Winning Health | Gold Coast Health Plan | Issue 2 | Fall 2022

24-Hour Advice Nurse Line: 1-877-431-1700/TTY 711 4 Fluoride varnish: Helping smiles stay strong Fluoride varnish is a protective coating brushed on the teeth to prevent tooth decay. It is safe, quick and doesn’t hur t. It’s recommended that all infants and children receive fluoride varnish star ting as soon as their first tooth comes out. It can be applied at well-child visits, other doctor appointments and the dental office. Sources: Centers for Disease Control and Prevention; California Department of Health Care Services Learn more: Enhanced Care Management (ECM) In January 2022, Gold Coast Health Plan (GCHP) started offering new benefits and services through the California Advancing and Innovating Medi-Cal (CalAIM) initiative. Enhanced Care Management (ECM) is a benefit that offers more services to members with highly complex needs. Here are some questions you may have about ECM: What is the ECM benefit? ECM gives members their own care team with a care coordinator. This person will talk to you and your doctors, mental health providers, specialists, pharmacists, case managers, and social services providers. This ensures that everyone works together to get you the care you need. An ECM care coordinator can help you: ●Find doctors. ●Get appointments for health-related services you may need. ●Better understand and keep track of your medications. ●Set up a ride to get to your doctor visits. ●Find and apply for communitybased services based on your needs, such as housing supports or medically nutritious food. ●Get follow-up care after you leave the hospital. How do I know if I have highly complex needs or if I qualify for ECM? ECM is for adults who: ●Do not have stable housing. ●Struggle with drug or alcohol use. ●Have a serious mental health condition. ●Have difficult health issues and needed to go to the hospital or emergency department many times over the last six months. If you think you may be eligible for the ECM program, a GCHP Care Management team member can help you get the care to meet your unique needs. Call Care Management at 1-805-437-5911, Monday through Friday from 8 a.m. to 5 p.m. If you use a TTY, call 1-888-310-7347. Who can refer a GCHP member for ECM services? Anyone can refer a member for ECM services. How long will it take for me to know if I qualify? Once you have been referred to the ECM program, you will be contacted for an assessment within five business days. After your assessment, you will be notified of eligibility within seven business days. Do I need to submit any documents or proof of my current situation? No. You will not need specific documents. Eligibility will be determined through phone or in-person assessments. Do I need to pay for these services? No. This benefit is at no cost to you. Who will be coordinating my needs? An ECM coordinator. Next steps: If you think you may be eligible for the ECM program, call Care Management at 1-805-437-5911, Monday through Friday from 8 a.m. to 5 p.m. If you use a TTY, call 1-888-310-7347.

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