They came to help, from across the Health Plan of San Joaquin organization. Drawing from Medical Management, Customer Service, Provider Services and Contracting, Claims/Billing and Appeals/Grievance, TEAM HPSJ (seen in part, above) recently hosted a lunch & learn session for our network practices serving HPSJ children. The topic was California Children's Services: How to help practices work more smoothly with CCS when the diagnosis is CCS-covered. 
         
CCS is a statewide medical case management program that authorizes and pays for medical services, treatment services and equipment for children meeting CCS eligibility criteria. Only certain medical conditions are CCS eligible. Some that may be eligible are: heart conditions, blood disorders, complications of premature birth and lung problems.

CCS services are of great consequence to many of our valued HPSJ network partners. With our in-house expertise and the ability to convene an educational session bringing together CCS staff and providers, we believe this is yet another one of the timely, important ways we can support our local practices, as well as HPSJ children and families.
         
Together, HPSJ and CCS staff were able to answer practical questions and point guests toward resources for provider staff, as well as how clinicians can prepare for those inevitable times when a young, CCS-eligible patient may need help, for example, by applying for and meeting standards for one of the CCS Physician Paneling Categories.
         
For more about CCS, go to California Department of Health Care Services (DHCS), at www.dhcs.ca.gov.ccs.
"We recognize how important it is for your patients, especially those with functional access needs, to be able to see their specialty providers and access needed treatments in a timely manner. CCS is pleased to work with Health Plan of San Joaquin on educating local providers about our services. We hope that by guiding clinicians through the referral process and teaching them how CCS determines a case to be eligible or not, we all can become more efficient. Offices can spend less time and energy on the process, and most importantly, families can access the care their children need."
- Maggie Park, MD, California Children's Services (CCS) Medical Director for San Joaquin County
"HPSJ is committed to improving the health of our community. We believe you can see this commitment in our efforts to increase the number of members that receive annual preventative services and manage diseases according to their physician's treatment plans." - HPSJ HEDIS & Accreditation Manager Tamara Foster

HEDIS: Healthcare Effectiveness Data and Information Set, a standardized set of performance measures developed by the National Committee for Quality Assurance to evaluate consumer health care.
Children
It is important that our children receive vaccinations on time, during annual wellness exams that include a complete assessment of nutrition, physical activity and weight management. Recommendations from the U.S. Department of Health and Humans Services underscore the importance of immunizations to protect kids against more diseases than in generations past. Many children have health reasons that prevent them from receiving many vaccinations, so it is  especially important that those they are in contact with are healthy, and immunized. For more, click here.

Women's Wellness Exams
Annual wellness exams can detect abnormalities early and increase chances of finding a cure, for example discovering abnormal cells before they turn into cancer. It is recommended that women receive an annual screening for cervical cancer starting at age 21 and then have one every three years. Breast cancer screening should be done annually for women over 40. HPSJ encourages women to see their primary care doctor every year for a complete wellness exam. It's the key to better health and part of a healthy lifestyle. For more, click here.
Our adult members - men and women - should also be monitored at each appointment for weight management to prevent diseases that are proven to be related to obesity, such as Type 2 diabetes.

For tips and a list of exams men need for good health, click here to go to the HPSJ Health Articles Library.

Also in the HPSJ Health Articles Library is "HPSJ urges women to stay informed about their health." To read the article and clip the list of recommended tests, click here. 
It's officially flu season. We want to help all those you work with - from patients, to clients or members, to constituents - get the preventative care they need. Sometimes it can be as simple as a reminder. For example, fliers (like this, at right) posted in offices, or starting the conversation at "Hello."

In need of marketing materials to post in your office, or use online? The CDC (Centers for Disease Prevention and Control) is a great resource for materials. They also have widgets  and other promotional services that can get the word out to individuals and their families. See what's available online at http://www.cdc.gov/flu/freeresources/print.htm. You can even search for materials by demographic to ensure that your particular audiences get the message you want to send about flu vaccines.

For members of Health Plan of San Joaquin
Flu vaccines are a covered benefit for HPSJ's almost 350,000 members. We want to make sure that each knows how to get the vaccines when apprpropriate.

For HPSJ's pharmacy benefit, the flu vaccines coverage is as follows:
  • All vaccines EXCEPT the FluMist and Fluzone (High Dose)
  • Only for patients age 19 or older
  • For <19 years old it is covered under the VFC program - these members should go to their doctor's office

"We know flu season can be tough for families and the clinics that serve them. HPSJ is committed to ensuring that all of our members have access to reliable health information, when they need it. HPSJ's HealthReach Nurse Advice Line includes 24/7 support and now includes a telephone live physician service.

