AGENDA PUBLIC POLICY/COMMUNITY ADVISORY COMMITTEE. KERN HEALTH SYSTEMS 9700 Stockdale Highway 2 ND Floor Conference Room Bakersfield, California 93311

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1 AGENDA PUBLIC POLICY/COMMUNITY ADVISORY COMMITTEE KERN HEALTH SYSTEMS 97 Stockdale Highway 2 ND Floor Conference Room Bakersfield, California Regular Meeting Tuesday, March 19, : P.M. All agenda item supporting documentation is available for public review at Kern Health Systems in the Administration Department, 97 Stockdale Highway, Bakersfield, during regular business hours, 8: a.m. 5: p.m., Monday through Friday, following the posting of the agenda. Any supporting documentation that relates to an agenda item for an open session of any regular meeting that is distributed after the agenda is posted and prior to the meeting will also be available for review at the same location. PLEASE REMEMBER TO TURN OFF ALL CELL PHONES, PAGERS OR ELECTRONIC DEVICES DURING BOARD MEETINGS. COMMITTEE TO RECONVENE Members: Janet Hefner, Jennifer Wood, Lubna Syed, MD, Kate Griffin, RN, Silvia Lozano Cuesta, Dianne Rosso, Jenny Albert, Cecilia Hernandez-Colin. CONSENT AGENDA/OPPORTUNITY FOR PUBLIC COMMENT: ALL ITEMS LISTED WITH A "CA" ARE CONSIDERED TO BE ROUTINE AND NON- CONTROVERSIAL BY KERN HEALTH SYSTEMS STAFF. THE "CA" REPRESENTS THE CONSENT AGENDA. CONSENT ITEMS WILL BE CONSIDERED FIRST AND MAY BE APPROVED BY ONE MOTION IF NO MEMBER OF THE BOARD OR AUDIENCE WISHES TO COMMENT OR ASK QUESTIONS. IF COMMENT OR DISCUSSION IS DESIRED BY ANYONE, THE ITEM WILL BE REMOVED FROM THE CONSENT AGENDA AND WILL BE CONSIDERED IN LISTED SEQUENCE WITH AN OPPORTUNITY FOR ANY MEMBER OF THE PUBLIC TO ADDRESS THE BOARD CONCERNING THE ITEM BEFORE ACTION IS TAKEN. STAFF RECOMMENDATION SHOWN IN CAPS

2 Agenda Public Policy/Community Advisory Committee Page 2 Kern Health Systems 3/19/213 Regular Meeting PUBLIC PRESENTATIONS 1) This portion of the meeting is reserved for persons to address the Committee on any matter not on this agenda but under the jurisdiction of the Committee. Committee members may respond briefly to statements made or questions posed. They may ask a question for clarification; make a referral to staff for factual information or request staff to report back to the Committee at a later meeting. Also, the Committee may take action to direct the staff to place a matter of business on a future agenda. SPEAKERS ARE LIMITED TO TWO MINUTES. PLEASE STATE AND SPELL YOUR NAME BEFORE MAKING YOUR PRESENTATION. THANK YOU! COMMITTEE MEMBER ANNOUNCEMENTS OR REPORTS 2) On their own initiative, Committee members may make an announcement or a report on their own activities. They may ask a question for clarification, make a referral to staff or take action to have staff place a matter of business on a future agenda (Gov. Code Sec [a]) CA-3) Minutes for Public Policy/Community Advisory Committee meeting on December 18, 212 (Attachment) APPROVE CA-4) Membership Enrollment Reports - Medi-Cal & Healthy Families (Attachment) APPROVE CA-5) Health Education Report 1 st Quarter: th Quarter (Attachment) APPROVE 6) Health Education Report 1 st Quarter (Isabel C. Silva, MPH, CHES Health Education Supervisor) Annual. (Attachment) APPROVE 7) Member Services Report 1 st Quarter (Lela Criswell Member Services Supervisor) th Quarter Grievance Summary Report th Quarter Tabulated Grievance Report (Attachments) APPROVE 8) Provider Relations Report 1 st Quarter (Jake Hall Provider Relations Supervisor) th Quarter Mystery Caller Report. (Attachment) APPROVE 9) Marketing Report 1 st Quarter (Louis Iturriria Director of Marketing and Member Services)

3 Agenda Public Policy/Community Advisory Committee Page 3 Kern Health Systems 3/19/213 Regular Meeting Member Materials: 1. Spring 213 Member Newsletter Calendar 3. New Image Campaign Louis Iturriria and Jacque Jans (handout) (Attachments) APPROVE ADJOURN TO TUESDAY, JUNE 18, 213 AT 12: P.M. AMERICANS WITH DISABILITIES ACT (Government Code Section ) The meeting facilities at Kern Health Systems are accessible to persons with disabilities. Disabled individuals who need special assistance to attend or participate in a meeting of the Board of Directors may request assistance at the Kern Health Systems office, 97 Stockdale Highway, Bakersfield, California or by calling (661) Every effort will be made to reasonably accommodate individuals with disabilities by making meeting material available in alternative formats. Requests for assistance should be made five (5) working days in advance of a meeting whenever possible.

