Health Promotion/Education

Health Promotion/Education

At the Health Plan of San Mateo (HPSM) we believe that healthy is for everyone. We offer a variety of resources to help our members learn how to live well and be healthy. Topics include asthma, diabetes, weight management, pregnancy, and tobacco cessation.

Physician Authority

No action of notice by HPSM shall require a participating physician to provide to the member, or order on behalf of the member, covered services which, in the professional opinion of the physician, are not medically necessary. Participating physicians may freely communicate with members about their treatment, regardless of benefit coverage and limitations.  When a physician determines that a member-requested service is not medically necessary and the member does not agree with the provider’s decision, the physician shall inform the member of their appeal rights through HPSM.

Programs

Diabetes Prevention Program (DPP)

This evidence-based 12-month lifestyle change program for HPSM Medi-Cal and CareAdvantage members with pre-diabetes is designed to prevent or delay the onset of type 2 diabetes. It includes weekly one-hour sessions led by trained Lifestyle Coaches for the first six months and monthly sessions in the last six months. Coaches help participants create plans for eating healthy, exercising more and losing weight. They also provide handouts to help people meet their personal health goals. Plus, program participants get group support. HPSM provides DPP to eligible members at no cost. Learn more about eligibility requirements and access the DPP Provider Referral Form.

Members can visit our page on the Diabetes Prevention Program or can contact our Health Promotion Unit at 650-616-2165.

Diabetes

Members recently diagnosed with diabetes or who are having difficulty following diabetes health guidelines can contact our Health Promotion Unit at 650-616-2165 for information about classes or other resources available. To get more information about diabetes, members can also go to our Health Tips page for Diabetes.

Baby + Me

The Baby + Me program promotes timely care and health from the start of pregnancy to birth and beyond. HPSM Medi-Cal members who are pregnant or who recently delivered a baby are eligible for this program.

Members who enroll can get up to $100 in Target gift cards for going to two appointments:

• During pregnancy: members who go to a prenatal visit within the first 12 weeks of pregnancy get a $50 Target GiftCardTM.
• After having their baby: members who go to a postpartum visit between one and 12 weeks after having their baby get a $50 Target GiftCard.

The program also helps connect our members to resources and services including:

• Breast pump vendors. Please provide your patients with a prescription so their order can be processed.
• Local programs for parents and families. These cover a wide range of needs, from nutrition support to parenting classes.
• Doula services.
• Evidence-based home-visiting programs.
• Information about quitting tobacco.
• Perinatal depression support groups.
• And more!

To refer a patient, submit a form on our Baby + Me signup page. Members can also contact our Health Promotion Unit at 650-616-2165.

Cancer Screening Rewards Program

HPSM CareAdvantage members due for a breast and/or colorectal cancer screening can get a Cinemark Prepaid Movie Ticket for getting screened. Once members complete their screening, the Cinemark Prepaid Movie Ticket will be shipped to the address they provided HPSM. It should arrive within 90 days of when they got their screening. For more information, contact our Health Promotion Unit at 650-616-2165.

Physical Activity

HPSM members who are interested in physical activity are referred to San Mateo County Park and Recreation Department programs. For more information, contact our Health Promotion Unit at 650-616-2165.

• YMCA locations throughout San Francisco, San Mateo, and Santa Clara counties. Locations may include exercise equipment, basketball courts, indoor or outdoor fitness studios, and indoor or outdoor swimming pools.
• More than 600 in-person and online group exercise classes led by certified instructors in yoga, Pilates, Zumba, cycling, aqua fitness, and more.
• In-person and online wellness coaching to help members meet their health goals.

Tobacco Cessation Services

Providers are required to ask about tobacco use at the first visit, annually, and at any relevant visit. Providers are encouraged to recommend tobacco cessation by:

• Asking permission to talk about tobacco use and readiness to quit.
• Advising patients to quit.
• Offering brief counseling.
• Prescribing cessation medication.
• Connecting patients to additional resources, like a quit line.
• Following up with continuous support to help prevent relapse.