For non-emergent needs and a list of urgent care locations, HPSJ members can call the number on the back of their HPSJ member ID card. Visit HPSJ.com for more information on flu resources and HPSJ's Nurse Advice Line Services."
- HPSJ Health Education Setar Testo



This season's flu vaccine is expected to arrive in October and will be available through health care providers and practitioners, and at local pharmacies.

Our United Way Superheroes have made a great start for the 2017 campaign. The HPSJ Modesto Office Team is led by (bottom right) Cristina Lemmo (HR), Ember Clinkenbeard (Medical Management) and - in full flight - Henry George (Configuration). 

They are well underway with plans for this year's United Way Stanislaus/HPSJ partnership kick-off October 2nd, in the Plaza of HPSJ's Modesto office.

 

 
"Health Plan of San Joaquin employees, in partnership with United Way in both Stanislaus and San Joaquin counties, contributed a combined $37,392 last year, for the 2016 campaign. For HPSJ, this is the latest in a long tradition where HPSJ employees step up and out, on behalf of our members and communities. During the past 18 years, HPSJ employees (now numbering almost 300) have raised $395,000.
- HPSJ Chief Financial Officer Michelle Tetreault, who is on the United Way Stanislaus board and is also a United Way Superhero, is seen (at left) in her daytime guise.
 
"Much of what we raise for United Way comes from office fundraising drives, everything from barbecue and bake sales, a silent auction and wear-your-jeans-to-work-days."
- HPSJ External Affairs VP David Hurst, a member of the United Way of San Joaquin County board of directors.

Team HPSJ French Camp, seen at right planning a full slate of fun & fundraising, is led by (from left) Julie Manivong (Medical Management), Melissa Surgick (Provider Contracts), Fran Hattner (Project Management), Jessiely Corpuz (Claims), Luisa Smith (External Affairs) and Susan Broughton (Project Management).

HPSJ employees also were treated to a United Way Agencies Information Fair with local community groups working in multiple ways on behalf of our community. Staff were able to hear about their mission and ask about the details of their work.
This month we have two more for the HPSJ Health Articles Library.

Halloween Safety Tips
This will keep everyone safe, and Halloween Happy.
Click here for the full article.

 
October is Health Literacy Month.
Click here for the full article

Because HPSJ has for decades been committed to the proposition that healthy families read, here are some more suggestions for how to celebrate literacy in October.
  1. Join CEO Amy Shin (seen at left) and HPSJ employees in our support for Little Free Libraries (LFL). Click here to find out how to become a LFL patron in your neighborhood.
  2. With the end of year holiday seasons approaching, this is a great time to start buying books - for all ages.
Please help spread the word for health by using these - and any of the other HPSJ Health Library articles for your print and/or online communications vehicles. Click here for the full catalogue.
20th Anniversary of Family Day in the Park -
Literacy Event for Thousands of Kids & Families
For most of these two decades, HPSJ has been a sponsor of this all-around great literacy event created by the Stockton Record. Again sponsoring the HEALTHY HIGHWAY section that we created, HPSJ hosted (and covered participation fees for) 14 additional local participants - Delta Health Care, University of the Pacific, Community Medical Center, Emergency Food Bank, Public Health Advocates, Shriners, Catholic Charities, APSARA, NAMI, (County) Department of Aging, Healings in Motion, VSP, Valley Mountain Regional Center (VMRC) and Beacon Behavioral Health.

With well over 15,000 attending, Record Editor Donald Blount said it best: "If you like reading, music, games and fun, then The Record's Literacy & Book Fair Family Day in the Park was the place to be on Saturday (Sept.16)."
Make-A-Wish®
Health Plan of San Joaquin is a proud supporter of Make-A-Wish® Northeastern California and Northern Nevada, the nationally recognized nonprofit with a mission to grant wishes to children with life-threatening medical conditions. As part of this M-A-W chapter, our local Mid-Valley Regional Council covers Stanislaus and San Joaquin counties. Since 1983 - when we were one of the first M-A-W chapters in the nation - we've granted more than 6,000 wishes. Click here to learn more about WISH STORIES.
"HPSJ has endorsed the important work of M-A-W for many years, including support for fundraisers, employee volunteers, interpreters and the use of our community rooms for planning meetings, training and special events. Last year, M-A-W granted 64 wishes with help from 54 local volunteers, as well as many physicians - including those in the HPSJ provider network - who refer eligible children."
- HPSJ External Affairs VP David Hurst, co-chair of the M-A-W Regional Council

You can help M-A-W grant the wishes of the 108 local kids waiting for their wish. Please volunteer or make a contribution today. Go to http://necannv.org/.     

