SEPTEMBER 2018 Volume 24, Issue 3 HEALTHY A newsletter for the members of Central California Alliance for Health

YOU AND YOUR HEALTH are important to us. Please call us at 1-800- 700-3874 (TTY: 1-800- 735-2929 or 7-1-1) if you have questions, need help or have concerns about your care as an Alliance member. We’re here to help! Service with a smile! Have you ever wondered who is on the ●● Answer questions about your ●● Send you a new Alliance ID card if other end of the phone when you call benefits you lose yours Member Services? ●● Explain how you can get medical ●● Assist you with concerns or Our representatives are caring, care and services complaints dedicated professionals. They are here ●● Let you know which doctors and We have representatives in Santa to answer your calls Monday through clinics you can go to Cruz, Monterey and Merced counties. Friday from 8 a.m. to 5:30 p.m. ●● Help you choose or change your They live and work in the communities Our representatives are ready to: Primary Care Provider we serve. What they have in common ●● Help you understand how your ●● Offer interpreter services if you do is that they care about our members health plan works not speak English, Spanish or Hmong and are here to help.

Important notice Member Services will not be available on the following dates and times due to companywide or departmental meetings:

●● November 7, all day

Permit No. 1186 No. Permit

● CA Merced,

● December 13, from 10:45 a.m. 95066 CA Valley, Scotts PAID

1600 Green Hills Road, Suite 101 Suite Road, Hills Green 1600 U.S. Postage U.S.

to 3:45 p.m. Health for Alliance California Central Standard Mental health services: ●● Medi-Cal. Members can access outpatient mental Your health services through Beacon Health Options (Beacon). To find more benefits: information or to find a provider near you, call Beacon at 1-855-765-9700 or visit its website at Did you beaconhealthoptions.com/ members/login. Inpatient and specialty mental health know? services for Medi-Cal members are covered through your county’s Mental Health Department. If you’re not Member benefits to 20 visits per benefit year those who are in a skilled or sure what type of care you Acupuncture and (July 1 through June 30) intermediate care nursing need, you can call Beacon, chiropractic services: for each service. There is a facility. To learn more about and they can help determine ●● Medi-Cal. Members can copayment of $10 per visit. your vision benefits or to that and connect you with get a total of two services You will need a referral from find a provider near you, call the right type of care. per calendar month. For your Primary Care Provider Vision Services Plan (VSP) at The numbers to call for example, you can get one to get these services, and 1-800-438-4560. The online the county Mental Health acupuncture visit and one you must go to a contracted VSP Provider Directory can Departments are: chiropractic visit within a provider in our service area. be found at https://provider XX Santa Cruz County: month or you can choose to For more information or .portal.ccah-alliance.org/ 1-800-952-2335 get two chiropractic visits to find a provider near you, providerdirectory/. XX Monterey County: within a month. No referral is call Member Services or visit ●● IHSS. Routine eye exams 1-888-258-6029 required, but you must go to www.ccah-alliance.org. and glasses are not covered XX Merced County: a contracted provider in our benefits. There are some 1-888-334-0163 service area. If your provider Routine vision care: medical vision services that ●● IHSS. Members can access feels you may benefit from ●● Medi-Cal. Members are benefits, such as specialty both inpatient and outpatient having more acupuncture can get an eye exam every care from an ophthalmologist. mental health services through visits for pain management, 24 months. Eyeglasses are For more information, please Beacon. Members can call he or she may send us an a covered benefit only for see your IHSS Evidence of Beacon at 1-800-808-5796 authorization request. members under age 21, Coverage, look on our website or visit beaconhealthoptions ●● IHSS. Members can get up those who are pregnant, and or call Member Services. .com/members/login. Medi-Cal services covered by the state (not the Alliance) Did you know that Medi-Cal offers comprehensive For more information or to find a dentist near you, dental benefits to both children and adults? The services call Denti-Cal at 1-800-322-6384, Monday through are provided through the Denti-Cal Program, not Friday, 8 a.m. to 5 p.m. (Pacific Standard Time) or visit through the Alliance. its website at www.denti-cal.ca.gov.

