Street Medicine Provider and Participation in Managed Care
| Date: | February 16, 2023 |
| To: | Health Plan of San Joaquin (HPSJ) Primary Care Providers, Specialists, Hospitals and Facilities |
| From: | HPSJ |
| Type: | Regulator/Informational |
| Subject: | Street Medicine Provider and Participation in Managed Care |
| Business: | Medi-Cal Managed Care |
In accordance with All Plan Letter (APL) 22-023, the Department of Health Care Services (DHCS) has provided Medi-Cal Managed Care Plans (MCPs) with opportunities to utilize street medicine providers to address clinical and nonclinical needs of their Medi-Cal Members experiencing unsheltered homelessness. For the complete details regarding APL 22-023, please visit the following link: https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2022/APL22-023.pdf
Street medicine is provided to an individual experiencing unsheltered homelessness in their environment, which is not intended for human habitation.
HPSJ will cover the provision of medical services for its members experiencing unsheltered homelessness through street medicine providers in the role of the Member’s assigned Primary Care Provider (PCP), through a direct contract with HPSJ, as an ECM Provider, as a Community Supports Provider, or as a referring or treating contracted Provider.
Contracted street medicine Providers may choose to serve as the Member’s assigned PCP upon Member election, similar to how Obstetrician-Gynecologist (OB/GYN) Providers can elect to serve as PCPs. To serve as a PCP, the street medicine Provider must meet the MCP’s eligibility criteria for being a PCP, be qualified and capable of treating the full range of health care issues served by PCPs within their scope of practice, and agree to act in a PCP role.
DHCS does not require a street medicine provider to be affiliated with a brick-and-mortar facility and has outlined various provisions. However, the street medicine Provider does not have the capability to provide Primary Care services on the street. In that case, the street medicine Provider must be affiliated with a brick-and-mortar facility (e.g., primary care medical office, Federally Qualified Health Center (FQHC), clinic, etc.).
If you have any questions, please call our Provider Services Team at 209-942-6340 or our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about the Health Plan of San Joaquin and our services is always available on our website https://www.hpsj.com/.