To help you help your patients quit tobacco, visit our Tobacco Cessation Information and Resources microsite. The website has recommendations, requirements and resources on the following topics:

• Identifying patients who use or have used tobacco.
• Treating patients who use tobacco: covers counseling, treatment, and other resources that can help your patients quit.
• Vulnerable populations: Covers clinical recommendations and guidelines for tobacco use and prevention in children, adolescents and pregnant people, including resources to help adolescent patients quit.
• Provider education and training: covers clinical guidelines, toolkits and ongoing trainings for continuing medical education credit (CME/CE).

For more information, members can go to our Health Tips pages on tobacco use, or they can contact our Health Promotion Unit at 650-616-2165

Health Education Member Materials

At HPSM, we place a great emphasis on primary prevention in all our work because we believe preventing a disease is the most effective way to keep a person healthy. Our online Health Tips pages offer a wide variety of health information and tips for staying healthy. Members can access our online Health Tips pages.

Topics covered include:

• Alcohol and Drugs.
• Alternative Care.
• Asthma.
• Child Health.
• Diabetes.
• Exercise.
• Flu.
• Heart Disease and Stroke.
• HIV and AIDS.
• LGBTQ+ Health.
• Medication Management.
• Mental Health.
• Nutrition.
• Older Adults.
• Pain Management.
• Oral Health.
• People with Disabilities.
• Pregnancy.
• Preventive Care.
• Quitting Tobacco Use.
• Self-Management Tools.
• Sexual Health.
• Teen Health.
• Weight Management.

For more information, members can contact our Health Promotion Unit at 650-616-2165.

Member Newsletter

Health Matters is HPSM’s member newsletter. It includes articles on a variety of topics to help keep our members healthy. View current and past issues of Health Matters.

Culturally and Linguistically Appropriate Services (CLAS)

The Health Plan of San Mateo (HPSM) is committed to delivering culturally and linguistically appropriate services to all eligible members with limited English proficiency (LEP) or sensory impairment and/or their medical decision makers. Understanding these requirements will help you provide quality care to our members and meet federal and state requirements.

Provider Responsibility

All HPSM contracted providers are required to provide linguistically appropriate services to members with limited English proficiency (LEP) or with a hearing impairment and/or their medical decision makers. At each point of contact, HPSM members with limited English proficiency must be provided information on:

• Their right to a qualified interpreter in all non-English languages, including sign language and how to access those services.
• How to address and file complaints pertaining to interpreter services (see Member Grievances section).
• Interpreter services availability at every point of contact at no cost.
• Their right not to be required to provide their own interpreter.

HPSM therefore offers free phone, video and in-person interpreter services provided by professionally trained interpreters.

HPSM’s CLAS Program complies with Title IV of the Civil Rights Act of 1964, which states, any agency, program, or activity that receives funding from federal government may not discriminate on the basis of sex, race, color, religion, ancestry, national origin, creed, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation, or identification.

Learn about our Language Assistance program.

Interpreter Services

All HPSM Network Providers must maintain a procedure for accessing telephone interpreters. Please contact interpreters@hpsm.org  for a sample clinic policy document. Additionally, interpreter services must be offered in a way that does not violate HIPAA requirements for exchanging PHI and ePHI and in ways that comply with federal and state privacy laws.

HPSM provides free telephonic, video, in-person, and sign language interpreter services to help you communicate with your LEP patients.

• Telephonic interpreter services are provided through Certified Languages International (CLI) and are available in more than 200 languages 24 hours a day, 7 days a week, at no cost to the member or provider.
• Video Remote Interpreter (VRI) services are also provided through CLI and are available on demand and by appointment through CLI’s online platform. The service includes sign language video interpreter services. These services can be used in office or during telehealth visits.
• In-person interpreter services for spoken language and can be scheduled no less than 5 business days in advance of the appointment. 
• All in-person spoken language or sign language interpreter services should be scheduled by the provider through HPSM. Requests forms can be sent online via secure email to interpreters@hpsm.org or faxed to 650-829-2079.