2 HEALTHY CCS services under Whole Child Model Program

The Alliance knows that California Children’s Services (CCS) families have created strong relationships with County CCS Program staff over the years. That is why we are working very closely with each County’s CCS Program to understand you and your child’s needs and to continue coordinating your child’s services without interruptions or delays. Here are some of the most frequently asked questions from our CCS families:

Is my child still able to: Do I still need to renew my Who can I call when I have a Q. � See their Primary Care Q. child’s CCS eligibility every Q. problem with CCS care, Provider (PCP)? year, and who can help with that? questions or any concerns? � See their specialists? � Get care at Valley Children’s, Yes, the County CCS Program staff The Alliance has Case Management Stanford Children’s, Lucile A. will continue to help complete the A. staff who can help answer questions Packard or another children’s annual eligibility for CCS. Members or concerns about your child’s care. hospital provider? will need to be both Alliance Medi-Cal A Case Manager will help coordinate members and enrolled in the CCS your child’s care and is your go-to Yes, your child is able to see their Program. person. If you don’t know who your A. existing PCP and specialist, as Case Manager is, call the Alliance long as the provider agrees to continue Who can I call if I have a problem Care Management Pediatric Line at seeing your child and is willing to Q. with my Medi-Cal eligibility? 1-800‑700‑3874, ext. 5513. work with the Alliance. The Alliance is honoring authorizations You should call your local County in place before the transition date A. Medi-Cal office. If your child (July 1). receives Supplemental Security Income (SSI), you should call the Social We are here TO HELP! Is my child able to get: Security Administration office. Q. � Their medication? ●● Member Services: � Their specialty medication? Are transportation services 1-800-700-3874 Q. available for my child’s ●● Care Management Yes, existing prescriptions are appointments? Pediatric Line: 1-800-700-3874, ext. 5513 A. being filled at your regular pharmacy. Yes, the Alliance can assist with ●● Transportation: 1-800-700-3874, ext. 5577 Existing prescriptions for specialty A. transportation services if your medications are being filled by an child has a medical appointment or if ●● Language Assistance: 1-800-700-3874 Alliance specialty pharmacy, called you need to pick up a prescription or Diplomat. We worked with your supplies. Prior authorization is required. ●● For the Hearing or Speech Assistance Line: specialty pharmacy to transition your Call the Transportation Coordinators’ 1-800-735-2929 1-800-700-3874, ext. 5577, medications to Diplomat. There line at at (TTY: Dial 7-1-1) should be no interruptions to existing least 5 to 7 business days before the ●● Website: www.ccah-alliance.org prescriptions. appointment or service date.

HEALTHY 3 FluMist for the 2018–2019 flu season FluMist is a nasal influenza vaccine. This vaccine was not on the list of recommended influenza vaccines for the past two years because it did not protect people against the strains of influenza going around in the United States. However, the Centers for Disease Control and Prevention (CDC) has voted to include FluMist in the list of recommended vaccines for children 2 to 4 years of age and for people 49 years or older for the 2018–2019 flu season. Children 2 to 4 years may need up to two doses of the vaccine. The flu season is during the winter months, but it is best to get the vaccine before the flu begins spreading in your community. Children that need two doses New shingles vaccine should start as soon as the vaccine is available, because the doses Shingrix® is a new vaccine approved the two-dose series to help prevent must be given at least four weeks by the U.S. Food and Drug shingles. The immune system gets apart. It takes about two weeks Administration to prevent the weaker as people age; this means after a person gets the vaccine for shingles virus (herpes zoster) for your risk of getting the shingles antibodies to start working in the people 50 and older. virus is greater. Shingrix® boosts your body and protect them from the body’s immune system to produce flu. What is shingles? more antibodies to fight the shingles Shingles is a virus. It causes a painful virus. blistering skin flare-up that is common The Shingrix® vaccine is covered by FOR MORE INFORMATION among people older than 50. Medi-Cal. You can get it from your ABOUT THE FLUMIST Primary Care Provider (PCP) or at a VACCINE, talk to your The vaccine pharmacy. You will need a prescription Primary Care Provider or Shingrix® is the only shingles vaccine from your PCP when you go to a visit the U.S. Food and that has been proven to work pharmacy. Drug Administration’s website at fda.gov/ 90 percent of the time. It is a two-dose For more information about the biologicsbloodvaccines/ vaccine series given as an injection Shingrix® vaccine, talk to your PCP. vaccines/approvedproducts/ into the muscle in the upper arm. The You can also visit the Centers for ucm508761.htm. second shot should be given two to Disease Control and Prevention at six months after the first shot. cdc.gov/vaccines/vpd/shingles/hcp/ It is important for you to get shingrix/recommendations.html.

