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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.

Helpful Information and Resources - Medical and Government Links

alth information. All the links will open in a new window and you will leave the IEHP website. Medical Links Medscape: free medical news, journal articles, and more. Yahoo! Health: medical dictionary, disease symptoms, and treatments. KidsHealth: animations, games, and articles for parents, teens, and kids. First 5 San Bernardino: statewide initiative to improve the early development of children. First 5 Riverside: statewide initiative to improve the early development of children. Text4Baby: get FREE messages each week on your cell phone to help you through your pregnancy and your baby's first year. Government Links San Bernardino County Department of Public Health: get information on WIC, child car seat safety and more. Riverside County Department of Public Health: get information on injury prevention, WIC, HIV, family health and more. PubMed: life science journals from the United States National Library of Medicine. Healthy Finder: 1600 health-related topics. NCQA (National Committee for Quality Assurance): reports on the quality of care delivered by managed care plans. NIH (National Institutes of Health): get health information, clinical trials, research, and more. CDC (Centers for Disease Control and Prevention): get information on healthy living, disease, Zika virus, emergencies, workplace safety, and environmental health. Quality of Care Report Card: get quality ratings of health plans. California Department of Managed Health Care  California Department of Health Care Services  

Governing Board - Andrew Williams

ogistics support and communications electronics officer for the U.S. Air Force. He received a Bachelor of Arts Degree in Mathematics from Morehouse College in 1964 and a Master’s of Science in Logistics Management, which he earned through the Air Force Institute of Technology, in 1970.

Awards and Recognitions

ence and access to care for the low-income working residents of the Inland Empire. These recognitions honor our steadfast commitment to improving access to quality, wellness-based healthcare services when and where members need it. NCQA Accreditation IEHP was the first Medicaid-only health plan in California to earn accreditation from the National Committee for Quality Assurance (NCQA) for its Medi-Cal health plan, in 2000. We have retained NCQA accreditation every year since. Innovation Awards from DHCS In November 2021, IEHP received the “Innovation Award - Runner Up 2021” for the Medi-Cal PCP Auto Assignment Redesign, which focused on directing Members to Providers with higher quality scores. In November 2020, IEHP was awarded the prestigious California Department of Healthcare Services (DHCS) Innovation Award. The award was based on IEHP’s groundbreaking work using location intelligence to reach high-risk members and providers in geographic areas affected by power outages, wildfires, and other natural disasters. This is the fourth time the health plan has received this honor. In 2018, IEHP received the Innovation Award from Department of Health Care Services (DHCS), for its Housing Initiative, which provides permanent supportive housing and intensive case management services to homeless, high utilizing Members. In October 2017 IEHP won a California Department of Health Care Services (DHCS) Innovation Award for improving the health of low-income members through a program that coordinates their complex physical and behavioral health care needs across the healthcare system in Riverside and San Bernardino counties. In 2015 IEHP won the first annual Innovation Award from DHCS for its Transitional Care Program, which strives to reduce emergency room usage and curtails the re-admission rates of members recently discharged from the hospital IEHP Receives the CORE Certification Seal  In April 2022, IEHP received the CORE Certification Seal for the Eligibility & Benefits, Claim Status, and Payment & Remittance CAQH CORE Operating Rule Sets. As a CAQH CORE-certified entity, IEHP has demonstrated that they follow a set of national operating rules and standards which improve business processes in healthcare — going above and beyond what is federally required.  The CORE Seal is widely recognized as the industry gold standard. IEHP Receives Rancho Cucamonga Fire District’s Business Partner of the Year Award In September 2021, IEHP was awarded Business Partner of the Year by the Rancho Cucamonga Fire District at the City’s Fire and Police Recognition. The distinguished award recognizes the health plan’s partnership with the City and County of San Bernardino to host an ongoing super vaccine clinic at the health plan’s headquarters. IEHP Receives Health Equity Award for Engaging Communication In 2020, IEHP received the Health Equity Award for their ability to engage and connect with members via text message during Governor Newsom’s social isolation order. The award was given by mPulse Mobile, a leader in conversational AI solutions for healthcare, during their annual Activate Awards. Click here to learn more. IEHP DualChoice Cal MediConnect Plan Earns Top Customer Satisfaction Score in the Nation The IEHP DualChoice Cal MediConnect Plan had the third-highest score in the country in the 2016 MMP CAHPS survey from the Centers for Medicare and Medicaid Services (CMS), which assesses the experiences patients have with their health plans. In 2016 there were 40 Medicare-Medicaid Plans (MMP) in the nation (called Cal MediConnect plans in California). Annual Excellence Award In 2016, IEHP received the Excellence Award from the Pharmacy Benefit Management Institute (PBMI) for its Pharmacy Pay for Performance Program, which leverages IEHP network pharmacies to offer clinical education to its members. Top Physician Satisfaction  Doctors and other medical providers ranked IEHP at or above the 90th percentile in most areas on a 2016 satisfaction survey administered by an independent survey vendor. They ranked IEHP at the:  99th percentile for “IEHP Compared to All Other Health Plans” 98th percentile for “Overall Satisfaction with Call Center Staff” 98th percentile for “Overall Satisfaction with Financial Services”   97th percentile for “Recommend IEHP to Other Physicians’ Practices” IEHP Receives Workplace of the Year Award from Advisory Board in March 2018 Inland Empire Health Plan (IEHP) has been awarded the Advisory Board 2018 Workplace of the Year Award. The annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. IEHP is one of only 20 organizations nationwide to receive the award. Favorite Employer IEHP was voted “Favorite Overall Company to Work For,” “Favorite Training Program” and “Favorite Workplace Culture” by Los Angeles News Group Readers in the 2014 Winning Workplaces survey. “Access to Caring” Award IEHP was recognized for making a difference in advancing health care access and availability to people with disabilities by the Western University of Health Sciences, in 2014. Energy Star Award for Superior Energy Performance IEHP’s corporate headquarters (“The Atrium”) in Rancho Cucamonga, Calif. earned the U.S. Environmental Protection Agency’s ENERGY STAR® certification for superior energy performance in 2017, demonstrating IEHP’s commitment to continued energy savings and environmental responsibility. “Gold Standard” Certification for Electronic Payments and Claims Processing In 2016 IEHP achieved Phase III certification for accurate and efficient electronic provider payments and claims reconciliation from the Council for Affordable Quality Healthcare (CAQH) and the Committee on Operating Rules for Information Exchange (CORE). The voluntary certification is widely viewed as the industry “gold standard” for provider payments and claims processing.

