Alcohol and Drug Screening, Assessment, Brief Intervention, and Referral to Treatment (SABIRT)

Pursuant 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 (PDF)
• 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.

Baby-N-Me 

To improve maternity health outcomes, IEHP launched a new prenatal app, Baby-N-Me, in June of 2018. This free app provides expectant mothers with clinically approved information and access to exclusive content based on their due date. IEHP Members can download this app in Google Play or Apple App stores.

Flyers for Members:

• 2021 Baby-N-Me App - English (PDF)
• 2021 Baby-N-Me App - 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.

California Children Services (CCS)

Welcome to IEHP's California Children Services (CCS) information page.

What is CCS?

CCS is a statewide program that enables children with qualifying conditions to receive specialized services related to that condition independent from IEHP. The CCS program provides diagnostic and treatment services, and medical case management for those who have qualifying conditions.

CCS also provides occupational and physical therapy services through the Medical Therapy Program (MTP). The Medical Therapy Program (MTP) is a special program that provides physical therapy (PT), occupational therapy (OT), for children who have disabling conditions, generally due to neurological or musculoskeletal disorders

Who Qualifies?

The CCS program services children and young adults under the age of 21 who have eligible medical conditions. Examples of CCS-eligible conditions include, but are not limited to, chronic and acute medical conditions such as cystic fibrosis, hemophilia, cerebral palsy, heart disease, cancer, traumatic injuries, and infectious diseases producing major sequelae.

For a more inclusive list of diagnoses and medical criteria of qualifying conditions please reference the below links:

https://www.dhcs.ca.gov/services/ccs

https://www.dhcs.ca.gov/services/ccs/Documents/CCSMedicalEligibility.pdf

Provider Responsibilities

Primary Care Physicians (PCPs), Specialty Providers, and IPA/Medical Groups are responsible for performing appropriate baseline health assessments and diagnostic evaluations sufficient to identify children and young adults with potential CCS-qualifying conditions and refer to CCS as needed.

PCPs are responsible for all well child and pediatric preventative services as these services are not a covered benefit of CCS. PCPs are also responsible in assisting CCS members with transition from CCS to IEHP authorizations at the age of 21 when members age out of the CCS program.

Benefits of CCS Enrollment

CCS Clients are not restricted to in area providers but have access to any CCS paneled provider within the state of California when a need for the specialty care has been determined to be CCS eligible. Once a client is determined to be eligible for CCS, the client will continue to be medically eligible for CCS until treatment is complete or age 21 when the CCS program ends.

Additional Resources

To assist our valued Providers, every Member active with CCS has a distinct red “CCS” widget in the Provider Portal. Opening that widget enables you to view the diagnosis being treated and any Specialists and their treatment authorization range.

For any questions about your Member’s CCS care or management, please do not hesitate to contact IEHP’s CCS Team at: (800) 706-4347 or by email at CCSCareManagement@iehp.org .

(By clicking on the links below, you will be leaving the IEHP site)

For additional CCS resources please reference the below links:

CCS Program Overview: https://www.dhcs.ca.gov/services/ccs

CCS Program Application: https://www.dhcs.ca.gov/formsandpubs/forms

CCS Brochure (English/Spanish): https://www.dhcs.ca.gov/services/ccs/Pages/CCSBrochure.aspx

How to become a CCS Provider: https://www.dhcs.ca.gov/services/ccs/Pages/ProviderEnroll.aspx

You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

Community Supports Services

Community Supports services are medically appropriate and cost-effective alternatives that MCPs may offer in place of services or settings covered under the California Medicaid State Plan.

Beginning January 1, 2022, IEHP will be offering 11 of the 14 DHCS Preapproved Community Supports services. Please click on the service for additional details.

1. 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.
2. 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.
3. 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.
4. 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.
5. Housing Tenancy & Sustaining Services
This service provides tenancy and sustaining services, with a goal of maintaining safe and stable tenancy once housing is secured.
6. Housing Transition Navigation Services
Housing transition services assist Members with obtaining housing.
7. 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.
8. 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.
9. 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.
10. 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.
11. Sobering Centers (Riverside County)
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.
12. Day Habilitation Programs
Day Habilitation Programs are provided in a participant’s home or an out-of-home, non-facility setting. The programs are designed to assist the participant in acquiring, retaining, and improving self-help, socialization, and adaptive skills necessary to reside successfully in the person’s natural environment.
13. Respite Services
These are provided to caregivers of participants who require intermittent temporary supervision. The services are provided on a short-term basis because of the absence or need for relief of those persons who normally care for and/or supervise them and are non-medical in nature.
14. Personal Care and Homemaker Services
This service is provided for individuals who need assistance with Activities of Daily Living (ADL), such as bathing, dressing, toileting, ambulation, or feeding. Personal Care Services can also include assistance with Instrumental Activities of Daily Living (IADL), such as meal preparation, grocery shopping, and money management.

IEHP Direct and Delegated Providers can submit referrals for Community Supports via the Provider Portal. For questions on how to submit a referral or more information relating to the above services, Providers can call the Provider Call Center at (909) 890-2054 or (866) 223-4347.

If you have programmatic questions, please email DGCommunitySupportTeam@iehp.org

• Community Supports Provider Brochure - English (PDF) | Spanish (PDF) | Chinese (PDF) | Vietnamese (PDF)
• Community Supports FAQs (PDF)
• Medi-Cal Community Supports or In Lieu of Services (ILOS) Policy 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.

IEHP Enhanced Care Management

IEHP Enhanced Care Management (ECM) is a no-cost Medi-Cal benefit that addresses the clinical and non-clinical needs of high-need, high-cost IEHP Members through systematic coordination of services and comprehensive care management. ECM is a collaborative and interdisciplinary approach to providing intensive and comprehensive care management services to individuals. It serves to build on the Health Homes Program (HHP) and Whole Person Care (WPC) pilots and transitions those pilots to one larger program to provide a broader platform to build on positive outcomes from each program.

