800) 633-4227). TTY/TDD (877) 486-2048. The call is free. You can tell Medi-Cal about your complaint The Cal MediConnect Ombuds Program also helps solve problems from a neutral standpoint to make sure that our members get all the covered services that we must provide. The Cal MediConnect Ombuds Program is not connected with us or with any insurance company or health plan. The phone number for the Cal MediConnect Ombuds Program is 1-855-501-3077. The services are free. You can tell the California Department of Managed Health Care about your complaint The California Department of Managed Health Care (DMHC) is responsible for regulating health plans. You can call the DMHC Help Center for help with complaints about Medi-Cal services. You may contact the DMHC if you need help with a complaint involving an urgent issue or one that involves an immediate and serious threat to your health, you disagree with our plan’s decision about your complaint, or our plan has not resolved your complaint after 30 calendar days. Here are two ways to get help from the Help Center: Call (888) 466-2219, TTY (877) 688-9891. The call is free. Visit the Department of Managed Health Care's website: http://www.dmhc.ca.gov/ You can file a complaint with the Office for Civil Rights You can make a complaint to the Department of Health and Human Services’ Office for Civil Rights if you think you have not been treated fairly. For example, you can make a complaint about disability access or language assistance. The phone number for the Office for Civil Rights is (800) 368-1019. TTY users should call (800) 537-7697. You can also visit https://www.hhs.gov/ocr/index.html for more information. You may also contact the local Office for Civil Rights office at: U.S. Department of Health and Human Services 90 7th Street, Suite 4-100 San Francisco, CA 94103 Telephone: (800) 368-1019 TDD: (800) 537-7697 Fax: (415) 437-8329 You may also have rights under the Americans with Disability Act. You can contact the Cal MediConnect Ombuds Program for assistance. The phone number is (855) 501-3077. When your complaint is about quality of care You have two extra options: You can make your complaint to the Quality Improvement Organization. If you prefer, you can make your complaint about the quality of care you received directly to this organization (without making the complaint to our plan). To find the name, address, and phone number of the Quality Improvement Organization in your state, look in Chapter 2 of your IEHP DualChoice Member Handbook. If you make a complaint to this organization, we will work with them to resolve your complaint. Or you can make your complaint to both at the same time. If you wish, you can make your complaint about quality of care to our plan and also to the Quality Improvement Organization. For more information on Grievances see Chapter 9 of your IEHP DualChoice Member Handbook. Handling problems about your Medi-Cal benefits If you have Medi-Cal with IEHP and would like information on how to pursue appeals and grievances related to Medi-Cal covered services, please call IEHP DualChoice Member Services at (877) 273-IEHP (4347), TTY (800) 718-4347, 8am - 8pm (PST), 7 days a week, including holidays. IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan) is a Health Plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. Information on this page is current as of October 08, 2021. H5355_CMC_22_2246727 Accepted