Mental Health - Mental Health & Wellness

tioning of the brain and emotions and how that balance (or imbalance) affects behavior and thoughts.  What is the stigma around Mental Health? There is still too much stigma surrounding behavioral and mental health. Historically, “crazy” or “mad” folks have been ostracized from society. This has been due to ignorance about mental health.  Unfortunately, there is still too much fear and mis-understanding in our communities about mental health. Many people suffer from mental health disorders. And given the current COVID-19 crisis, many more people will suffer from mental illness. Too many people suffer in silence with mental illness The latest statistics before COVID stated that about 1 in 5 people were diagnosed with a mental illness in America Those numbers will increase now during the COVID-19 crisis Mental Health includes wellness, self-care, emotional regulations, relationship issues, and parenting among other facets of everyday life Mental well-being is important to everyone Mental illness can happen to anyone Everyone deserves access to mental health treatment. Things you can do to learn more or to get help Understand the importance of mental health wellness and what is a mental illness. Click here to learn more. Take a quick check up from the neck up. Click here to take an online screening.  Tips for staying mentally well during COVID-19 Self-care is critical: listen to your warning signs of struggling with your emotions and doing the basic things like showering, eating, sleeping, and exercise Do something that brings you enjoyment every day: play with your children or spouse, take walks, read a book, do something creative Connect with someone outside your home every day via telephone or other video technology Eat nutritiously, do not binge or eat too many sweets Avoid alcohol Continue to see your therapist via tele-health Continue to take care of your physical, financial, and spiritual needs Be patient with yourself and others Readily forgive yourself Exercise, do yoga, go for a walk.  Stay active, but do not overdo it Seek treatment for your mental health whenever needed At IEHP Behavioral Health, we put just as much importance on your mental health as on your physical health. Your mental health includes a balance of emotional, psychological and social well-being.  It affects how you think, what you feel, and how you act.  Your mind and body are connected and therefore, one can affect the other. When your mind suffers, your body suffers as well. At IEHP Behavioral Health, our goal is to help you live your best and healthiest life, both mentally and physically.   Mental illness is more common than you might think and IEHP is here to help and support. Did you know that one in five adults in the United States suffers from a mental illness that can be treated? These people are battling mental illnesses such as depression, anxiety, and even drug or alcohol abuse.   If you think you may be experiencing a behavioral or mental health challenge and want to seek treatment, schedule an appointment with your Doctor. If you don’t have a Doctor, you can find a behavioral health specialist in your area, 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 and ask to speak to the Behavioral Health Department. If you are experiencing thoughts of hurting yourself or someone else, please go to your closest emergency room, call 911, or reach out to the National Suicide Prevention Lifeline at 1-800-273-8255. Remember that you are not alone.   Many people are struggling or will struggle with mood and anxiety issues during this time. Reach out for help.   Mental health help is available and we want you to get help. Available Resources San Bernardino County Behavioral Health Riverside County Behavioral Health San Bernardino County Substance Use Riverside County Substance Use Psychiatry Walk-in Clinic (Montclair) Psychiatry Walk-in Clinic (Palm Desert) Psychiatry Walk-in Clinic (Victorville) Teen Mental Health Guide COVID-19 Maternal Mental Health FAQ Substance Abuse and Mental Health Services Administration Find a provider Maternal Mental Health & Wellness Resources  National Postpartum Support International Local Inland Empire Maternal Mental Health Collaborative Resources

Provider Resources - Health and Wellness

and achieve health goals. IEHP’s Health & Wellness Programs help Members learn how to manage their health and make healthy lifestyle changes. You can refer your IEHP Members to these programs anytime by logging into the Secure Provider Website and completing the Health Education Program Request Form. Health Resources Kids and Teens Managing Your Illness Pregnancy and Postpartum Senior Health Weight Management Health & Wellness Brochures and Handouts Inland Empire Health Plan (IEHP) offers many Wellness Programs that focus on the health and well-being of our Members. All of our programs are free, join us at our next session and learn ways to stay healthy.  Get information on important health topics through our health education brochures and handouts: Controlling Asthma (PDF) Diabetes. What's next? (PDF) Eat Healthy, Feel Better (PDF) Fever in Children (PDF) Flu Decision Guide (PDF) Flu Shot (PDF) High Blood Pressure (PDF) Immunizations - English (PDF) Immunizations - Spanish (PDF) Immunizations - Chinese (PDF) Immunizations - Vietnamese (PDF) PAP and HPV Tests: What to Expect (PDF) Diabetes Prevention Program (DPP) - Live the Life You Love Format: Online (small group) Duration: One year Ages: 18 years and over This online year-long lifestyle change program helps you make real changes that last.  During the first 6 months, you will meet weekly with a small online group to learn how to make healthy choices into your life. In the second 6 months, you will meet monthly to practice what you have learned. No person is alike, so the program will be tailored to meet your needs and honor your customs and values. You will also be paired with a health coach for one year to help you set your goals, such as how to: Eat healthier Add physical activity into your daily life Reduce stress Improve problem-solving and coping skills Studies have shown that those who finish the program can lose weight and prevent Type 2 Diabetes. Small changes can have big results! Let's start living the best version of you and living the life you love. Find out if you qualify! Click here to visit the Skinny Gene Project online, or Call Skinny Gene Project at (909) 922- 0022, Monday - Friday 8am – 5pm., or Email hello@skinnygeneproject.org For Providers DPP Rx Pad (PDF) Educational Resources 2021 Population Needs Assessment (PNA) Report IEHP’s Population Needs Assessment (PNA) identifies Member health status and behaviors, Member health education priorities, cultural/linguistics needs, health disparities, and gaps in service related to these issues. The findings of the PNA may help Providers better understand and serve our Members. For questions, please contact IEHP Health Education Department at healthed@iehp.org 2021 Population Needs Assessment (PNA) Report Loving Support Program IEHP supports and sponsors the Loving Support Program that is run by Riverside University Health System (RUHS). Loving Support is a program committed to helping mothers achieve their breastfeeding goals. This service offers help and support with the first days at home, return to work, support groups, and timely answers to challenges nursing mothers face. Members can directly contact the Loving Support 24/7 Helpline at 888-451-2499. No referral is necessary. English and Spanish-speaking certified lactation specialists and Internationally Board Certified Lactation Consultants (IBCLCs) are available 24 hours a day, 7 days a week to answer questions. Messages are recorded after hours and promptly addressed. Member Education Resources The following websites are good sources of easy-to-read patient information that can be downloaded, printed, or ordered. By clicking on these links, you will be leaving the IEHP website.  RESOURCE  DESCRIPTION Medline Plus A service of the US National Library of Medicine and the National Institutes of Health. Easy to read information and audio tutorials on many health topics in English and Spanish. Topics are available in multiple languages. Food and Drug Administration - Office of Women's Health Easy-to-read handouts in English, Spanish and other languages on nutrition, diabetes, depression, and other topics related to women’s health. Learning About Diabetes, Inc. Easy to read “Handouts and Visual Aids” in color on diabetes care and nutrition to help patients eat the right foods to control blood sugar. Weight Control Information Network An extensive list of health education materials about healthy weight and physical activity in English and Spanish. Materials can be printed or ordered. Health Information Translations Easy-to-read educational handouts on many health topics and in multiple languages.   You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