Learn how to access interpreter services.

As a reminder, HPSM interpreter services are meant to be used for HPSM members and/or their medical decision makers only. Vendor utilization is monitored and education is provided should HPSM interpreter services appear to be utilized incorrectly.

Telephonic Interpreter Services for Office/Clinic & Telemedicine Visit

To access the service:

• Dial CLI at 800-225-5254.
• Provide the CLI operator with the following information:
  • Access code: 64095.
  • Language needed.
  • Provider office name.
  • Provider type (Options are dental, medical, therapy (including physical/speech/behavioral) DME or vendor)
  • HPSM member name.
  • HPSM member date of birth (DOB).
• For an office visit, start conversation after the CLI operator connects you to an interpreter.
• For telemedicine visit, provide HPSM patient phone number. After you have briefed the interpreter, dial # to call the HPSM patient at the number you provided the CLI operator. Start conversation once you are connected to the HPSM patient.

Video Remote Interpreter Services for Office/Clinic & Telemedicine

Visit Ensure you have Wi-Fi at the office/clinic for online access to CLI platform. For a telemedicine visit, also ensure HPSM member has internet access to receive telemedicine appointment link.

To access the service:

• Using either Chrome, Firefox, or Safari web browser, go to CLI platform.
• Access code: 64095hpsm
• Follow prompts for clinic/provider name, HPSM patient’s full name and date of birth.
• Select language.
• Wait for interpreter to appear on the screen.
• For telemedicine visit, inform interpreter that you will be inviting your patient to the session.
  • Click the button with the outline of a person and a + sign to send meeting link to HPSM patient via text or email. HPSM patient needs to click the link to join the video call.

View Instructions and a video tutorial.

In-person Interpreter Services

All in-person spoken language or sign language interpertor services should be scheduled through HPSM at least five days in advance. 

To schedule an in-person interpreter:

• Complete the In-Person Interpreter Request Form.
• Submit the completed form online, fax the completed form to HPSM at  650-829-2072 or send via secure email to interpreters@hpsm.org.
• You will receive an email confirmation from HPSM staff once your request is scheduled.

Provider Language Documentation Requirements for Members with Limited English Proficiency

1. Document the member's language preferences and language services that were offered (other than English).
   1. For members with limited English proficiency, document their preferred language in their medical record.
   2. At every point of care (onsite or virtual) inform members that they have access to phone or video interpreters free of charge and offer to get an interpreter.
   3. Document the date that interpreter services were offered and indicate whether member agreed or declined assistance.
2. Document your staff's bilingual capabilities and keep HPSM informed of changes. Because HPSM publishes the language capabilities of all network providers in its provider directories, providers must inform Provider Services about:
   1. The availability of practitioners and staff who are fluent in the preferred languages of assigned members, including:
      1. Demonstration of proficiency in preferred languages.
      2. Assessment of language proficiency.
      3. Number of years’ experience working as a qualified medical interpreter (if any).
      4. Changes to staff’s language proficiencies (e.g., if a staff member who speaks a preferred language no longer works for the practice).
   2. You can update your provider directory listing in the provider portal.

Note: Except for an emergency involving an imminent threat to the safety or welfare of the individual or the public, Providers cannot suggest that HPSM members use family members (including children) or friends as informal interpreters. If an HPSM member refuses professional interpreter services and insists on using a family member or friend and the accompanying adult agrees to provide that assistance, the provider must document the member’s preference in their medical record.

Services for Members with Disabilities

HPSM recognizes that our members with disabilities have specific needs in addition to their general medical needs. We provide services that are integrated within the daily activities of every department, such as:

• Access to TTY for our hard-of-hearing members.
• Large-print materials for our visually impaired members.
• Information on the physical accessibility of providers offices in our provider directory for our wheelchair-using members.

We also have a Integrated Care Management unit in our Health Services Department to assist our members with complex chronic conditions to ensure they receive the care management they need to optimize their health outcomes. If you have HPSM members with disabilities who need additional services, please notify HPSM Integrated Care Management unit at 650-616-2060.