Pediatric Care

The following resources are for primary care providers who work with members up to 21 years of age. They include information about HPSM's programs for youth, clinical guidelines, referral instructions and more.

Programs

HPSM offers many programs for children up to the ages of 21, women who are expecting, and more.

HPSM Integrated Care Management

HPSM Integrated Care Management is a service for HPSM members who need additional support in accessing healthcare services. Members will be assessed and referred to a care coordinator or team best able to support their needs. Those with complex developmental or behavioral needs will find additional support through HPSM’s Integrated Care Management model. Families in need of additional support accessing services such as speech therapy, occupational therapy, physical therapy, and behavioral health therapy can be referred to the Integrated Care Management team.

To refer members for Pediatric Integrated Care Management:

Whole Child Model

HPSM has partnered with San Mateo County CCS to provide comprehensive health care for children with complex and chronic medical issues. These conditions vary from the comparatively moderate (such as diabetes) to the potentially debilitating (developmental disability, blindness, cancer and many others). Each special needs child requires frequent, ongoing medical care above and beyond what other children typically need. CCS helps children and their families access this care, which makes a world of difference. The program offers targeted case management to support eligible members in receiving necessary medical services.

Any members with complex medical needs should be referred to the California Children’s Services team.

Behavioral Health Treatment (BHT) / Applied Behavioral Analysis (ABA) / Autism Spectrum Disorder (ASD) Program

The Behavioral Health Treatment (BHT) benefit is available to all HPSM members under 21 years old who would benefit from services like Applied Behavioral Analysis (ABA). Eligibility for these services are determined by a Comprehensive Diagnostic Evaluation (CDE). The members receiving BHT/ABA typically include those with Autism Spectrum Disorder (ASD), those who display patterns of developmentally inappropriate behaviors, and those who exhibit developmental deficits that can be corrected or ameliorated. HPSM contracts with Magellan to provide medically necessary, evidence-based BHT services that prevent or minimize behavioral conditions and promote, to the maximum extent practicable, the functioning of an eligible member.

Pregnancy and Postpartum: Baby + Me Program

Baby + Me is HPSM’s care program for pregnant women, new moms and their babies! Baby + Me offers referrals to community resources and information for pregnant women, new moms and their families.

Plus, participants can earn up to $100 in Target GiftCardsTM for going to two doctor appointments!

  • Visit within the first 12 weeks of pregnancy and participants gets a $50 Target GiftCardTM 
  • Visit between 1 and 12 weeks after delivery and participants get a $50 Target GiftCardTM

If your patient is eligible, you can complete the online enrollment form below with them or refer them to HPSM's Health Education Unit at 650-616-2165. Your patients may also enroll in Baby + Me on their own. If they qualify for the program, HPSM will mail a different form to them along with a self-addressed stamped envelope (SASE). They will bring this form to their appointment for you to fill out. Once the form is completed, please either mail it to HPSM in the SASE or fax it to 650-829-2073.

The Bullseye Design, Target and Target GiftCards are registered trademarks of Target Brands, Inc. Terms and conditions are applied to Gift Cards. Target is not a participating partner in or sponsor of this offer.


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