Community Supports - Flexible Care Choices: Community Supports

e options. These may be offered (instead of state plan-covered services) to qualified Members at medium to high levels of risk. Community Supports can help you remain healthy, reduce complications from illnesses, and avoid unnecessary stays in the hospital, nursing facilities, and emergency departments You may find that Community Supports with IEHP can help during a transition in housing or care. If you need help managing your health, IEHP’s Community Supports might be the right choice. When you need extra care IEHP’s Community Supports are open to any Medi-Cal or IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan) Member who needs supportive care. Community Supports may nurture your whole health—to care for your body and mind. Members who could benefit from Community Supports may be: Facing times without housing Struggling to get food for their loved ones Having asthma issues and need changes to their living space How your Care Team can help you If you can be helped by Community Supports, you may get a care team that can assist in identifying your needs. Then, they will coordinate no-cost services. This includes finding resources for housing, care after leaving the hospital, and dealing with asthma at home. Who may be on your care team: Nurse Care Manager Behavioral Health Care Manager Care Coordinator Community Health Worker Support when you need it Your care team can assist you by phone or in person, and they can even meet you at your location. You are not alone with IEHP’s Community Supports. What community supports are offered? Asthma Remediation: Environmental Asthma Trigger Remediations are physical modifications to a home environment that are necessary to ensure the health, welfare, and safety of the individual, or enable the individual to function in the home and without which acute asthma episodes could result in the need for emergency services and hospitalization. Community Transition Services/Nursing Facility Transition to a Home: Assist members to live in the community and avoid further institutionalization.These services are non-recurring set-up expenses for individuals who are transitioning from a licensed facility to a living arrangement in a private residence where the person is directly responsible for his or her own living expenses. Environmental Accessibility Adaptations (Home Modifications): Environmental Accessibility Adaptations (EAAs also known as Home Modifications) are physical adaptations to a home that are necessary to ensure the health, welfare, and safety of the individual, or enable the individual to function with greater independence in the home: without which the Member would require institutionalization. Housing Deposits: Housing Deposits assist with identifying, coordinating, securing, or funding one-time services and modifications necessary to enable a person to establish a basic household that do not constitute room and board. Housing Tenancy & Sustaining Services: This service provides tenancy and sustaining services, with a goal of maintaining safe and stable tenancy once housing is secured. Housing Transition Navigation Services: Housing transition services assist Members with obtaining housing. Medically Supportive Food/Meals/Medically Tailored Meals: Malnutrition and poor nutrition can lead to devastating health outcomes, higher utilization, and increased costs, particularly among Members with chronic conditions. Meals help individuals achieve their nutrition goals at critical times to help them regain and maintain their health. Results include improved Member health outcomes, lower hospital readmission rates, a well-maintained nutritional health status, and increased Member satisfaction. Nursing Facility Transition/Diversion to Assisted Living Facilities: Nursing Facility Transition/Diversion services assist individuals to live in the community and/or avoid institutionalization when possible. The goal is to both facilitate nursing facility transition back into a home-like, community setting and/or prevent skilled nursing admissions for Members with an imminent need for nursing facility level of care (LOC). Individuals have a choice of residing in an assisted living setting as an alternative to long-term placement in a nursing facility when they meet eligibility requirements. Recuperative Care (Medical Respite): Recuperative care, also referred to as medical respite care, is short-term residential care for individuals who no longer require hospitalization, but still need to heal from an injury or illness (including behavioral health conditions) and whose condition would be exacerbated by an unstable living environment. An extended stay in a recovery care setting allows individuals to continue their recovery and receive post-discharge treatment while obtaining access to primary care, behavioral health services, case management and other supportive social services, such as transportation, food, and housing. Short-Term Post-Hospitalization Housing: Short-Term Post-Hospitalization housing provides Members who do not have a residence and who have high medical or behavioral health needs with the opportunity to continue their medical/psychiatric/substance use disorder recovery immediately after exiting an inpatient hospital (either acute or psychiatric or Chemical Dependency and Recovery hospital), residential substance use disorder treatment or recovery facility, residential mental health treatment facility, correctional facility, nursing facility, or recuperative care and avoid further utilization of State plan services. Sobering Centers: Sobering centers are alternative destinations for individuals who are found to be publicly intoxicated (due to alcohol and/or other drugs) and would otherwise be transported to the emergency department or jail. Sobering centers provide these individuals, primarily those who are homeless or those with unstable living situations, with a safe, supportive environment to become sober. To learn more about Community Supports, call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347.