4 HEALTHY A good time Do you have your to consider new glucose meter? The Alliance has changed the preferred diabetes products. Now members are covered for a breast health OneTouch Verio Flex® glucose meter. Alliance members with diabetes As of yet, there is no sure way to should have been given a prescription prevent breast cancer. by their Primary Care Provider (PCP) Even so, there are for a new glucose meter and test strips. steps you can take to If you do not have the new meter lower your risk. and test strips yet, you can: One key step? Stay at a healthy body ●● Talk to your PCP to get a new weight. This is even more important in prescription and take it in to your pharmacy. midlife and later. Here’s why: ●● Call to ask for a free meter to be shipped to your After a woman’s periods stop, most of her home at 1-855-544-4119 (code: 750CCA01; insurance estrogen comes from fat cells. Estrogen can spur the growth company: Alliance). of many breast tumors. That’s why too many pounds Please note: To get test strips, you will need a later in life could raise breast cancer risk. This seems to be prescription from your PCP. especially true if those pounds end up on your waist. There are a number of other steps you can take to help Why do we have a new glucose meter? prevent breast cancer. These include: The OneTouch Verio Flex® meter comes with Bluetooth® Avoid alcohol. Drinking can raise your risk of getting Smart technology. This allows you to send your readings breast cancer. In fact, your risk goes up the more you drink. to a mobile device, such as a smartphone or a tablet. You Move more. Exercise may be able to help lower your will be able to review your readings and monitor your risk. Try to get 150 minutes of moderate exercise or 75 glucose levels over time. The meter also allows you to minutes of vigorous exercise each week. modify the setting so Know the risks of hormone therapy. There are risks you will know if your and benefits of taking hormone therapy. Talk to your readings are within doctor to learn more. the range limits recommended by Finding breast cancer early your PCP. Follow the Breast cancer can still develop even with the above steps in the Quick safeguards. So be sure to talk to your doctor about when to Start Guide, which have mammograms. will come with your Regular mammograms can help find cancer in its early new meter, to get stages. Finding cancer early can help give you a head start started. For more on treatment. information, you can Some women may have certain risk factors. So you may visit onetouch.com/ need to talk with your doctor about additional screening products/glucose- tests, such as an MRI scan. meters/onetouch- Source: American Cancer Society verio-flex.

HEALTHY 5 Maternal mental health is important

A new baby changes the life of everyone in the family, especially mom. When a baby arrives, we may think it is a joyful time, but 1 in 7 women feels depressed during pregnancy or in

Formulary changes DRUG NAME USED FOR ACTION Firvanq Diarrhea due to bacteria Added called Clostridium difficle Hydrocortisone 2% lotion, Trianex 0.05% Ointment Inflammation/eczema Removed Condylox 0.5% gel Genital warts Removed Ibandronate 150mg tablet Osteoporosis Added Clindamycin 1% pledget/swab Acne Added Glyburide-metformin Diabetes Added Pioglitazone-metformin, Nateglinide, Chlorpropamide, Novolog, Diabetes Removed, Prior Apidra, Humalog Auth. required Lantus vial Diabetes Prior Auth. required VP-vite Rx, Calcium citrate 250mg Supplement Added Methylphenidate 5mg/5ml solution ADHD Added Cyclobenzaprine 7.5mg Muscle relaxant Removed Fluocinolone acetonide 0.01 % solution Skin dermatitis Added Flurbiprofen drops, Maxidex suspension Eye inflammation Added FML Forte suspension Eye inflammation Removed Levofloxacin drops, Ciprofloxacin droperette Eye infection Added Timoptic-XE gel, Istalol drops Glaucoma Removed Prasugrel Blood clots Added

6 HEALTHY ● FOR MORE the first year after the baby arrives. ● Totally overwhelmed INFORMATION AND A new mother may feel fear about ●● Weepy RESOURCES, VISIT: caring for her newborn. Fathers ●● Anxious or nervous ●● 2020 Mom’s website at and partners may also experience ●● Angry 2020mom.org depression or anxiety. Many new ●● Scared by your thoughts ●● Spanish Postpartum Support parents and families need help ●● Like you’re not yourself International at postpartum getting used to the changes a baby ●● Guilt .net/en-espanol brings. ●● Regret Caring for a new baby is hard work. ●● Shame You or your partner may not be getting Remember, you and your baby are enough sleep. You may not be eating not alone. You can: enough. You may be worried about the ●● Ask friends and family members for Beacon Health Options (Alliance’s baby’s health or struggling to care for support. contracted provider for mental health) your baby. ●● Talk to your doctor, midwife or at 1-855-765-9700 to ask for help. If you or a loved one has any (or all) child’s doctor about your feelings. IHSS members can call Beacon at of the following feelings, ask for help: ●● Medi-Cal members can call 1-800-808-5796.