Special Programs - Alcohol and Drug (SABIRT)

ant to the Department of Health Care Services (DHCS) APL 21-014 (PDF), “Alcohol and Drug SABIRT,” IEHP has updated its requirements for alcohol and substance use screening in the primary care setting. Helpful resources: Correspondence - June 2022 - Alcohol and Drug SABIRT Training Guide (PDF) Screening Tools Alcohol Use Disorders Identification Test (AUDIT-C) Brief Addiction Monitor (BAM) (PDF) Cut Down-Annoyed-Guilty-Eye-Opener Adapted to Include Drugs (CAGE-AID) (PDF) Tobacco Alcohol, Prescription Medications and other Substances (TAPS) (PDF) National Institute on Drug Abuse (NIDA) Quick Screen for Adults Drug Abuse Screening Test (DAST-10) (PDF) Parents, Partner, Past, and Present (4Ps) for pregnant women and adolescents (PDF) Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) for non-pregnant adolescents (PDF) Michigan Alcoholism Screening Test Geriatric (MAST-G) alcohol screening for geriatric population (PDF) Assessment Tools Alcohol Use Disorders Identification Test (AUDIT) (PDF) Brief Addiction Monitor (BAM) (PDF) NIDA-Modified Alcohol, Smoking and Substance Involvement Screening Test (NM-ASSIST) (PDF) Drug Abuse Screening Test (DAST-20) (PDF) Pamphlets Riverside Brochure (English) (PDF) Riverside Brochure (Spanish) (PDF) San Bernardino Brochure (English) (PDF) San Bernardino Brochure (Spanish) (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.