Urgent Care and Medi-Cal

ic of the moment, it may not always be clear where to go to get help. Besides the worry of the injury or illness itself, you may also be thinking, “does Medi-Cal cover urgent care?” Finding an urgent care clinic that takes Medi-Cal is not the only priority. You also need to think about what kind of treatment you need and where to go to get it. Consider the following example: It is a Saturday morning, and you have a severe stomachache and now start to have a fever. You want to get medical treatment as soon as possible but know your Doctor is closed on the weekend. So, you are not sure whether to go to an urgent care clinic or the emergency room. You also want to make sure there are urgent care clinics nearby that accepts Medi-Cal. Yes, many urgent care clinics do accept Medi-cal. At IEHP we have over 90 urgent care clinics in our network that offer Members care afterhours, on weekends and on holidays, when your primary care doctor might be closed. Click here to search for an IEHP urgent care clinic in your area. Now, that you know that urgent care clinics accept Medi-Cal, let’s review when you might need urgent vs emergency care.  Urgent Care vs. Emergency Room  Urgent care is not the same as emergency care. Urgent care centers are for illnesses and injuries that are not life-threatening, yet still require treatment. Some examples include common illness like the flu, minor fever or headache, painful sore throat, earache or sinus pain, back pain, minor injuries like a sprained ankle, etc. Most urgent care centers provide same-day services and usually have shorter waiting times than emergency rooms.   Emergency rooms (ER) are for life-threatening emergencies and accidents where immediate treatment is required. Emergency rooms are open 24 hours a day 7 days a week and provide care for critical or life-threatening conditions. Visit your nearest ER or call 911 if you experience: changes in mental status, such as confusion, chest pain or pressure, coughing or vomiting blood, difficulty breathing or shortness of breath etc.  When to Visit Urgent Care  Urgent care clinics are not a substitute for your regular doctor. When you can't reach your Doctor after-hours or your Doctor is not available, you have options to get your needed care. Many people don’t realize there is a middle ground between a doctor’s visit and a trip to the ER.  Urgent care centers regularly handle a range of medical problems, including: Fevers Dehydration Small wounds  Vomiting/diarrhea Sprains Allergies Bites Cold or flu symptoms Emergency rooms handle life threatening conditions, including:  Head injuries Broken bones Chest pains Breathing difficulties Heart attack Stroke Serious burns Serious bleeding Be Prepared  Does urgent care take medical history into account? Absolutely! Your medical records form an important part of your treatment and follow-up care. As such, we always recommend you are ready with the following details: Information on pre-existing conditions. Details of past surgeries, when you had them, and which hospital and doctors performed them. A list of prescription medications you take, the dosage, and how often you take them.  A list of any over-the-counter medications you take, the dosage, and how often you take them. Any allergies you have. Make sure to bring your IEHP Member Card While nobody likes to think about being in an accident or suffering a sudden illness, it is important to be prepared. Your Doctor understands your health and medical background. Doctors at urgent care clinics will not have access to the same depth of information as your primary doctor, therefore, we recommend you that you follow up with your primary care Doctor after visiting an urgent care.  After-Hour and Urgent Care Services for IEHP Members  If you think you need urgent care, it’s always recommended to call your doctor’s office. If your doctor’s office is closed, you can call the IEHP 24-Hour Nurse Advice Line at (888) 244-4347, TTY (866) 577-8355, or click here to search for an IEHP Urgent Care clinic.   Of course, always call 911 if immediate medical care is needed. At IEHP, we pride ourselves on improving lives by delivering quality and accessible healthcare and will not rest until our communities enjoy optimal care and vibrant health. If you have any questions about your Medi-Cal benefits please call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347 to learn more.