4 SUMMARY PUBLIC POLICY / COMMUNITY ADVISORY COMMITTEE KERN HEALTH SYSTEMS 97 Stockdale Highway 2 ND Floor Conference Room Bakersfield, California Regular Meeting Tuesday, December 18, : P.M. COMMITTEE RECONVENED AT 12:5 P.M. Members present: Silvia Lozano Cuesta, Kate Griffin, Janet Hefner, Jennifer Wood Members absent: Jenny Albert, Cecilia Hernandez-Colin, Dianne Rosso, Lubna Syed NOTE: The vote is displayed in bold below each item. For example, Hefner-Wood denotes Member Hefner made the motion and Member Wood seconded the motion. CONSENT AGENDA/OPPORTUNITY FOR PUBLIC COMMENT: ALL ITEMS LISTED WITH A "CA" ARE CONSIDERED TO BE ROUTINE AND APPROVED BY ONE MOTION. COMMITTEE ACTION SHOWN IN CAPS PUBLIC PRESENTATIONS 1) This portion of the meeting is reserved for persons to address the Committee Members on any matter not on this agenda but under the jurisdiction of the Committee Members. Committee Members may respond briefly to statements made or questions posed. They may ask a question for clarification, make a referral to staff for factual information or request staff to report back to the Committee Members at a later meeting. Also, the Committee Members may take action to direct the staff to place a matter of business on a future agenda. SPEAKERS ARE LIMITED TO TWO MINUTES. PLEASE STATE AND SPELL YOUR NAME BEFORE MAKING YOUR PRESENTATION. THANK YOU! NO ONE HEARD

5 Summary Page 2 Public Policy / Community Advisory Committee Meeting 12/18/212 Kern Health Systems COMMITTEE MEMBER ANNOUNCEMENTS OR REPORTS 2) On their own initiative, Committee Members may make an announcement or a report on their own activities. They may ask a question for clarification, make a referral to staff or take action to have staff place a matter of business on a future agenda (Gov. Code Sec [a]) NO ONE HEARD CA-3) Minutes for Public Policy/Community Advisory Committee meeting on July 17, 212 APPROVED Hefner-Wood: All Ayes CA-4) Membership Enrollment Reports - Medi-Cal & Healthy Families APPROVED Hefner-Wood: All Ayes CA-5) Member Services Reports 3 rd Quarter nd Quarter Grievance Summary Report nd Quarter Tabulated Grievance Report APPROVED Hefner-Wood: All Ayes CA-6) Provider Relations Report 3 rd Quarter nd Quarter Mystery Caller Report APPROVED Hefner-Wood: All Ayes CA-7) Marketing Member Materials 3 rd Quarter - 1. Fall 212 Member Newsletter 2. MCAL Provider Directory (draft) 3. MCAL Member Handbook (draft) 4. HFAM Provider Directory (draft) 5. HFAM Member Handbook (draft) 6. Advice Nurse Line Brochure (draft) APPROVED Hefner-Wood: All Ayes CA-8) Health Education Report 3 rd Quarter nd Quarter rd Quarter 3. HFP 212 Group Needs Assessment Update APPROVED Hefner-Wood: All Ayes

6 Summary Page 3 Public Policy / Community Advisory Committee Meeting 12/18/212 Kern Health Systems 9) Member Services Report 4 th Quarter rd Quarter Grievance Summary Report rd Quarter Tabulated Grievance Report APPROVED Wood-Hefner: All Ayes 1) Provider Relations Report 4 th Quarter rd Quarter Mystery Caller Report CINDY STEWART, CLINICA SIERRA VISTA, HEARD; APPROVED Griffin-Hefner: All Ayes 11) Marketing Report 4 th Quarter - Member Materials - 1. Winter 213 Member Newsletter CINDY STEWART, CLINICA SIERRA VISTA, HEARD; APPROVED Lazono-Griffin: All Ayes 12) Health Education Report 4 th Quarter - 1. Medi-Cal 212 Group Needs Assessment Update APPROVED Lazono-Wood: All Ayes 13) Quality Improvement/Disease Management Report 4 th Quarter HEDIS Rates for Medi-Cal Managed Care Plans CINDY STEWART, CLINICA SIERRA VISTA, HEARD; APPROVED Hefner-Wood: All Ayes ADJOURNED TO TUESDAY, MARCH 26, 213 AT 12: P.M.

