Staying Healthy Assessment Training (SHA) Information for non-clinical staff and providers on completing the Staying Healthy Assessment Provider Relations.

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Presentation transcript:

Staying Healthy Assessment Training (SHA) Information for non-clinical staff and providers on completing the Staying Healthy Assessment Provider Relations

Eureka | Fairfield | Redding | Santa Rosa About Us Mission: To help our members, and the communities we serve, be healthy. Vision: To be the most highly regarded managed care plan in California.

Eureka | Fairfield | Redding | Santa Rosa Staying Healthy Assessment The Staying Health Assessment (SHA) is an (IHEBA) approved by the Department of Health Care Services (DHCS) and is designed to help determine and meet any specific behavioral health education needs the patients might require. The SHA consists of seven age-specific pediatric questionnaires and two adult questionnaires. Our threshold language English, Spanish, and Russian are available on PHC website. Information on other languages are available. Partnership Health Plan of California wants our providers to meet state regulations. The purpose is to ensure Medi-Cal member’s healthcare needs are met. The SHA through its set of questionnaire can help Providers identify high-risk behavior, set priorities for behavior change, and refer patients for appropriate services. The state may audit your office to make sure the SHA is being utilized.

Front and Back Office Staff

Eureka | Fairfield | Redding | Santa Rosa Front & Back Goals Identifying and tracking high-risk behaviors of insured member. Prioritizing each member’s need for health education to lifestyle, behavior, environment, and cultural and linguistic needs. Providing tailored health education, intervention options, referral and follow-up.

Eureka | Fairfield | Redding | Santa Rosa SHA Completion By Member Explain the SHA’s purpose and how the SHA will be used by PCP. SHA forms are available in multiple languages. Interpretation accommodation if needed. Assure confidentiality of SHA response, and that the patient has the right to skip any question. Parent or caregiver must complete the form for children under 12 years. Self completion preferred method for accurate response to sensitive questions. A member’s refusal to complete the SHA must be documented on age- appropriate SHA questionnaire. PCP or other clinic staff may verbally ask questions and record response.

Eureka | Fairfield | Redding | Santa Rosa Patient Initial Visit Front office staff will include SHA as part of the initial packet prior to visit with clinical practitioner. Length of scheduled appointment to initiate the SHA may be case specific. Appointment schedule arranged in accordance with appointment time.

Eureka | Fairfield | Redding | Santa Rosa IHA Visit & SHA Age Groups The IHA visit is required 120 days of enrollment. The SHA assessment is completed during member’s initial encounter. Starting at age 3 yrs. review every 12 months. Highly recommend for Seniors due to risk factors yrs. Within 120 days of enrollment yrs. 1 st Scheduled Exam (after entering new age group) Adult & Seniors administer every 3 to 5 years. PCP reviewed, and initial.

Eureka | Fairfield | Redding | Santa Rosa SHA Periodicity

Eureka | Fairfield | Redding | Santa Rosa SHA Questionnaire

Eureka | Fairfield | Redding | Santa Rosa SHA Questionnaire (child)

Eureka | Fairfield | Redding | Santa Rosa SHA Questionnaire (adult)

Eureka | Fairfield | Redding | Santa Rosa SHA Questionnaire

Questions?

Clinical Providers (MD, PA, FMNP, DO)

Eureka | Fairfield | Redding | Santa Rosa Primary Care Providers The PCPs are responsible for reviewing each member’s SHA in combination with the following relevant information: Medical history, conditions, problems, medical/testing results, and member concerns. Social history, including member’s demographic data, personal circumstances, family composition, and social support.

Eureka | Fairfield | Redding | Santa Rosa Physician’s Role Review the completed SHA with the member and initiate a discussion with the member regarding behavioral risks the member identified in the assessment. Prioritize each member’s health education needs and initiate discussion and counseling regarding high-risk behaviors. Based on the member’s behavioral risks and willingness to make lifestyle changes, the PCP should Provide tailored health education counseling, intervention, referral, and follow-up. Review the SHA with the member during the years between re-administration of a new SHA assessment. Sign “SHA Annual Review” section of the questionnaire to document an annual review was completed and discussed with the member. Providers may use an alternative IHEBA with prior approval of the Medi-Cal Managed Care Division (MMCD).

Eureka | Fairfield | Redding | Santa Rosa Provider Training PHC must provide resources and training to providers and subcontractors to ensure the delivery of culturally appropriate patient health education services. SHA requirements. Instructions on how to use the SHA or DHCS approved alternative assessment. Documentation requirements. Timelines for administration, review, and re- administration. Specific information and resources for providing culturally and linguistically appropriate patient health education services/interventions.

Eureka | Fairfield | Redding | Santa Rosa SHA Attestation

Eureka | Fairfield | Redding | Santa Rosa PHC Website SHA questionnaires and resources are available on the PHC website at:

Questions?