COVID-19 - COVID-19 Vaccine

c9; border: none; color: white !important; padding: 15px 32px; border-radius: 25px; display: inline-block; text-align: center; cursor: pointer; } COVID-19 Vaccines: Latest news and updates The COVID-19 vaccines are safe, effective and free for all IEHP Members. Recommended for everyone ages 5 and older, the vaccines can help protect people from severe illness, hospitalization and death due to COVID-19. The vaccines won’t make people sick or give them COVID-19. They may have some minor side effects, which are not harmful and should last no more than a few days. The vaccines can help us end the pandemic and save lives. Vaccinated people should keep wearing a mask, washing their hands often and maintaining at least 6 feet of distance in public places. IEHP Members can learn more by continuing to visit the IEHP website and or visiting the California Department of Health’s website. CLICK HERE TO FIND A VACCINE CLINIC NEAR YOU How vaccines build immunity While the COVID-19 vaccines are relatively new - the technology and science behind the vaccines have been in development for decades. In the video below, we demonstrate how years of vaccine research and advanced technology allowed researchers and scientists worldwide to be prepared to develop an mRNA vaccine that could help fight the spread of a global infectious disease. PFIZER VACCINE GETS FULL FDA APPROVAL On August 23, 2021, the U.S. Food and Drug Administration (FDA) approved the first COVID-19 vaccine – the Pfizer-BioNTech COVID-19 Vaccine (widely known as the Pfizer vaccine). The approved vaccine will now be marketed as Comirnaty (koe-mir’-na-tee) for the prevention of COVID-19 disease in people 16 years of age and older. Effective October 29, 2021 the Pfizer vaccine is available under emergency use authorization, including for use by children aged 5 through 18 years of age and for the administration of a booster dose in certain immunocompromised people. Please note, the Pfizer vaccine and Comirnaty are the same vaccine. The FDA reports that they have the same formulation and are interchangeable.  Where can I get the vaccine? For Members who want the vaccine, there are several options: IEHP recommends My Turn online at myturn.ca.gov. My Turn online, a website from the California Department of Public Health, is a convenient, one-stop website where those who want a COVID-19 vaccine can: Set up their first, second and booster shot appointments Set up family or group appointments Find walk-in clinics in their area Set up in-home vaccinations (if needed) Arrange for transportation (if needed) For those without internet access, the California COVID-19 Hotline at 1-833-422-4255 can help provide the same services. Large pharmacy chains, like CVS and Walgreens provide the vaccine. Many have walk-in appointments available. IEHP recommends calling the pharmacy first to confirm. Vaccine appointment sign-ups are also available online through the public health department in your county. For Riverside County, visit www.ruhealth.org/covid-19-vaccine. For San Bernardino County, visit www.sbcovid19.com/vaccine/.  Do I have to pay for the vaccine? No. The vaccine is free for everyone who wants it.  Is the vaccine safe? Yes, the top medical experts in our nation and state agree that COVID-19 vaccines are safe and effective. The vaccines were tested in large clinical trials to make sure they meet safety standards. Many people from different ages, races, and ethnic groups, as well as those with different medical conditions, were part of the trials. Does the vaccine have side effects? Most people do not have serious problems after being vaccinated for COVID-19. Any minor symptoms that result usually go away on their own within a week. Call your Doctor immediately if you start to have any of the following symptoms: severe headache, abdominal pain, leg pain/swelling, or shortness of breath, chest pain, feelings of having a fast-beating, fluttering or pounding heart. Your Doctor or health care provider will explain any potential side effects and what you need to do about them.  Since the emergency use authorization of the Moderna and Pfizer-BioNTech COVID-19 vaccines, myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining outside the heart) have occurred in some people who have received these vaccines. In most of these people, symptoms began within a few days following the second dose of these vaccines. There have been confirmed reports of myocarditis or pericarditis in individuals who received COVID -19 vaccine, particularly among males ages 30 and younger. While this is concerning and is under further investigation, myocarditis or pericarditis after COVID vaccination is extremely rare as more than 318 million doses of COVID-19 vaccines have been administered in the United States from December 14, 2020 through June 21, 2021. Will there be any long-term side effects? COVID-19 vaccines are being tested in large clinical trials to assess their safety. It will take time and more people will need to get the vaccine before we learn about very rare or long-term side effects. The Food and Drug Administration (FDA) and the U.S. Centers for Disease Control (CDC) will continue to monitor the safety of COVID-19 vaccines. Health care providers are required to report any problems or adverse events following vaccination to the Vaccine Adverse Event Reporting System (VAERS). What if I have side effects? Contact your Doctor right away. The CDC offers a smartphone-based tool called v-safe to check in on people’s health after they receive a COVID-19 vaccine. When you get your vaccine, you should also get a v-safe handout telling you how to enroll in the program. If you enroll, you will get regular text messages with links to surveys where you can report any problems or side effects after getting a COVID-19 vaccine. Can the vaccine give me COVID-19? No, the vaccine cannot give you COVID-19 because it does not contain an infectious virus. How many shots will be needed? The Pfizer and Moderna vaccines require two shots, 3 to 4 weeks apart. While the first shot helps build protection, you will need to come back a few weeks later for the second one to get the most protection the vaccine can offer. Your Doctor will advise you when you should return for the second shot, as it varies by type of vaccine. The J&J vaccine requires only one shot. Do I need the booster shot? Studies show after getting vaccinated against COVID-19, protection against the virus and the ability to prevent infection with variants may decrease over time and due to changes in variants. However, the booster shot may increase your immune response to COVID-19 and its variants, increasing prevention efforts against the virus. Who can get a booster shot? Booster shots are available to everyone ages 12 years and older who are fully vaccinated but the timing of the booster varies by vaccine and age group. When can I get the booster shot? If you received the Pfizer-BioNTech vaccine, everyone 12 years or older should get the booster at least five months after completing your primary COVID-19 vaccination series. If you received the Moderna vaccine, adults 18 years and older should get the booster at least six months after completing your primary COVID-19 vaccination series. If you received the Johnson & Johnson’s Janssen vaccine, adults 18 years and older should get the booster at least two months after receiving your J&J/Janssen COVID-19 vaccination. Does the booster shot have side effects? You may experience side effects after getting the booster shot. These are normal signs that your body is building protection against COVID-19. Do I need to keep wearing a mask and avoiding close contact with others once I get fully vaccinated? Yes. While experts learn more about the protection that COVID-19 vaccines provide, please keep using all the tools we know can help stop the spread of COVID-19. This means keep wearing a mask, washing your hands often, avoiding crowds, and maintaining at least 6 feet of distance in public places. Can children and babies get COVID-19? Yes. Children can get COVID-19. Most children with COVID-19 have mild symptoms, or they may have no symptoms at all, which is called being asymptomatic. Fewer children have been sick with COVID-19 compared to adults. But, infants (children younger than 1 year old) and children with certain medical conditions might have a higher risk for getting COVID-19. Can children get a COVID-19 vaccine? COVID-19 vaccines are approved for children 5 years old and older. To learn more, visit the CDC website and/or your county’s public health departments online:  Click here for San Bernardino County Click here for Riverside County Can I take the COVID-19 vaccine and the flu vaccine at the same time? Yes. The CDC has approved the use of routine vaccines for children, adolescents and adults (including pregnant women) on the same day as COVID-19 vaccines (as well as within 14 days of each other). Talk to your Doctor about what’s best for you. If I have previously tested positive for COVID-19, can I still get the vaccine? Yes. People are advised to get a COVID-19 vaccine even if they have been sick with COVID-19 before. This is because re-infection with COVID-19 is possible. Those who had a diagnosis in the past three months, be sure to talk to your Doctor about when you should get the vaccine. Will IEHP provide transportation to a COVID-19 vaccine clinic? Yes, IEHP will provide transportation to a COVID-19 vaccine clinic in the county where you live. How do I request transportation? Contact IEHP Transportation Call Center at 1-800-440-4347. Will the drive wait with me? No, the driver will not wait. Transportation will be provided as a roundtrip. You will need to contact the transportation provider to request a return pickup once you are ready. Can I take my family members? IEHP will provide transportation to an IEHP Member and one other passenger. How much time is needed to request transportation? IEHP will assist with transportation to the COVID-19 vaccine clinic in fewer than 5 business days. However, we cannot guarantee same-day requests. Where can I learn about COVID-19 and COVID-19 vaccines? IEHP Members can learn more by visiting the IEHP website or the California Department of Health’s website. Members can also learn more about COVID-19 at the California Coronavirus Response website or the CDC’s website