Plan Updates - Coronavirus (COVID-19) Advisory

e Control and Prevention (CDC) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus that was first detected in China and which has now been detected in almost 70 locations internationally, including in the United States. The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19"). IEHP will continually update you on the latest recommendations, news, and resources on COVID-19 as it becomes available. COVID-19 Therapeutics Available for Members In an effort to provide the most up-to-date treatments against COVID-19, IEHP continues to maintain a list of providers, including but not limited to infusion clinics, ancillary, hospital and non-hospital based infusion centers offering COVID-19 infusion therapy treatment. Under all Member coverage, outpatient COVID therapeutics will be offered immediately after a Member is determined to be clinically eligible under and Emergency Use Authorization (EUA). List of Infusion Sites COVID-19 Infusion Treatments by Organization (PDF) Test-To-Treat COVID-19 Vaccine Reimbursement for Medi-Cal Providers DHCS has carved out the COVID-19 vaccine from Medi-Cal managed care health plans and will reimburse providers under the Fee-for-Service (FFS) delivery system for both medical and pharmacy claims. Medi-Cal will reimburse the associated COVID-19 vaccine administration fee at the allowable Medicare rate for all claims (medical, outpatient, and pharmacy), based on the number of required doses for all Medi-Cal beneficiaries. For further information: June 13, 2022 - DHCS COVID-19 Vaccine Administration Provider FAQs   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. FIND A TESTING AND VACCINATION SITE NEAR YOU TODAY! RIVERSIDE Riverside County Public Health COVID Testing Site Vaccine Information Vaccine Locations & Registration Registrations encouraged but not required for: The CDC recommends everyone ages 6 months and older get vaccinated against COVID-19 as well as a booster for everyone 5 years and older, if eligible. For more information, visit the Riverside Country Vaccine webpage. Teenagers 5 to 17 years old must register for a vaccination clinic that offers the Pfizer vaccine and be accompanied by a parent/legal guardian or present a signed written consent from a parent/legal guardian and be accompanied by an adult. Pfizer Minor Consent Form (PDF) | Spanish  The Moderna and Johnson & Johnson vaccines can only be given to individuals age 18 years and older. Johnson & Johnson Fact Sheet (PDF) | Spanish - Published April 26, 2021  SAN BERNARDINO San Bernardino County Public Health COVID Testing Site Vaccine Locations & Registration Additional Dose and Boosters Information COVID-19 Vaccine Consent Form (PDF) | Spanish   The CDC recommends everyone ages 6 months and older get vaccinated against COVID-19 as well as a booster for everyone 5 years and older, if eligible. For more information, visit the San Bernardino County Pediatric COVID-19 Vaccination web page Walk-ins are now available at County-operated vaccination sites. Walk-in individuals will not need to bring any additional information to the site, however be prepared to register on site, which will include answering health screening questions. Walk-ins may experience longer wait times and availability may vary based on site demand.  Centers for Disease Control and Prevention (CDC) Clinical Care Guidance Vaccines Vaccination Plans January 10, 2022 - Continued Coverage of COVID-19 Diagnostic Testing (PDF) CalVax CalVax is a state-wide centralized system for health care Providers enrolled or interested in participating in the California COVID-19 Vaccination Program, developed by the California Department of Public Health (CDPH). The new CalVax platform will provide a system to manage vaccine enrollment, ordering, inventory, administration, reporting and data analytics. Training materials such as job aids, videos, and recorded demos will be available to support all system users as they navigate through the new CalVax platform (mycavax.cdph.ca.gov).  CA Notify • CA Notify Flyer in English (PDF) and Spanish(PDF) • CA Notify Shareable Tools for web and social media • CA Notify Website  Financial Assistance Resources Riverside County Medical Association - COVID-19 Financial Toolkit for Medical Practice U.S. Department of Health & Human Services (HHS) CARES Provider Relief Fund Learn more about the Provider Relief Fund (PRF) Provider Relief Fund (PRF) Portal U.S. Small Business Administration. Borrowers may be eligible for Paycheck Protection Program (PPP) loan forgiveness. See if you're eligible here. Guidance Regarding Monoclonal Antibody Treatment for COVID-19 Even with decreasing cases and hospitalizations, those with high-risk conditions who have tested positive for COVID-19 are encouraged to get monoclonal antibody treatment at Riverside University Health System (RUHS) – Medical Center. In January, the U.S. Food and Drug Administration (FDA) limited the use of certain monoclonal antibody therapies that were ineffective against the omicron variant. In response, RUHS – Medical Center is administering sotrovimab, an IV infusion shown to be effective against omicron and other variants. January 14, 2022 - RUHS-Medical Center Offers Monoclonal Antibodies Treatment Quest Diagnostic For more information, please visit Quest Diagnostics FAQs COVID-19 Specimen Collection Instructions (Watch Video Here)                        Fact Sheet for Healthcare Providers for COVID-19 Testing (View PDF Here)   LabCorp For more information, please visit LabCorp's COVID-19 page. Which COVID-19 Test is Right For You? COVID-19 FAQs If you do not have the ability to collect specimens for COVID-19, please refer to your County Public Health resources for guidance on directing Members for testing.   Telehealth IEHP is strongly encouraging the utilization of telehealth for visits that can be conducted over the phone or via other audiovisual telecommunications.  IEHP has published a telehealth FAQ which is available here: Telehealth Services Due to Limiting Exposure to COVID-19 (PDF)- October 17, 2022 Remember: IEHP Provider Telehealth Information (PDF) IEHP expects that Providers will offer telehealth services and support to their Members during their published business hours.  Existing authorizations are valid and do not need to be changed even if services are being provided via telehealth You can request a POS 02 or POS 10 on your authorization however if you do not, you can still utilize the authorization for telehealth services even if a different POS was approved. When billing the claim for the service, you will utilize a POS 02 or POS 10. ONLY Services that are deemed clinically appropriate to provide via telehealth should be provided via telehealth. If there are treatments, exams, procedures or other services that cannot be provided via telehealth, those are not eligible to be provided via telehealth.  Provider Resources for Combatting COVID-19 Fatigue ACEs Aware - Support for those on the front lines as California addresses stress and anxiety related to COVID-19   Department of Health Care Services (DHCS) and California Department of Public Health (CDPH) COVID 19 Response Department of Health Care Services (DHCS) California Department of Public Health (CDPH)   The California Department of HealthCare Services (DHCS) has published a COVID-19 response page with guidance for Providers and Partners, Home and Community Based Services and Behavioral Health. Found Here: DHCS COVID‑19 Response | DHCS COVID-19 Medi-Cal FAQs The California Department of Public Health (CDPH) also has a page with new guidance documents and additional resources and news releases. Found Here: CDHP COVID-19 Updates Centers for Medicare & Medicaid Services (CMS) CMS Health Care Provider Toolkit - Help link to COVID-19 related questions   San Bernardino Medical Society The San Bernardino County Medical Society promotes the science and art of medicine, the care and well-being of patients, the protection of the public health and to promote the betterment of the medical profession. The latest news, research and developments on the COVID-19 outbreak for physicians can be found here: SBCMS COVID-19. January 07, 2021 - COVID-19 Vaccines For All Practicing Physicians and Staff – San Bernardino County (PDF) 2-1-1 San Bernardino County Resource & Information Guide   2-1-1 San Bernardino County has curated a COVID-19 Resource & Information Guide and will update this page regularly as the situation changes. For more information, please click here.   Correspondences May 2, 2022 - Webinar - IWIN COVID and the Community April 13, 2022 - COVID-19 “Test to Treat” Initiative April 8, 2022 - 2nd Round of Free At-Home COVID-19 Test Kits Available February 23, 2022 - COVID-19 Oral Antiviral Drugs – Coverage and Dispensing Pharmacies  January 28, 2022 - Free OTC COVID-19 Antigen Kits Available January 26, 2022 - Free At-Home COVID-19 Tests Available by Request January 5, 2022 - Extending SNF COVID-19 Per Diem Rate December 22, 2021 - COVID-19 Vaccine Billing for Medicare Advantage Enrollees Effective DOS January 1, 2022 December 16, 2021- COVID-19 Vaccine Incentive Program – Program Guide December 16, 2021 - REMINDER: COVID Vaccine Enrollment Survey - Your Response is Requested December 10, 2021 - REMINDER: COVID Vaccine Enrollment Survey - Your Response is Requested December 10, 2021 - COVID-19 Vaccine Billing for Medicare Advantage Enrollees December 3, 2021- COVID-19 Vaccine Enrollment Survey December 1, 2021- CDC Encourages COVID Booster Due to Omicron Variant November 17, 2021- UPDATE! COVID-19 Vaccine FQHC, RHC and IHF Incentive Program November 9, 2021- Three Upcoming Webinars on Building COVID-19 Vaccine Trust October 22, 2021- 2021 COVID-19 Vaccination Member Incentive October 22, 2021- NEW!!! COVID-19 Vaccine FQHC and RHC Incentive Program October 19, 2021- COVID-19 Treatment – RUHS Monoclonal Antibody Treatment Center October 12, 2021- Reminder - NEW COVID-19 Vaccine PCP Incentive Program - Kickoff Meeting October 6, 2021- NEW COVID-19 Vaccine PCP Incentive Program- Kickoff Meetings October 4, 2021- New COVID-19 Vaccine PCP Incentive Program September 8, 2021- CDPH Webinar: How to Have Crucial Conversations About COVID-19 Vaccines – Thursday, September 9th August 18, 2021 - Riverside County Public Townhall on COVID-19 Vaccines For additional resources regarding COVID-19, please visit: Centers for Disease Control and Prevention (CDC) Riverside County Public Health San Bernardino Public Health You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