Coming Oct. 11:  the M-A-W Volunteer Orientation; click here for details. 
Taft Elementary Library Grand Re-Opening
The invitation to HPSJ from Taft Elementary School Principal Jana Brooks for the Grand Re-Opening of the campus library said: "Your organization was instrumental in helping get books on the shelves during their Holiday Bookfair when your employees placed many orders for cheesecakes to help with the contribution of a Barnes & Noble Gift Card - used to purchase new books for the students."

HPSJ Health Promotions Specialist Angela Dennis (front row, third from left) represented Health Plan of San Joaquin for the joyous ceremony, that included our fellow supporters from - Stockton Unified Board of Trustees, The Record, Barnes & Noble, Bank of Stockton, Family Resource and Referral Center, Tuleburg Press, San Joaquin Delta College Teachers Association and Weston Ranch Library.
Veterans' Town Hall 
Comes to HPSJ Community Room

Congressman Jerry McNerney hosted a town hall for veterans in the HPSJ French Camp Community Room. Special guests were (from left) HPSJ CEO Amy Shin and Assemblywoman Susan Eggman.

As part of HPSJ's decades-old tradition of local collaboration and partnership, we often make our French Camp and Modesto community rooms available for community organizations to hold such gatherings.
 

Pride Festival 2016

As a long-time Pride Center supporter, HPSJ was delighted to again be a sponsor for the Pride Festival.
This sixth Pride Festival was a fund and friend-raising event that helps makes possible the Center's life-altering, even life-saving, year-round support for our regional community. 

As you can tell from one of the many pictures HPSJ staff snapped, it was also a rollicking good time. Here's Syla Ka (HPSJ Outreach) with her new friend!

For more about the Pride Center, click here.
 
I received a call from a husband who wanted to change his wife's primary care physician (PCP). His wife, an HPSJ member, spoke only Arabic - her PCP does not. Using our Customer Service Language Line, she and I were able to speak together directly. She explained that she wanted to switch her PCP because of the language barrier. She has several health conditions that require routine medical follow-ups, but often skips these appointments because her husband works and she believes she has no one to translate during office visits. 

I told her about some of the language services HPSJ offers that can help her. These include In-Person Interpretive Services and Language Line options to help her communicate during appointments.

She was extremely appreciative, especially as she could communicate on the call, without needing her husband's help.
- Health Plan of San Joaquin Customer Service Supervisor Miriam Lopez
We work closely with a wide variety of diverse individuals who've had challenges navigating or understanding how to use the health care system.

Language barriers can have harmful effects. Patients who face such barriers are less likely than others to have a usual source of medical care; they receive preventive services at reduced rates; and they have increased risk of non-adherence to medication prescribed by their doctors. HPSJ is focused on making sure our Limited English Proficient (LEP) and Deaf & Hard-of-Hearing members have equal access to health care services by providing interpreters and translation services.

An HPSJ member or any LEP patient should never have to depend on a family member or friend to interpret for them at an appointment. We work diligently to schedule for our members a trained and qualified interpreter for all their medical and health care-related appointments.
- HPSJ Health Promotion and Cultural & Linguistics Manager Jenny Dominguez
 
Please join HPSJ employees as we walk to support these causes
  • October 15, American Cancer Society, Making Strides Against Breast Cancer (Modesto) click here for information   
  • October 21, Disability Resource Agency for Independent Living, Great Pumpkin Color Walk/Run (Modesto)  click here for information
Sixteen employees stepped out September 16 for HPSJ Walks for Health to support the Stanislaus Heart Walk in Turlock. Led by HPSJ Vice President for Human Resources Marc Radner, our HPSJ Walkers Team Leader for the Day (4th from the right), here are many of them (from left): Brittani Baker (Claims), Angela Dennis (External Affairs), Kentraiell Miller (Claims), Zachary Radner (Marc’s son), Nancy Calderon (External Affairs), Marisa Hampton (HR), Glenda Guzman (Provider Services), Christina Nieto (Claims), Chris Felton (HR), Marc Radner (HR), Cris Lemmo (HR), Nancy McFadden (Configuration) and Fran Hattner (Project Management Office). 

Click here for more information from the American Heart Association.
CHEER
Community Health Education and Engagement Referral Program

Health Plan of San Joaquin is dedicated to helping members staly healthy and happy. We provide services and programs that help members manage their health. We partner with organizations in our community to provide members with quality health education classes to achieve and maintain healthy lifestyles and promote positive outcomes. Click here for more.
   
Proud to be an NCQA Accredited Health Plan
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