Latest News - Inland Empire Health Plan Promotes Autism Awareness

rents of Members to feel confident in advocating for themselves, their children, and family members to access the behavioral healthcare they need. The health plan supports more than 7,500 Members who are utilizing behavioral health treatment services for autism spectrum disorder (ASD) and related conditions. Such services may include: applied behavioral analysis, speech therapy, physical therapy, occupational therapy, psychiatry services and more. “Having Autism or being on the spectrum is nothing to be afraid of,” said Heather Waters, IEHP’s Manager of Behavioral Health and Care Management. “As a health plan, we want to take the stigma out of asking or seeking behavioral healthcare and encourage our Members or parents of Members to trust their gut and ask for support as soon as they spot any signs or symptoms of possible developmental delays.” Waters shared that early treatment and recognition of symptoms, as early as one year of age and before a child enters school, can result in better health outcomes, especially for children. Signs and symptoms vary and can range from obsessive or compulsive behaviors to poor social skills, delayed milestones, and more. IEHP Medi-Cal Members can be referred to services and treatment for ASD symptoms by a Medical Doctor or a Licensed Psychologist. This allows Members under 21 years of age to access critically important behavioral and developmental therapies immediately, while they undergo the autism evaluation process.   IEHP’s Internal Behavioral Health Team helps Members and their families navigate an ASD diagnosis through actively coordinating services and additional resources through partnerships with several provider groups and local agencies across the region. Recently, IEHP collaborated with the Inland Empire Autism Assessment Center of Excellence (AAC) to provide a Member in Indio with a complete Autism Diagnostic Evaluation through telehealth appointments. “Even with care coordination challenges like location and Member condition, the situation wasn’t impossible,” said Waters. “As the Member and their family connected with the AAC, our team checked in regularly to make sure the services were effective and to remind the family and Member that they were not alone in this journey.” To receive an evaluation or additional services, Members are encouraged to call IEHP’s Member Services at 1-800-440-4347 and ask for the Behavioral Health Department.