Innovations and Quality Performance - Our Commitment to Innovation

healthcare needs of our Members for more than two decades. With our Strategic Priorities guiding us, we will continue to seek opportunities for innovation and improvement – putting access to quality healthcare and our Members, Providers and Community above all else. Community Health Assessment The 2022 Inland Empire Community Health Assessment Stakeholder Committee, comprised of over 40 representatives across 25 community organizations, united over the past year to collect and analyze the region’s health and wellness data. The group identified those four at-risk population groups, Senior citizens, communities of color, individuals with low incomes and those living in remote and rural areas, as well as six priority areas of focus: Basic Needs for Health and Safety, Human Housing, Meaningful Work and Wealth, Cardiovascular Disease and Diabetes, Maternal and Infant Health and Mental and Behavioral Health. The committee shared the findings in a first-of-its-kind joint regional Community Health Assessment report. Community Health Needs Assessment (CHNA) The 2022 Inland Empire Community Health Needs Assessment (CHNA) identifies the top health and well-being needs of Inland Empire residents. The findings in the CHNA will be used to build community interventions that generate collective investments addressing the identified priorities. There are seven assessments within the CHNA, the first three target the entire Inland Empire region, along with Riverside and San Bernardino counties. The remaining four assessments comprise drilled-down analyses for Montclair Hospital Medical Center, Redlands Community Hospital, San Antonio Regional Hospital and San Gorgonio Memorial Hospital service areas. Click here to view the assessment. Provider Recruitment IEHP’s innovative Network Expansion Fund (NEF) was the first program of its kind in the state. Established in 2014, the NEF allocates $30 million in specially designated funds to attract board-certified PCPs, Specialists and mid-level Providers to the Inland Empire, addressing the region’s chronic Provider shortage and improving access to care for more than 1.2 million IEHP Members. To date, more than 280 Providers have been recruited as a direct result of this program. Behavioral Health Integration Complex Care Initiative The Behavioral Health Integration Complex Care Initiative (BHICCI) is a collaboration between IEHP and more than 30 clinics in the Inland Empire that provides a footprint for the California Department of Health Care Services (DHCS) Health Homes Program, going live January 1, 2019. The goal is to improve Members’ health outcomes by staffing a complex care team to provide comprehensive care management and by coordinating complex physical and behavioral health needs across multiple Providers and health care systems in Riverside and San Bernardino counties. BHICCI care teams are currently transitioning into community-based care management entities (CB-CMEs) that provide Health Homes services in preparation for Health Homes go-live. Health Homes Program The Health Homes program (HHP) is an integrated care management program for patients with complex needs that builds on IEHP’s Behavioral Health Integration Complex Care Initiative (BHICCI), as legislated by the Department of Health Care Services (DHCS). The HHP coordinates the physical, behavioral, and community-based Long-Term Services and Supports (LTSS) needs of Members with severe chronic physical and/or mental health conditions. The primary goal of HHP is to improve the overall health outcomes of members through the delivery of care coordination and complex care management. Since the launch of the program in January 2019, more than 9,000 Members have seen overwhelmingly positive clinical health outcomes related to blood pressure, diabetes and depression. Click here to learn more about the Health Homes Program.  EHR and Health Information Exchange IEHP has partnered with the San Bernardino County Medical Society and the Riverside County Medical Association to form the Inland Empire EHR Resource Center, to assist Providers and clinics in selecting and implementing electronic health record systems. Additionally, IEHP was part of the Inland Empire Health Information Exchange, which merged with the CalIndex Health Information Exchange to form Manifest Medex (MX). MX is a statewide health information exchange that has significant penetration and use in the Inland Empire, with all Inland Empire acute care hospitals and many medical groups and Physicians contributing patient clinical and administrative data. MX brings needed technology to access and securely share electronic patient health records for most of the 4.4 million people living in the Inland Empire. It allows Doctors, clinics, hospitals and other health care Providers to electronically review and access medical records, resulting in timely and improved quality of health care for patients in our community. DocOnline This innovative program provides another option for Members to receive medical advice after hours from a Physician. IEHP Members can speak to a board-certified Physician by phone or via video chat, quickly and easily. The Physician can access the IEHP formulary and the IEHP Pharmacy Network to e-prescribe medications for IEHP Members if needed. When fully implemented, this service will enhance Member access and convenience while reducing unnecessary emergency room and urgent care visits. Telehealth IEHP is supporting the expansion of telehealth services throughout the Inland Empire, to improve access to critically needed specialty care and to aid in rapid diagnosis and treatment. Telehealth eliminates one of the Inland Empire’s longstanding barriers to care – geographic distance to health care resources. With telehealth’s information and communication technologies, the treatment and prevention of disease or injury can occur long-distance, erasing geography as a critical factor impeding care. Telehealth can also be used to support Provider training and Member education. IEHP is currently supporting telehealth for certain services: behavioral health, retinal examinations, dermatology, and orthopedic consultations. Plans are underway to expand to additional services in alignment with Member needs. eConsult eConsult, a collaboration among IEHP, Arrowhead Regional Medical Center and Riverside University Health Care System, allows PCPs to connect directly with specialists electronically when a patient may need a specialist referral. Through a private, secure system, PCPs can receive timely clinical advice from specialists that may allow them to manage a majority of patients in the primary care setting (some patients may need a face-to-face visit with a specialist). IEHP is sponsoring the initiative for the first 24 months and will design, implement and evaluate eConsult at more than 70 clinic sites throughout Riverside and San Bernardino counties. Secure Online Member Portal and App IEHP Members can take an active role in managing their own health 24/7 via a secure online account that can be accessed through the IEHP website or mobile app. Members can view and print their IEHP Member Cards; view lab tests, Immunization Cards and authorizations; find or change Doctors; search the Provider Directory; enroll in health education classes; check eligibility; and more. The separate Baby-N-Me prenatal care app helps improve maternity health outcomes by making it easy for expectant moms to track pregnancy milestones, identify health issues, and stay healthy with reminders and helpful tools. Texting and Alerts IEHP uses two-way texting and Short Message Service (SMS) alerts to educate Members about their plan benefits and how to navigate the health care system. These alerts are targeted approaches that communicate seasonal health information about topics such as immunizations, preventive care, medication adherence, and new health plan features. Long-Term Services and Supports (LTSS) IEHP’s Long-Term Services and Supports (LTSS) program enables seniors and persons with disabilities to live independently in their homes as long as safely possible, and provides care in a Skilled Nursing Facility (SNF) when they cannot. LTSS includes the Multipurpose Senior Services Program (MSSP) and Community-Based Adult Services (CBAS), as well as SNF services when required. IEHP also helps coordinate any In-Home Supportive Services (IHSS) benefits. Since May 2018, IEHP has helped transition 750 Members out of long-term care facilities and back into the community. A 24-hour in-home emergency caregiver program and a case management program, developed in partnership with the Riverside County Department of Social Services, received the 2017 and 2018 Achievement Award from the National Association of Counties. IEHP has also partnered with the University of California, Los Angeles on a Geriatric Workforce Enhancement Program to provide patients, families and caregivers with the knowledge and skills they need to improve health outcomes and increase the quality of care for older adults.   

