Central California Alliance For Health

 

Health Education and Disease Management Programs


The Alliance is committed to improving access to affordable health care for our members. We offer innovative programs to help members achieve healthier outcomes. These programs are managed by a multidisciplinary team comprised of experienced health educators and registered dietitians. They assist members with techniques to stay healthy and understand and manage chronic conditions, including enrollment in Health Education and Disease Management Programs. Members can receive incentives for their participation in some of these programs through the Alliance’s Member Incentive Program. Only Alliance Medi-Cal members who do not have other health insurance are eligible to participate in the Member Incentive programs.


For more information about our Health Education and Disease Management programs, please click the links below:

•  Care Management Services
•  Quick Reference Guide
•  Clinical Health Education Benefits



Health Education

Appropriate Use of the Emergency Department

In order to reduce avoidable Emergency Department (ED) visits for young children, the Alliance offers members the book titled What To Do When Your Child Gets Sick. This book is written in easy-to-read language for parents and caregivers for children from birth to 8 years of age and can be sent to any member upon request by the member or their primary care provider (PCP).


Breastfeeding Support

The Alliance gives new moms access to breastfeeding education, support, and referrals. New moms are eligible for a free breast pump if either mom or baby has medical issues that prevent nursing at the breast or if the mother is returning to work or school and wants to continue breastfeeding.


• Click here for the Breastfeeding Support and Breast Pump Benefit Description.

• Click here for the Breast Pump Vendor List.

Health Education Resources

The Alliance offers a wide variety of health education resources for our members. These resources can be accessed by calling the Health Education Line at (800) 700-3874 ext. 5580.


The Alliance Health and Wellness Calendar,includes a list of community resources on a variety of topics, including behavioral health, nutrition/fitness, pain management/alternative treatment, social support services/domestic violence, and substance use/tobacco cessation. Classes or programs are offered at no cost, low cost, or on a sliding scale to help members and their families live a healthier life.

Living Healthy, our quarterly trilingual (English, Spanish, and Hmong) member newsletter, provides information on Alliance services and benefits, personal health, and local health education resources.

Ask Me 3 is a patient education program designed to improve communication between patients and health care providers, encourage patients to become active members of their health care team, and promote improved health outcomes.

• The Centers for Disease Control and Prevention offers information on topics ranging from disease and conditions, to healthy living, travelers’ health, emergency preparedness and more.

Healthy Moms and Healthy Babies Program

The Alliance's Healthy Moms and Healthy Babies (HMHB) program is designed to encourage pregnant women to seek early prenatal and postpartum care. These members can earn up to $50 in gift cards.


Early Prenatal Care - Pregnant members who have a prenatal visit (Early Prenatal Care) within their first 13 weeks of their pregnancy or within 42 days of becoming an Alliance member can receive a gift card. PCPs who submit the form to the Plan within 21 business days from the date of services to indicate members have received an initial prenatal consultation will receive payment through our CBI program. The prenatal visit does not need to be a comprehensive official prenatal exam and can simply be a diagnosis of pregnancy and referral to relevant specialist or PCP for continued prenatal services.


Early Prenatal Care Form


• Fillable Early Prenatal Care Form in English or Spanish or Hmong.

Fax this form to the Alliance at 1 (877) 793-8504.


Postpartum Care - New moms can also receive a gift card for their postpartum visit (Postpartum Care) if they see their PCP within 21-56 days of the birth of their child. The member will receive this incentive once the PCP has billed the Plan for the encounter and no form is required. The provider to which the member is linked at the time of the visit will receive payment for either 1) performing the visit or 2) the visit is being performed by a referral specialist.



Text4Baby - free information to keep you and your baby healthy

The Healthy Mothers Healthy Babies coalition has developed a free text messaging program to provide new moms with tips on the importance of prenatal and postpartum care, breastfeeding, lead poisoning prevention, immunizations, nutrition, exercise, and much more. Pregnant women and new moms who sign up will receive messages timed with their due date or baby's date of birth.



• Click here for information on how to sign up for the Text4Baby program.

Tobacco Cessation Support Program

The Tobacco Cessation Support program offers many ways to help members quit smoking. Members are referred to the convenient, toll-free California Smokers' Helpline at 1-800-NO-BUTTS (1-800-662-8887), which provides free cessation counseling over the phone for anyone in California. The program can also help members enroll in an approved smoking cessation class. Providers can complete the program application form to make a referral, or a member can self-refer. The program is a state-wide support organization that offers members a No Butts kits containing literature, quitting aids ideas, and approved smoking cessation classes for their specific county.


• Click here for the Tobacco Cessation Support program application, including eligibility and referral process information.

• Click here for the Tobacco Cessation Benefit Description.