7 Data Gathered from the DHCS - California Health Care Options Monthly Enrollment Reports Month KFHC Health Net Total Enrollees % KFHC Enrollment Kern Family Health Care Medi-Cal Enrollment Report Summary Members % Health Net Enrollment KFHC Growth H/Net Growth % KFHC Growth % Health Net Growth Jan ,598 44, ,555 72% 28% % 1.1% Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Comparison Enrollment Summary 213 KFHC vs HN 15, 1, 5, Jan 13 Feb 13. KFHC HN

8 Data Gathered from the DHCS - California Health Care Options Monthly Enrollment Reports Kern Family Health Care Medi-Cal Enrollment Report Summary Choice Month KFHC Health KFHC/HN Net Choice Ratio % Total Choice KHS % H/NET % Jan-13 2,141 1,2 2.9:1 48% 3,161 68% 32% Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Total 2,141 1,2 68% 3,161 68% 32% 2,5 Choice Summary 213 KFHC vs HN 2, 1,5 1, 5 Jan 13 Feb 13 KFHC Health Net

9 Healthy Families Program Monthly Enrollment Data 212 Total Enrollment in Kern County 211 KFHC BLUE CROSS KAISER HEALTH NET TOTAL ENROLLMENT Enrollment # Date Data %'s Data %'s Data %'s Data %'s KFHC Commercial Plans Jan-11 23,585 11,131 47% 3,436 15% 4,822 2% 4,196 18% 11,131 12,454 Feb-11 23,52 11,5 47% 3,323 14% 4,967 21% 4,225 18% 11,5 12,515 Mar-11 23,632 11,7 47% 3,226 14% 5,165 22% 4,234 18% 11,7 12,625 Apr-11 23,78 11,59 47% 3,99 13% 5,293 22% 4,257 18% 11,59 12,649 May-11 23,798 11,47 46% 3,2 13% 5,435 23% 4,314 18% 11,47 12,751 Jun-11 23,692 1,944 46% 2,888 12% 5,532 23% 4,328 18% 1,944 12,748 Jul-11 23,622 1,946 46% 2,792 12% 5,541 23% 4,343 18% 1,946 12,676 Aug-11 23,554 11,32 47% 2,71 11% 5,4 23% 4,421 19% 11,32 12,522 Sep-11 23,54 11,5 47% 2,67 11% 5,261 22% 4,586 2% 11,5 12,454 Oct-11 23,58 11,124 47% 2,65 11% 5,81 22% 4,725 2% 11,124 12,456 Nov-11 23,48 1,998 47% 2,781 12% 4,941 21% 4,76 2% 1,998 12,482 Dec-11 23,46 1,962 47% 2,94 13% 4,771 2% 4,733 2% 1,962 12,444 Totals 283,81 132,35 47% 35,445 13% 62,29 22% 53,122 19% 47% 53% Total Enrollment in Kern County 212 KFHC BLUE CROSS KAISER HEALTH NET TOTAL ENROLLMENT Enrollment # Date Data %'s Data %'s Data %'s Data %'s KFHC Commercial Plans Jan-12 23,146 1,826 47% 3,1 13% 4,557 2% 4,762 21% 1,826 12,32 Feb-12 23,114 1,821 47% 3,5 13% 4,435 19% 4,88 21% 1,821 12,293 Mar-12 23,27 1,848 47% 3,162 14% 4,314 19% 4,883 21% 1,848 12,359 Apr-12 23,25 1,865 47% 3,285 14% 4,171 18% 4,929 21% 1,865 12,385 May-12 23,236 1,864 47% 3,327 14% 4,6 17% 4,985 21% 1,864 12,372 Jun-12 23,121 1,82 47% 3,311 14% 3,946 17% 5,44 22% 1,82 12,31 Jul-12 22,94 1,715 47% 3,316 14% 3,844 17% 5,29 22% 1,715 12,189 Aug-12 22,815 1,669 47% 3,354 15% 3,736 16% 5,56 22% 1,669 12,146 Sep-12 22,691 1,627 47% 3,383 15% 3,634 16% 5,47 22% 1,627 12,64 Oct-12 22,63 1,67 47% 3,421 15% 3,551 16% 5,51 22% 1,67 12,23 Nov-12 22,489 1,572 47% 3,385 15% 3,466 15% 5,66 23% 1,572 11,917 Dec-12 22,366 1,54 47% 3,36 15% 3,379 15% 5,87 23% 1,54 11,826 Totals 274, ,774 47% 39,355 14% 47,93 17% 59,747 22% 47% 53% Data Gathered from the Managed Risk Medical Insurance Board Monthly Enrollment Reports

