Don’t miss the April 15 Pediatric Lunch and Learn
Make sure to sign up for our upcoming webinar featuring Dr. Carmela Sosa, MD, as well as speakers from WIC and the Alliance. Details and registration are available on our website.
Care can’t wait: Encouraging timely care for Alliance members
Timely care plays an important role in preventing serious health concerns and supporting long-term health outcomes. When routine visits and screenings are delayed, small health issues can become more complex over time.
To help reinforce the importance of preventive care, the Alliance is launching a member-focused campaign called Care can’t wait. Members may see this message across multiple communication channels, including newsletters, web content, text outreach and community engagement efforts. Providers can access and share the “Care can’t wait” flyers here.
Why this matters
Many members face barriers that can make it difficult to prioritize preventive care. Consistent messaging from trusted providers can help reinforce the value of staying engaged in care and addressing health concerns early.
Providers play an essential role in helping members understand the importance of routine visits and recommended screenings.
How you can support this effort
You can help reinforce the “Care can’t wait” message by encouraging members to:
- Schedule routine checkups and preventive care visits.
- Stay up to date on recommended vaccines.
- Complete routine health screenings.
- Ask questions and discuss concerns during visits.
Encouraging preventive care and early screening helps support better health outcomes and strengthens continuity of care for Alliance members.
We appreciate your continued partnership in helping members stay connected to the care they need.
Behavioral health: A triage approach for timely access
Behavioral health timely access issues can be exacerbated when patients are not referred to the level of care that best aligns with their presenting problem. The Alliance is committed to partnering with providers to help members get the care they need when they need it.
Providers can improve access by ensuring members receive the right level of assessment based on clinical need. Developmental and behavioral concerns may require different kinds of evaluation. A structured triage approach helps prioritize specialized testing while allowing other concerns to be addressed through appropriate clinical pathways.
Key triage principles
Refer to the appropriate professional based on patients’ needs
| What the patient needs | Who to refer to | |||
|
Licensed marriage and family therapist (LMFT)/licensed clinical social worker (LCSW)/licensed professional clinical counselor (LPCC) | |||
|
Psychologist | |||
|
Psychiatrist | |||
Referrals are guided by screening results
Screenings, clinical history and presenting concerns help determine the appropriate next steps for evaluation or treatment.
Match evaluation type to clinical need
Some cases require formal testing (e.g., complex autism with traumatic brain injury) while others can be evaluated through behavioral health assessment (e.g., ADHD and anxiety).
Promote coordinated care
Collaboration among primary care providers, behavioral health clinicians and specialists can help:
- Support continuity of care.
- Clarify diagnoses for complex medical or mental health conditions.
- Ensure that medication is managed beyond the primary care setting.
Alliance resources
Providers can submit a Care Management Referral Form through the Alliance website.
Catch up on All Plan Letter updates
The Alliance would like to bring your attention to the following APL updates:
- DHCS APL 26-001– Initial Health Appointment (supersedes 22-030).
- DHCS APL 26-002– Medi-Cal Managed Care Plan Responsibilities for Non-Specialty Mental Health Services.
For updates on recent DHCS All Plan Letters, including a summary of relevant provider takeaways, visit the All Plan Letters page on our website.
You can also contact Alliance Provider Relations at 800-700-3874, ext. 5504.