Women's Preventive Screenings

The Alliance is committed to encouraging early detection and preventive screenings for women's health issues. The Alliance sends quarterly mailings to remind members who, according to claims data, are due for a chlamydia screening, breast cancer screening, or cervical cancer screening. Reports listing linked members who are due for breast cancer and cervical cancer screenings are available to all providers in the Alliance Provider Portal.





Disease Management

Healthier Living Program

The Alliance’s Healthier Living Program (HLP) is based on Stanford’s Chronic Disease Self-Management Program, and is designed to help Alliance members diagnosed with chronic conditions gain self-confidence in their ability to control their symptoms and understand how their health problems affect their lives. The program focuses on problems that are common to individuals suffering from any chronic condition, such as pain management, nutrition, exercise, medication usage, emotions, and communicating with doctors. The HLP is led by two trained Alliance staff facilitators and the workshops consist of six, 2 1/2 hour sessions. For a list of upcoming classes, click here.



Healthy Breathing for Life Program

In the Healthy Breathing for Life (HBL) program, Health Programs staff work with members ages 5-64 to assess their level of understanding about asthma management. Members can also be referred to an Alliance-approved clinical asthma education provider.


The Asthma Action Plans provides instructions and information on how to self-manage asthma daily, including taking medications appropriately and how to recognize and handle worsening asthma.


• Click the links below for the HBL Programs forms.
  – Fillable AAP in English or Spanish or Hmong

• Click here for the Healthy Breathing for Life program overview.

• Click here for the Asthma Education Benefit Description.

• Click here for Approved Asthma Education Providers.

Healthy Weight for Life Program

Healthy Weight for Life (HWL) is an Alliance health program designed to promote healthy lifestyles, self-care and the prevention of chronic disease. The Alliance works with contracted providers to identify and refer member ages 2-18 whose Body Mass Index (BMI) is at or above the 85th percentile. Members who lower their BMI percentile by 3 or more percentile points can receive up to $50 in gift cards.


Click the links below to view additional information about BMI calculations, the HWL Program, and to access the HWL Program forms. Referring providers must use these forms to refer members to the HWL Program.

PCPs that complete the initial referral form and a follow-up form 6-12 months and fax these forms to the Alliance at (877) 793-8504 may be eligible for payment through our CBI program. Forms must be completed by the linked PCP site to receive credit. Payments are per approved form, per linked member, per year.


Please fax only the completed referral form to the Alliance, not the prescription form. Give the completed prescription form to the patient and keep a copy in the patient's file.

Initial Referral, 6-Month and 12-Month Follow Up Referral Form
   - English
Initial Referral, 6-Month and 12-Month Follow Up Referral Form
   - Spanish
Initial Referral, 6-Month and 12-Month Follow Up Referral Form
   - Hmong
Instructions for Calculating BMI
CDC BMI Percentile Calculator for Child and Teen


Live Better with Diabetes Program

Health Programs staff work with members with diabetes and provide education on diabetes management. Alliance staff also refer members to Alliance-approved clinical diabetes management education providers.


• Click here for the Diabetes Prevention and Self-Management
   Education Benefit Description.

• Click the links below for a Diabetes Eye Exam Services
   Resource List
   English or Spanish or Hmong.

Weight Watchers Support Program

The Weight Watchers Support (WWS) program provides scholarships for members to participate in the Weight Watchers weight management program. This program is not an Alliance or Medi-Cal benefit. In order to join the WWS program, the member must have the Alliance as their primary insurance, the member must meet the referral criteria provided by their PCP, and the program application must be completed by the provider. Members can only be enrolled in the WWS program once due to a limited number of scholarships available.


• Click here for the program application, which includes eligibility and referral information.



How to Become a Clinical Health Education Provider

The Alliance offers clinical health education and self-management services. If you are interested in becoming an Alliance approved Clinical Health Education (CHE) provider, please review the appropriate checklist below for details on the application and approval process. The application and information for submission are located below the checklists.


Clinical Health Education Provider Approval Checklists:

      •  Diabetes Self-Management Education

      •  Asthma Self-Management Education

      •  Breastfeeding and Lactation Self-Management Education


Clinical Health Education Provider Application


If you would like to become an Alliance CHE provider, please complete the application and submit copies of current medical license(s) and other documentation outlined in the appropriate checklist linked above. You may submit this information via mail, email, or fax to:


Mail: ATTN: Health Programs
Central California Alliance for Health
1600 Green Hills Road, Suite 101
Scotts Valley, CA 95066-4981


Email: cheb@ccah-alliance.org


Fax: (831) 430-5852


For information about or referrals to Health Education and Disease Management Programs, please call the Health Education department at (800) 700-3874 ext. 5580.


 

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