Latest News - Celebrity Chef Provides Healthy Cooking Demos to I.E. Residents

althy cooking to the Inland Empire (I.E.) by showing Members and community residents how to cook delicious, traditional meals with a healthy and spicy twist at the health plan’s Victorville Community Resource Center.   A 2018 MasterChef Latino judge, Chef Mario is a Boyle Heights native and has expertise elevating the culinary experience of residents in and around the Los Angeles area. Chef Mario’s demonstrations highlight cooking with both new and familiar ingredients that are proven to address common health issues in the region, including diabetes and hypertension.  “Healthy eating doesn’t need to mean bland or boring food and Chef Mario knows how to make that possible,” said IEHP’s Community Health Senior Director Cesar Armendariz. “We’re thrilled to connect Chef Mario to our Members and communities to learn how to better utilize spices and well-known ingredients to better manage our health and wellness in a vibrant, delicious manner.” Chef Mario’s cooking demonstrations are open to the community and take place in July every Tuesday from 12:30 p.m. - 1:30 p.m. Classes in August will be every Thursday from 10:30 a.m. - 11:30 a.m. at the health plan’s Victorville center, located at 12353 Mariposa Road, Suites C-2 & C-3. IEHP also plans to record demonstrations for public use in the coming months.  “This partnership means so much to me on a personal level. A healthy way of life should be available to all – it’s such an important component of health care that is often ignored,” said Chef Mario. “Food is the connection to everything, from our physical well-being to our mental well-being. There has been no greater time than now to embrace healthy eating but not sacrifice the flavor. I'm so excited to partner with IEHP and have so many fun demos, recipes and other surprises coming.” In addition, IEHP will connect Chef Mario to community partners for additional cooking demonstrations and civic events. “IEHP is proud to provide education and resources to Members and community residents who want to learn how to better manage their health through cooking. We’re excited to have Chef Mario’s help as we continue to look for ways to serve our community,” said IEHP Chief Executive Officer Jarrod McNaughton. To learn more about IEHP’s Community Resource Centers or to find a nutrition class, visit the community resource page.  alt=" "="" src="-/media/dc4dca59a6f446009bdb09836af76cc9.ashx?h=400&w=300" class="" />

