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/ / Providers & Community Partners Advisory – California Wildfires & Smoke, and PG&E Power Shut-Offs

Provider Alerts

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Date: October 30, 2019
To: HPSJ Providers, HPSJ Pharmacies, and
Community-Based Organizations – San Joaquin Co. & Stanislaus Co.
From: Health Plan of San Joaquin Medical Management
Subject: HPSJ Expedites Access to Benefits & Prescriptions for Any HPSJ Medi-Cal Member Affected During California Fire Season

  • Refrigerated Prescribed Medications
  • Electrical Medical Equipment

 

Health Plan of San Joaquin (HPSJ) has set up streamlined access to benefits and
prescriptions for any of its members who may be impacted by the power outages and fires
now raging in Northern California.

Further, HPSJ is providing information for members, providers, and the local community
via our web sites (hpsj.com and miembros.hpsj.com/) and HPSJ social media (Facebook,
Twitter, and LinkedIn).

HPSJ is taking these steps so that our members who may be affected by these disasters are able to have ready access to medical services and prescriptions that they might need, as well as life-sustaining medical equipment that needs electricity to work. While the majority of people served by our programs reside in San Joaquin and Stanislaus counties, there are members who are traveling beyond their home community, as well as dependents who may be out of area, and are in one of the fire-impacted and/or outage
areas.

For affected members served by HPSJ, the assistance provided will include:

  • Ease of Access to Medications and Prescriptions
    • HPSJ is contracted with nearly all pharmacies in California, including all major chains. Members may go to any of these pharmacies. In the rare instance that a pharmacy is not part of the network, HPSJ will reimburse the member for out of pocket charges.
    • If members have had their prescriptions lost, damaged or destroyed due to fire or mandated evacuations, they may immediately refill them, even if they are not due to be refilled.
    • HPSJ offers a three-day supply for medications, including controlled medications that are part of a benefit, but may be subject to restrictions.
  • Provider Access
    •  Members unable to be seen by their network or customary providers, including urgent care and hospitals, will be assisted in identifying alternative providers, including, if necessary, out-of-network physicians.
  • Mental Health
    • HPSJ’s partner, Beacon Health Strategies, will help members find mental health help if they cannot reach their usual source of care. Members can call Beacon Health Strategies, at 1-888-581-7526.
  • Urgent Care
    • If the fires and/or outages cause members to need urgent care, they may go out of HPSJ’s network; if they have to pay for this, they will be reimbursed.
  • Toll-free numbers for questions including loss of member ID card, access to
    prescription refills, and appropriate out-of-network providers, or how to access nearby health care:

    • HPSJ Customer Service number, at 1-888-936-PLAN (7526), TTY/TDD 711
    • HealthReach 24/7 Nurse/Physician Advice Line, at 1-800-655-8294

If you have any further questions regarding this situation – including about prior
authorizations, pre-certifications, or referrals, or regarding replacements of members’
medical equipment or supplies, as well as any other related matter – please contact our
Customer Services Department at 209-942-6320, Monday – Friday, 8:00AM—6:00PM)

RE HPSJ Patients – with special health needs, please see below.

REFRIGERATED MEDICATIONS – TIPS FOR MEMBERS:

Many refrigerated medications are stable at room temp for a few days.

  • Try to keep medications cool, but do not use ice, as some medications (including
    insulin) lose effectiveness if frozen.
  • Store medications in a cool, dry place and away from direct heat or sunlight.
  • For questions about specific medications and guidance on storing insulins, please call your local drugstore and ask a druggist.

Insulin – Tips for HPSJ members.

  • Should be stored at 36° to 48°.
  • Once opened, it can be stored at room temp for up to 28 days.
  • High temperatures (below 35° and above 86°) can ruin a vial of insulin.
  • Insulin should be kept as cool as you can in very high heat and guarded from
    freezing.
  •  If you suspect that the insulin has been ruined –
    • Insulin may need to be replaced if it:
      • Is cloudy
      • Has clumps even after you rolled it like you are supposed to
      • Has threads or strings in it
      • Has changed color
      • Or your blood sugar stays high even after your normal correction dose
    • In a power outage or emergency, call our Customer Service staff at 1-888-936-
      PLAN (7526)-TTY/TDD 711 (Monday-Friday, 8:00AM to 6:00PM), or 1-855-828-
      1486 during after hours, weekends or holidays to get an early refill in an crisis.

If members are worried about refrigerated medications not being safe to use and want a replacement or refill, they can call their local drugstore/pharmacist

  • HPSJ Pharmacy Services will allow members to get medications replacements if
    their medications have spoiled during outages from non-refrigeration.
  • For such emergencies, as described in this Alert, HPSJ’s Pharmacy Services approves at least a [72-hour] supply of most medications without limit. This includes medications awaiting submission or okay of a prior authorization ask. Certain limits apply.

ELECTRICAL MEDICAL EQUIPMENT – GUIDANCE FOR HPSJ MEMBERS

Members can call HPSJ’s contracted medical equipment provider, Western Drug
Medical Supply, 24/7, at 1-818-956-6691, if they use life-sustaining medical
equipment that needs electricity to work.

Western Drug Medical Supply can help HPSJ members get other devices. Such as:

  • E Cylinders
  • An oxygen concentrator could be temporarily replaced with an oxygen tank
  • A battery-operated version of a DME or special batteries

For home dialysis patients –

  • There is a home renal dialysis clinic to which every potentially affected HPSJ
    member is attached. The clinic will squeeze in any member needing emergency
    services in the event of a power outage.
  • If the member needing emergency services cannot immediately get to the home
    renal dialysis clinic, the alternative protocol in place is as follows:

    • Each machine has two hours of battery life in case of power outage
    • For any power outage over two hours, every member has enough supplies for 5-7 days to administer dialysis manually in their home without electricity
    • If the member still needs to get to their assigned renal dialysis facility and is unable to get transport to that dialysis facility, calling 911 is recommended.

HPSJ will prioritize support for members with:

  • Oxygen-related or heart-lung aid devices
  • Infusion/IV or feeding/nutrition supplement equipment
  • Mobility aid equipment
  • In-Home dialysis equipment

If HPSJ members have a problem getting vital or life-sustaining supplies during a
power outage, please have them call HPSJ Care Coordination at 209-942-6352
(Monday-Friday, 8:00AM—5:00PM).

Thank you for being our partner in serving the health of HPSJ members and our entire
community.

For updates, please continue to check https://www.hpsj.com/providers/

 

Attachment:

Like you, we also are concerned about the health effects of smoke
from the wildfires. Following please find the “Wildfires Smoke Fact
Sheet” (2 pages)

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