Provider Resources - Educational Opportunities

isciplinary Care Team (ICT) Dual Choice Medicare CM IPA Training Alzheimer's and Dementia Care Specialty Mental Health Care Coordination Staying Healthy Assessment (SHA) Training National LGBT Health Education Webinars Online Cultural Competency Training Interdisciplinary Care Team (ICT) Fact Sheet (PDF) Healthcare Provider Toolkit: Assisting Patients with Requests for Workplace Accommodations or Leaves of Absence (PDF) Dual Choice Medicare CM IPA Training 2021 Care Management Delegation Oversight Medi-Cal IPA Training (MP4 Video) - December 08, 2021 Discussion Topics: Health Risk Assessments (HRA) Individual Care Plans (ICP) Interdisciplinary Care Team (ICT) Coordination of Care Delegated IPA Reporting Requirements   2021 Care Management Delegation Oversight Medi-Cal IPA Training (MP4 Video) - February 16, 2021 Alzheimer's and Dementia Care A Project ECHO Opportunity From The Alzheimer's Association For Inland Empire Primary Care Clinics What is Project ECHO®? You are invited you to attend interactive, teleconference-held learning sessions to bring advanced training and support to PCPs. Offered by The Alzheimer’s Association for Inland Empire Primary Care Clinics, these expert, panel-led lessons, and group consultations are meant to build capacity within Primary care and increase access to specialty care. 95% of all attendees have found the courses useful AND have implemented needed changes to their practices Inland Empire ECHO Flyer (PDF) Inland Empire ECHO Seminar Schedule (PDF) Seminar Registration Form (PDF) Please email registration form to rbgoldberger@alz.org Specialty Mental Health Care Coordination The Centers for Medicare and Medicaid Services (CMS) is requiring IEHP and its IPAs to document and report the efforts made to coordinate the care of IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan) Members receiving specialty mental health services through the County Mental Health Plans.   As of June 1, 2018, IEHP has put policies and procedures in place to comply with these process and reporting requirements: On the first (1st) of each month, IEHP will provide IPAs and County MH Clinics a list of IEHP DualChoice Members known to be receiving specialty mental health services through the County MH Plans. IPAs are expected to outreach to these Members and their County MH Clinic Provider, as well as, document their outreach attempts and outcomes as outlined in Policy 25C2, “Care Management Requirements – Delegated IPA Responsibilities.” IPAs are required to provide data elements specific to this measure, as outlined in Policy 25F1, “Encounter Data Reporting - Medicare MMP Reporting Requirements – IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan)" and Attachment, “Medicare Provider Reporting Requirements Schedule” in Section 25. IEHP, through its Delegation Oversight process, will monitor the IPAs’ compliance with documentation and reporting requirements, as outlined in Policy 25A2, “Delegation Oversight Audit.” To access the On-Site training material presented to IPAs and County Mental Health Clinics, click here (PDF). Staying Healthy Assessment (SHA) Training The Staying Healthy Assessment (SHA) forms consist of seven age-specific pediatric questionnaires and two adult questionnaires.  The Primary Care Physician (PCP) is responsible for ensuring the SHA is administered to each Member within 120 days of enrollment and may be administered as part of the Member's initial health assessment. The training resources below provide information on completing the SHA for your patients. DHCS Staying Health Assessment (SHA) Reference Page Initial Health Assessment Standards (PDF) Staying Healthy Assessment (SHA) Training (PDF) SHA Instruction Sheet for Providers (PDF) SHA Pediatric Questions by Age Group (PDF) SHA Adult Questions by Age Group (PDF) Alternative IHEBA Review Form (PDF) Bright Futures Notification Form (PDF) SHA Format Notification Form (PDF) To access the SHA questionnaires under Forms, please click here. National LGBT Health Education Webinars IEHP has put together a list of webinars, provided by a third party, to provide educational programs, resources, and consultation to health care organizations with the goal of optimizing quality, cost-effective health care for lesbian, gay, bisexual, transgender, and all sexual and gender minority (LGBT) people. The National LGBT Health Education Center is part of the Division of Education and Training at The Fenway Institute, Fenway Health. The Fenway Institute (TFI) is an interdisciplinary center for research, training, education, and policy development that works to ensure access to quality, culturally affirming medical and mental health care for traditionally underserved communities, including LGBTQIA+ people and those affected by HIV/AIDS. The mission of Fenway Health is to enhance the wellbeing of the LGBTQIA+ community as well as people in our neighborhoods and beyond through access to the highest quality health care, education, research, and advocacy. Fenway Health is one of the largest providers of LGBTQIA+ health care and HIV primary care in the country; as such, it is a leader in the field of LGBTQIA+ health and informs much of the promising practices and innovative models that the Education Center disseminates to health centers nationwide. By clicking on these links, you will be leaving the IEHP website. The National LGBT Health Education Center Webinars  Courses Include:  HIV Prevention/PrEP at Health Centers: An Overview and Current Best Practices What’s new in PrEP and STIs? Cases From a Sexual Health Clinic Insurance Considerations for Navigating Gender-affirming Care Building Your Family: LGBTQ Reproductive Options Behavioral Health Assessments and Referral for Gender-Affirming Surgery Navigating Gender Affirming Care Collecting Sexual Orientation and Gender Identity (SO/GI) Data In Electronic Health Records Providing Mental Health Assessments for Gender Affirming Surgery Referral Letters Online Cultural Competency Training AHRQ Health Literacy Modules Available for Continuing Education (CE) and Maintenance of Certification (MOC) Credit  Physicians and nurses can earn CE credits while learning about the challenges in caring for patients with low health literacy as well as strategies to improve overall patient communication and care. OptumHealth Education is issuing continuing education credit for taking the AHRQ-developed Health Literacy Knowledge Self-Assessment. No fees are charged for the two CE activities: By clicking on these links, you will be leaving the IEHP website. 1. An Updated Overview of Health Literacy Link (optumhealtheducation.com) 2. Improving Health Literacy by Improving Communication Skills Link (optumhealtheducation.com) Pediatricians and family physicians can earn credit for re-certification (MOC Part 2) as well as CE by taking the Health Literacy Knowledge Self-Assessment through the American Board of Pediatrics and the American Academy of Family Physicians, respectively. To learn about AHRQ’s tools to address health literacy, visit Health Literacy Topics at:  https://www.ahrq.gov/health-literacy/index.html To find out about other free AHRQ continuing education opportunities, go to: https://www.ahrq.gov/patient-safety/education/continuing-ed/index.html To contact AHRQ, visit https://www.ahrq.gov/contact/index.html   Office of Minority Health - https://cccm.thinkculturalhealth.hhs.gov/ CDC - www.cdc.gov U.S. Department of Health and Human Service, Health Resources and Services Administration - www.hrsa.gov You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