ECM provides these vulnerable Members an additional care team to help coordinate and manage their care. The care team consists of a Nurse Care Manager, a Behavioral Health Care Manager, a Care Coordinator, and a Community Health Worker. These specially trained professionals collaborate with IEHP Members' Primary Care Physicians, Specialists, and family support systems to create a personalized plan of care.

Beginning January 1, 2022, please direct eligible IEHP Members who need the ECM services to call IEHP Member Services at (800) 440-4347, Monday - Friday, 8am - 5pm. TTY users should call (800) 718-4347.

If you have programmatic questions, please submit them to ECM@iehp.org.

• IEHP Enhanced Care Management Member Brochure (PDF)
• CalAIM Enhanced Care Management Policy 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.

IEHP Gender Health

For education and training on gender health care, please access the following resources:

• IEHP Transgender-Gender Health Center of Excellence Program Guidelines (PDF)
• IEHP Gender Health Brochure (PDF)
• Adult (PDF) (For IEHP Members 18+)
• Child (PDF) (For Parents and Children under 18)
• IEHP Social Health Survey (PDF)
• Questionnaire - Providers for Transgender Members (PDF)

You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

ADA and Beyond

By clicking on the links below, you may be leaving the IEHP website.

ADA and Beyond: A resource for health providers, IPAs and others interested in the Americans with Disabilities Act, California law as it related to accessibility and Universal Design.

In partnership with our Provider Network, IEHP strives to break down barriers to medical care and promote health and wellness for Members with disabilities.

With accessibility issues often cited as an obstacle to care, we publish this site to help all stakeholders in the health care system understand the barriers and in some cases the solutions. We invite you to browse these topics:

• 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.

1. Policies, Practices, and Procedures
2. Communicating with Customers Who Have Disabilities
3. New Buildings, Additions, and Remodeling
4. Removing Barriers in Buildings That Are Not Being Remodeled
5. Providing Access When Removing Barriers Is Not Readily Achievable
6. Maintaining Accessibility
7. Transporting Customers
8. ADA Compliance Costs and Tax Incentives
9. Enforcement of the ADA
10. Information Sources

Take the ADA online course

Pacific Region ADA Technical Assistance

Disability Business Technical Assistance Center (DBTAC) Region IX 

National Institute on Disability and Rehabilitation Research U.S. Department of Education
1995

Get information on your compliance obligations, problem-solving assistance, and referrals from ADA experts – without the high cost of a consultant. The 10 regional ADA & IT Technical Assistance Centers serve strictly as educational entities to help you understand your rights and responsibilities and have no enforcement or advocacy responsibilities. Federal Region IX, Pacific, serves: Arizona, California, Hawaii, Nevada, and the Pacific Basin.

• Visit Pacific ADA Center
• Visit DBTAC Homepage
• Visit NIDRR

Community Based Adult Services (CBAS)

• 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.

Major Organ Transplant (MOT)

Effective January 1, 2022, per DHCS All Plan Letter (APL) 21-015, Inland Empire Health Plan (IEHP) is now responsible for coverage of the Major Organ Transplant (MOT) benefit for adult and pediatric transplant recipients and donors, including related services such as organ procurement and living donor care.

 

What Transplant Services are Available for Members?

 

Centers of Excellence (COE)

For transplant care, IEHP has partnered with various, local, Centers of Excellence (COE). A COE is a recognized program within an existing healthcare center that provides a concentration of specialized care,  delivered in a comprehensive, interdisciplinary manner. Their focused care in distinct areas provides exceptional, integrated care that can lead to better Member outcomes.  

• Bone Marrow - CHLA, City of Hope, LLUMC, UCSD, USC (Norris)
• Heart - USC (Keck), LLUMC, Rady's Children, Sharp Memorial, UCSD
• Intestinal - CHLA
• Kidney-Pancreas - LLUMC, UCI
• Liver- CHLA, LLUMC, USD, USC (Keck)
• Lung - UCSD

     You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here

 

My Path Palliative Care

My Path is IEHP’s palliative care program that provides Member and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. My Path addresses the Member’s needs, including physical, emotional, and spiritual, while facilitating Member autonomy, access to information, and choice. The My Path program consists of: a palliative care assessment and consultation; advanced care planning; individualized written plan of care; pain and symptom management; mental health and medical social services; care coordination; and a palliative care team.

• My Path Program Brochure (PDF)
• My Path Program - Pediatric Brochure (PDF)
• My Path Program Guidelines (PDF)
• My Path Program FAQs (PDF)
• My Path - A Palliative Care Approach (PDF)
• Certification of Advanced Disease (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.

Services for Teen Patients 

Help your teen patients get the services they need! 

The online teen resource guide will help direct teens to community resources - from abuse and domestic violence counseling, to birth control and pregnancy testing, to job training and recreation.

By clicking on this link, you will be leaving the IEHP website.

• San Bernardino County Teen Resource Page

Click on the following links to jump to that specific section:

Total Fracture Care Program

The Total Fracture Care Program allows IEHP Members to be seen by a participating Orthopedist for global fracture care without a prior authorization.  This Program ensures that Members in need of fracture care by an Orthopedist, as determined by an Emergency Department Physician, Urgent Care Physician or Primary Care Provider, will receive timely access to care.

Policy Reference:

• 10 - Medical Care Standards

Total Fracture Care Providers

• Arrowhead Orthopaedics 
  • For more information and locations, please visit: https://www.arrowheadortho.com/
• Newport Care Medical Group
  • For more information please call: (951) 363-5064

 

You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.