Latest News - Statewide Initiative Supports Behavioral Health of I.E. Youth

h Molina Healthcare, County Behavioral Health, the Offices of Education in Riverside and San Bernardino counties, and select local school districts and charter schools to implement the Student Behavioral Health Incentive Program (SBHIP).  The three-year program is in accordance with the California Department of Health Care Services’ (DHCS) goal to expand prevention and early intervention behavioral health services in schools and provides financial incentives to partnering school districts and charter schools. A total of $389 million has been allocated for California. Between both IEHP and Molina Healthcare, up to $50,845,334 can be utilized to support this program. According to the American Psychological Association, one in five young women and one in ten young men experience a major depressive episode before the age of 25. The COVID Collaborative also notes one in 330 California children have lost either a parent or caregiver in the last two years, adding significant stress and trauma to the lives of California’s youth, along with stay-at-home orders and remote learning.  “If the past few years have taught us anything, it’s that we need to be proactive in addressing mental health and wellness needs early on, before traumas have a chance to manifest later in life,” said Amrita Rai, IEHP’s clinical director of community behavioral health.  Through SBHIP efforts, existing mental health initiatives will be bolstered, and coordination between schools, managed care plans, county behavioral health and community partners aim to address the equity gap and improve access to mental health prevention and treatment for students.  Resources will be directed to fill gaps in these areas throughout the participating schools and their respective communities. Services will be limited to schools who are participating in SBHIP and who receive funding.   “We are well into a crisis when it comes to the mental health and wellness of our youth. Now is the time to be bold and work tirelessly for our children because what we do now will affect generations to come,” said Rai. “Why not focus our resources, our passion, and our commitment back into the community and schools? Our children spend most of their lives in school, which makes this multi-organizational partnership so worthwhile.” Partnerships with local education agencies and school sites include San Bernardino County Superintendent of Schools (SBCSS); Riverside County of Education; Palm Springs Unified School District; Hemet Unified School District; San Bernardino City Unified School District; Rialto Unified School District; Victor Valley Union High School; Ontario-Montclair School District; Leadership Military Academy; Nuview Union School District; Provisional Accelerated Learning Academy; and Riverside County Office of Education Alternative Education Program.  While the initiative will begin at these partner sites, it is anticipated that learnings would benefit other schools and districts interested in implementing similar programs in the future.   “San Bernardino County Superintendent of Schools recognizes the growing mental health crisis among our youth and supports this joint effort to address this critical issue,” said County Superintendent Ted Alejandre. “SBCSS seeks to build capacity within countywide systems and increase access to much needed support to ensure every child receives the services they need when they need them.”  “Educators at the Riverside County Office of Education and within all Local Educational Agencies (LEA) in Riverside County, are vitally interested in addressing the needs of the whole student beyond the classroom. Linking arms with partners across the county via the Student Behavioral Health Incentive Program (SBHIP) will equitably provide mental health services to those who might not otherwise have access to this level of support,” said Riverside County Superintendent of Schools, Dr. Edwin Gomez. Selection of school districts and charter schools was dependent on DHCS guidelines and considered specific criteria, such as the number of students who received Medi-Cal, were foster youth or English learners, received free or reduced priced meals, were interested in participating in the program and other factors.  “It’s the right thing to do. This program gives us a great opportunity to extend both heart and hand to children in our community,” said Dr. Takashi Wada, IEHP’s chief medical officer. “Working together, we can equip them with necessary skills, habits and care they can use today and through adulthood, setting them up for a healthier and happier tomorrow.”  “The COVID-19 pandemic has exacerbated and elevated behavioral health needs in our communities, including in young people. Mental and emotional wellbeing make up a significant portion of overall health and healthy youth lead to improved community wellness. We are proud to partner with IEHP, local offices of education and mental health professionals to address the youth behavioral health crisis in tangible, preventative ways.” said Dr. Sayeed Khan, chief medical officer at Molina Healthcare. Program preparation began this year and will support a January 2023 launch at all 10 participating local education agencies. Through careful planning and implementation, the program will aim to build and support a sustainable system beyond the life of the program, which will end in December 2024. alt=" "="" src="-/media/7c6d40e217094fb1be8ec6cec9473878.ashx?h=233&w=350" class="" />

Latest News - New IEHP Program Combats Loneliness and Depression

xperiencing loneliness, anxiety or depression. The partnership connects 70,000 Members to support services for mental health screenings.   The program began in March and will run through the fall of 2022. Members who elected to participate were invited to download the Pyx App on their smart phones or tablets, which immediately connects to Pyx-ir, an interactive robot. Pyx-ir will regularly converse, ask wellness questions and connect Members to IEHP services and call centers, depending on need. The program’s services rolled out to English and Spanish speaking Members who receive both Medicare and Medi-Cal benefits (Cal MediConnect Members), as well as Medi-Cal Members who are seniors with a disability or have been identified as unable to leave their homes and are at a greater risk for loneliness.   “Isolation and stay-at-home orders have tremendously impacted these populations in the last two years,” said Anna Edwards, IEHP’s Care Management Clinical Director. “Our partnership with Pyx Health will extend care beyond the health plan’s usual business hours and truly meet the Members where they are.” For continuity of care, Pyx Health will provide the health plan with comprehensive reports based on Member screenings to connect Members with additional resources at the plan level. If needed, Members will also have the option to connect with Pyx Health’s Compassionate Call Center representatives who will be able to route information and reports to IEHP’s Care Management Team.  “In addition to usual health plan services, we believe our partnership with Pyx Health will provide Members a unique aspect of personalized care,” said Dr. Takashi Wada, IEHP’s Chief Medical Officer. “We’re eager to learn how this pilot program and type of service can engage Members in their own health and how it will positively impact their overall wellness.”