Provider Resources - Utilization Management Criteria

e. IEHP has created UM Subcommittee Approved Authorization Guidelines to serve as one of the sets of criteria for medical necessity decisions. Our goal in creating this page is to provide you with easily accessible electronic versions of IEHP’s UM guidelines. IEHP utilizes a variety of sources in developing our UM guidelines which include: Medicare and Medi-Cal’s coverage policy statements Evidence in the peer-reviewed published medical literature Technology assessments and structured evidence reviews Evidence-based consensus statements Expert opinions of healthcare Providers Evidence-based guidelines from nationally recognized professional healthcare organizations and public health agencies. IEHP is also licensed to use MCG Guidelines, Apollo Medical Review Criteria, and InterQual to guide in utilization management decisions. Since medical technology is constantly evolving, our clinical guidelines are subject to change without prior notification. Additional UM Subcommittee Guidelines may be developed as needed or may be withdrawn from use. Please note that benefits may vary based on Member’s line of business; therefore, certain services discussed in the UM Subcommittee Guidelines may not be a covered benefit. Table of Contents (PDF) Providers may obtain information about criteria, either in general or relating to specific UM decisions, from IEHP upon request by contacting the IEHP UM Department. Please contact the IEHP Provider Relations Team at (909) 890-2054 to be connected to the UM Department.  Behavioral Health Behavioral Health Treatment (BHT) Criteria (PDF) Behavioral Health Home Based Services (PDF) Criteria for Multidisciplinary Diagnostic Treatment (PDF) Community Supports Services Community Transition Services Nursing Facility Transition to a Home (PDF) Nursing Facility Transition-Diversion to Assisted Living (PDF) Housing Deposits (PDF) Housing Transition Navigation Services (PDF) Housing Tenancy and Sustaining Services (PDF) Asthma Remediation (PDF) Environmental Accessibility Adaptations (Home Modifications) (PDF) Medically Tailored Meals (PDF) Sobering Centers (PDF) Recuperative Care (PDF) Short-Term Post-Hospitalization Housing (PDF) Diagnostic Testing Elastography (PDF) Inflammatory Bowel Disease Serology (PDF) Vestibular Autorotation Test (PDF) Gynecology and Obstetrics Fetal Non-Stress Testing (PDF) Neurology Bone Marrow Transplant in Treatment of Multiple Sclerosis (PDF) Pain Management Pain Management - Centers of Excellence (COE) (PDF) Referrals to Pain Management Specialist (PDF) Pharmacy Biosimilar Products (PDF) CAR-T Therapy (PDF) Surgical Procedures Adolescent Bariatric Consultation and Surgery (PDF) Bronchial Thermoplasty (PDF) Liver Biopsy in Conjunction with Bariatric Surgery (PDF) Natural Orifice Transluminal Endoscopic Surgery (PDF) Transgender Services (PDF) Other Allocation of Limited Critical Care Resources During a Public Health Emergency (PDF) Care Plan Option (PDF) Complementary and Alternative Medicine or Holistic Therapies (PDF) Congregate Living Health Facilities (PDF) Criteria for Custodial Care: Medi-Cal (PDF) Enhanced Care Management (PDF) Hair Removal Guideline (PDF) Health Homes Program (HHP) (PDF) My Path (A Palliative Care Approach) (PDF) Tertiary Care Center Referral Requests (PDF) Transitional Care Medicine (PDF) Transportation Criteria (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.

Testimonials - Gayani DeSilva

ted States are living with some form of behavioral health issue.  In fact, according to the National Alliance on Mental Illness, 50 percent of lifetime mental health illnesses begin by age 14. Yet unlike diabetes or cancer, most people don’t feel comfortable talking about their behavioral health concerns with their Doctor.  Dr. Gayani DeSilva is hopeful that will change sooner rather than later.  “Physical health and mental health affect the whole person, so it’s important that both are considered when we look at how to improve quality and awareness,” said Dr. DeSilva, a psychiatrist and the medical director of Behavioral Health at IEHP.  Before joining the health plan in 2019, Dr. DeSilva treated IEHP Members in a variety of settings and even then she realized IEHP was different in terms of its coordination of behavioral health care. She saw that IEHP patients were more educated about how to access their services and were more confident that they would get the treatment they needed.  Now, as an IEHP Team Member, Dr. DeSilva knows why.  “The team is very conscientious and aware of what our Members need. We don’t just want to meet the expectations of our Members, but exceed them,” she said. Dr. DeSilva said her role as medical director isn’t just to provide clinical leadership for the department. She also wants to facilitate the ongoing integration between Utilization Management, Behavioral Health and Care Coordination even more. Removing barriers and improving access to care is another top priority, she said. That’s the goal behind a new program that will offer home-based behavioral health services to IEHP Members who are unable to go outside of their house for treatment.  “We’re always thinking of how to do things better in order to meet the needs of our Members,” she said.   

Managing Your Illness - Diabetes

thy lives.  Although having diabetes can put you at risk for serious health problems, there is a lot you can do to stay well and delay or prevent any complications. The Diabetes Self-Management Workshop is for people with type 2 diabetes and their relatives or that need information on diabetes self-management.  Diabetes Self-Management Workshop Format: Group Duration: 6 weeks (2 hours per workshop) Ages: Any age if diagnosed with type 2 diabetes (anyone under 18 years old must be accompanied by parent or guardian) Participants have the opportunity to ask questions, offer comments, and share their experiences and ideas about managing and controlling diabetes. We will have weekly action plans to help you, your friends and your family learn and practice self-management skills. In this workshop participants will learn about: Diabetes and health risks How to manage diabetes Healthy lifestyle changes Meal planning Diabetes medicines This workshop is offered in Riverside and San Bernardino.  Call IEHP Health Education Department at 1-866-224-IEHP (4347) or 1-800-718-4347 for TTY users to sign up! Additional Resources By clicking on the links below, you will be leaving the IEHP site. Loma Linda Diabetes Treatment Center IEHP Members can call 909-558-3022 to make an appointment. American Diabetes Association  Learn more about diabetes, meal planning, and eating out. This website also gives you free recipes. www.diabetes.org   Center for Disease Control & Prevention (CDC) Diabetes Home Diabetes and Your Feet Learn how to protect your feet and kee them healthy for an active life. National Diabetes Education Program  Learn how you can avoid problems related to diabetes. You can select topics you want to learn more. www.ndep.nih.gov   You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. Download Adobe Acrobat Reader.  