PARENTS

zero-tolerance stance Talk to your college kids about drinking on underage drinking throughout college. You’re You’re the parent of a new 4 college students report child the risks of drinking showing continued concern college freshman—and it that drinking—and and make it clear that you for your child’s well-being. won’t be long before you especially binge drinking— do not want him or her to Be honest. If your drop your child off in the has hurt them academically. use alcohol. Zero-tolerance child asks about your past dorm and drive away. But They’ve missed classes, done messages are the most drinking behavior, be before you do, it’s important poorly on exams and papers, effective way to keep kids honest. Own up to any risks to make sure your child is and received low grades as a from drinking in college. you took—and any negative fully aware of the risks of result of using alcohol. Keep talking. The first outcomes that resulted. college drinking. They can’t 6 weeks of the freshman But answer your child’s be overstated. Your role year are a vulnerable time questions in ways that don’t Every year in the U.S., The good news: You still for heavy drinking. Even suggest underage drinking college drinking contributes have heavy influence over so, keep reinforcing your is OK. to: your child’s choices, even ●● 1,569 accidental deaths, into the college years. including car crashes Studies show students who ●● 97,000 sexual assaults and choose not to drink often date rapes make that choice because ●● 696,000 assaults by their parents talked about another student who has the danger of drinking with been drinking them. So: In addition, about 1 in Speak up. Tell your

HEALTHY 7 First tooth or first birthday = first visit with the dentist

You don’t have to wait for all juice, out of your baby’s bottle. of your baby’s teeth to arrive ●● Don’t let your baby fall asleep to get started on healthy oral with a bottle or sip from a habits. Tooth decay—the bottle or cup all day. At about disease that causes cavities— 6 months, start using a cup so is caused by germs in your that a bottle won’t be needed by mouth, so keeping your baby’s the baby’s first birthday. mouth clean (and yours too!) ●● As your baby’s teeth arrive, will help teeth stay strong and start brushing twice a day healthy. Just like in adults, with a little dab of fluoride healthy teeth help babies chew, toothpaste (about the size of a talk, smile and feel good. And grain of rice). healthy baby teeth save room ●● Ask your baby’s pediatrician for grown-up teeth too. or dentist about fluoride A first birthday gives varnish. This is a benefit you and your baby a lot to covered by Medi-Cal for celebrate. Here are some tips to children newborn to 5 years. help your baby have a healthy Three services are allowed in a mouth and teeth starting at an 12-month period. early age: Like other healthy habits, ●● Take your baby to the dentist caring for your mouth and by his or her first birthday or teeth starts early and lasts a when a first tooth appears— lifetime. Help your baby have whichever comes first. a great start—and take care of ●● Keep sugary drinks, such as your own too!

NEED HELP FINDING A DENTIST FOR YOUR BABY? Alliance Medi-Cal members can: ●● Call Denti-Cal at 1-800-322-6384. ●● Visit www.denti-cal.ca.gov. ●● Ask for a referral from your baby’s doctor or pediatrician.

LIVING HEALTHY is published for the members and community Member Services Director Jan Wolf partners of CENTRAL CALIFORNIA ALLIANCE FOR HEALTH, 1600 Green Hills Road, Suite 101, Scotts Valley, CA 95066, Editor Erin Huang telephone 831-430-5500 or 1-800-700-3874, ext. 5505, website www.ccah-alliance.org. Health Education Coordinator III Mao Moua

Information in LIVING HEALTHY comes from a wide range of Sandra Orozco medical experts. If you have any concerns or questions about specific content that may affect your health, please contact your Health Programs Manager Deborah Pineda HEALTHY health care provider. www.ccah-alliance.org Models may be used in photos and illustrations. 2018 © Coffey Communications, Inc. All rights reserved.