Winning Health | Gold Coast Health Plan | Issue 3 | Winter 2015

health

winning

Member Services

Luis Aguilar

Health Education Lupe González, PhD, MPH

Editor

Steven Lalich

Chief Medical Officer

C. Albert Reeves, MD

WINNING HEALTH is published as a community service for the

friends and patrons of GOLD COAST HEALTH PLAN, 711 E.

Daily Drive, Suite #106, Camarillo, CA 93010-6082, telephone

1-888-301-1228/TTY 1-888-310-7347.

Information in WINNING HEALTH comes from a wide range of

medical experts. If you have any concerns or questions about

specific content that may affect your health, please contact your

health care Provider.

Models may be used in photos and illustrations.

autism

old Coast Health Plan

(GCHP) covers behavioral

health treatment (BHT)

for autism spectrum disorder

(ASD) through Beacon Health

Strategies. is treatment includes

applied behavior analysis and other

evidence-based services that have

been reviewed and shown to work.

e services should develop or

restore, as much as possible, the daily

functioning of a Member with ASD.

BHT services must be:

Medically necessary.

Prescribed by a licensed doctor

or a licensed psychologist.

What to know about autism

hen a child rst starts

smiling or pointing, he

or she is learning how to

interact with the world.

Kids with autism, though, often

don’t engage the world this way. ey

don’t learn, communicate and react

to things the same way as other kids.

e word

autism

is used to

describe a range of developmental

disabilities. It is caused by a

problem in the brain. Autism

usually appears in the rst three

years of life.

An infant or child with autismmay:

Smile later than other babies.

Not respond to his or her name.

Prefer not to be held.

Avoid eye contact.

Repeat certain actions over and over.

Have trouble understanding

feelings.

Have trouble with changes in

routine.

Have trouble relating to people.

Typically, children should be

checked for autism at 18 months

and 24 months. But don’t wait. If

you notice signs, bring it up to your

child’s Provider.

ere is no cure for autism.

But acting early may help lessen

AUTISM SPECTRUM DISORDER

Behavioral Health Treatment

Approved by GCHP.

Given according to the Member’s

Plan-approved treatment plan.

You may qualify if you:

Are under 21 years of age.

Have a diagnosis of ASD.

Have behaviors that interfere

with home or community life,

such as anger; violence; self-

injury; running away; or di culty

with living skills, play and/or

communication skills.

You do not qualify if you:

Are not medically stable.

Need 24-hour medical or nursing

services.

Have an intellectual disability and

need procedures done in a hospital or

an intermediate care facility.

BHT services provided through a

Regional Center will continue until a

transition plan is developed. Further

information will then be available.

Who to call:

Beacon Health Strategies,

1-855-

765-9702

/TTY

1-800-735-2929

8:30 a.m. to 5 p.m., Monday through

Friday.

GCHP Member Services,

1-888-

301-1228

/TTY

1-888-310-7347

8 a.m. to 5 p.m., Monday through

Friday.

its impact. With treatment and

support, children with autism can

grow, learn and thrive.

Sources: American Academy of Pediatrics; Centers for Disease Control and Prevention