Leadership Team - Edward Juhn, MD, MBA, MPH

ement of the quality journey in transformative ways to ensure the health plan’s commitment in providing the highest quality of care for the communities they serve. Dr. Juhn brings over 15 years of experience in optimizing the intersection between clinical services, public health, and data and technology. As a mission-driven servant leader, he has had multiple layers of healthcare system experience, including the payer, medical group and hospital. He has been involved in both enterprise strategy and tactical operations and has had success in building private and public sector partnerships.  Prior to joining IEHP, Dr. Juhn served as Sr. Medical Director at Blue Shield of California where he worked on innovative initiatives leveraging big data, advanced analytics and technology-enabled service offerings impacting the quadruple aim and health equity. With this payer, he also managed ACO and non-ACO groups in Northern California and served on the clinical advisory group for the Blue Venture Fund. Additionally, Dr. Juhn has experience as a clinical scientist at an Intel-funded startup company and served as Chief of Healthcare Innovation and Strategy at Premier HealthCare, where he was part of the Accountable Care Coalition of Greater New York that helped establish one of the first ACO’s in the country focusing on the needs of adults with intellectual and developmental disabilities.    Dr. Juhn received his BA and MD from George Washington University, his executive MBA from New York University, and his MPH from Johns Hopkins University. He is board certified in Internal Medicine, a fellow of the American College of Physicians, and was a clinical instructor at Stanford Medicine. He has also served as a member of the Interoperability Standards Priorities Task Force, a subcommittee under the Health Information Technology Advisory Committee (HITAC).

Accessibility

technologies for individuals with disabilities by generating content that conforms to the Web Content Accessibility Guidelines (WCAG) 2.0, and Section 508 of the Rehabilitation Act meeting the requirements within the Americans with Disabilities Act. As part of the development process and ongoing website maintenance, IEHP tests the site using assistive technologies, including screen readers, screen magnifiers, speech recognition software and text-only browsers. IEHP uses tools, such as the W3C HTML. Validator, WAVE by WebAIM and the Color Contrast Analyzer, to ensure the best experience possible for all visitors. Should you have any feedback or concerns related to the accessibility of this webpage and resources contained within it, please contact us via email at ada@iehp.org If applicable, please include the web address, brief description of the issue encountered and your contact information.

Pregnancy and Postpartum

al care as early as possible improves the chances of a healthy pregnancy and childbirth.  Receiving postpartum care after childbirth is just as crucial for a woman to make sure she is healing properly and gets the help she needs to care for herself and her baby. IEHP has programs that offer support for our pregnant Members throughout their pregnancy and after.   Baby-N-Me App     This is a free app for IEHP Members who are pregnant or have a baby under 2 years old. On this app pregnant Members can get up-to-date information about their growing baby like ultrasound videos, get handy tools like a weight gain calculator, complete a survey that screens for postpartum depression, set appointment reminders, and much more!    Parents of a baby under 2 years old can get parenting tips and advice, age-adapted information about their baby’s growth, feeding patterns, and tools to track diaper changes, growth, and vaccines.  You can download this app for free through iTunes or Google Play Loving Support Loving Support is committed to helping mothers achieve their breastfeeding goals. The Helpline offers advice, referrals to mom support groups and support and encouragement to get breastfeeding off to a good start. International Board Certified Lactation Consultants (IBCLCs) also offer guidance, pumping strategies and tips for returning to work/school or are pumping for their premature babies.  Call Loving Support with any questions or concerns you may have throughout the first year and beyond.  You can contact the Loving Support 24/7 Helpline at 888-451-2499/951-358-7212. The staff speaks English and Spanish. Additional Resources The ABC's of Safe Sleep (Video) Centers for Disease Control and Prevention: Pregnancy Depression During and After Pregnancy

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.

COVID-19 - Mental Health

otions and how that balance (or imbalance) affects behavior and thoughts.   What is stigma? There is still too much stigma surrounding behavioral and mental health.  Historically, “crazy” or “mad” folks have been ostracized from society.  This has been due to ignorance about mental health.  Unfortunately, there is still too much fear and mis-understanding in our communities about mental health.  Many people suffer from mental disorders.  And given the current COVID-19 crisis, many more people will suffer from mental illness. Too many people suffer in silence with mental illness The statistics before COVID were about 1 in 5 people were diagnosed with a mental illness in America Those numbers will increase now during the COVID-19 crisis Mental Health includes wellness, self-care, emotional regulations, relationship issues, and parenting among other facets of everyday life Mental well-being is important to everyone Mental illness can happen to anyone Tips for staying mentally well during COVID-19 Self-care is critical: listen to your warning signs of struggling with your emotions and doing the basic things like showering, eating, sleeping, and exercise Do something that brings you enjoyment every day: play with your children or spouse, take walks, read a book, do something creative Connect with someone outside your home every day via telephone or other video technology Eat nutritiously, do not binge or eat too many sweets Avoid alcohol Continue to see your therapist via tele-health Continue to take care of your physical, financial, and spiritual needs Be patient with yourself and others Readily forgive yourself Exercise, do yoga, go for a walk.   Stay active, but do not overdue it Remember that you are not alone.   Many people are struggling or will struggle with mood and anxiety issues during this time .  Reach out for help.   Mental health help is available and we want you to seek help. Resources Psychiatry Walk-in Clinic (Montclair) Psychiatry Walk-in Clinic (Palm Desert) Teen Mental Health Guide  A simple guide to manage stress      

Helpful Information and Resources - IEHP Voice ID

HP!   In early 2022, IEHP launched an innovative technology called IEHP Voice ID. This voice recognition system uses your voiceprints to identify you.  Your speech tones can be stored in safe databases and later used to identify your unique voice—like fingerprints or facial scans.  How will I benefit from using IEHP Voice ID?  By opting in to IEHP Voice ID, you can save the time it would take to go through the series of questions to prove your identity. Each Member who uses IEHP Voice ID could cut the time to verify their identity from 3 minutes to less than 30 seconds! Using IEHP Voice ID streamlines each call—our Member Services representatives will know right away that they are talking to the right member.  Is it safe?  IEHP Voice ID is more secure than passwords, PINS, security questions, and older forms of security. The IEHP Voice ID system will send an alert if it finds copied speech or a recorded voiceprint. Voice biometrics experts say that a voiceprint is safer. It includes more than 100 unique behavioral traits of each person, such as accent, pitch, length of the vocal tract, and so on. How can I sign up for IEHP Voice ID? IEHP Members 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 to sign up for IEHP Voice ID. The use of this service is optional. It does not cost you anything to sign up.