10 Healthy Families Program Monthly Enrollment Data , Total Enrollment in KC 212 KFHC, Blue Cross, Kaiser & HN 2, 15, 1, 5, KFHC Blue Cross Kaiser HN Jan 12 Feb 12 Mar 12 Apr 12 May 12 Jun 12 Jul 12 Aug 12 Sep 12 Oct 12 Nov 12 Dec 12 25, Total Enrollment in KC 212 KFHC and Combined Commercial Plans 2, 15, 1, KFHC Commercial Plan 5, Jan 12 Feb 12 Mar 12 Apr 12 May 12 Jun 12 Jul 12 Aug 12 Sep 12 Oct 12 Nov 12 Dec 12 Data Gathered from the Managed Risk Medical Insurance Board Monthly Enrollment Reports

11 Report Date: January 14, 213 KERN HEALTH SYSTEMS FOURTH QUARTER 212 Reporting Period: October 1, 212- December 31, 212 REFERRALS FOR HEALTH EDUCATION SERVICES The Health Education (HE) department receives referrals from various sources, both internally and externally. Internal referrals are received from Kern Health Systems (KHS) Utilization Management (UM) department through outpatient referrals, Member Services (MS) department through the Transition of Care (TOC) report, Disease Management (DM) department, Care Management (CM), and the Quality Improvement (QI) department. Externally, KHS providers and community based organizations submit referrals for education services according to the member s diagnosis. Kern Family Health Care (KFHC) members can also self-refer for education services for their own diagnosis or health concerns. During the fourth quarter, there were a total of 1,28 referrals received. Six hundred and eighteen (618) were received internally from various departments and 41 were received from outside sources. Other CBO % Self Referral 5% Referral Source QI P4P 11% Provider 24% Other 6% DM 5% TOC 31% CM 19% UM 5% Note: % represents less than 1% 4 th Quarter 212 Page 1 of 14

12 KERN HEALTH SYSTEMS FOURTH QUARTER 212 The HE department receives referrals for a number of health conditions. During the fourth quarter, there were 171 referrals received for asthma, 135 for diabetes, 17 for gestational diabetes, 33 for nutrition counseling, 72 for smoking cessation,187 for high blood pressure, 29 for High Cholesterol, 245 for pediatric/teen obesity weight management, and 139 for adult obesity weight management. Referrals by Topic Smoking Cessation 7% Adult Wt Mgmt 13% Ped/Teen Wt Mgmt 24% Nutrition Counseling 3% High Cholesterol 3% High Blood Pressure 18% Asthma 17% Diabetes 13% Gestational Diabetes 2% During the fourth quarter, the HE department processed 1,52 referrals. Out of the referrals processed, a total of 326 members were referred for health education services, 87 refused, 117 were not successfully contacted, 52 members were mailed health education materials, and 2 members were identified as being ineligible due to disenrollment. Referral Status Refused 8% Mailed Materials 5% Accepted Services 31% Not Eligible % Unable to contact 11% Note: % represents less than 1% 4 th Quarter 212 Page 2 of 14

13 KERN HEALTH SYSTEMS FOURTH QUARTER 212 Members who were not successfully contacted are mailed a letter requesting that they contact KHS HE department as soon as possible. Of the members who were mailed a letter, 25 contacted the HE department. Member reasons for refusal of health education services were also collected. During this quarter, the top 5 reasons for referral refusal were due to the following: 1. Member is not interested in the service. 2. Member/Parent doesn t feel that the service is needed. 3. Member received previous education in the past. 4. Member is unable to receive services due to personal issues. 5. Member is unable to receive services due to work/school schedule. The HE department offers various types of services through KHS or through community partnerships. Education services include the following topics: Asthma Diabetes Gestational Diabetes Nutrition Counseling Smoking Cessation Weight Management for overweight/obesity Kern Family Health Care (KFHC): Adult Weight Management for overweight/obese members Pediatric/Teen Weight Management for overweight/obese members Classes are held at: Kern County Public Health Services 18 Mt. Vernon Avenue Bakersfield, CA 9335 Greenfield Family Resource Center 52 Monitor Street Bakersfield, CA 9337 Classes are held every month in English and Spanish. Class discussions include, but are not limited to portion control, calorie counting, food label reading, meal planning, and physical activity. 4 th Quarter 212 Page 3 of 14

14 KERN HEALTH SYSTEMS FOURTH QUARTER 212 Individual Nutrition Counseling Appointments are held at: Kern Family Health Care 97 Stockdale Hwy. Bakersfield, CA Appointments are held monthly and services are provided by a registered dietitian or health educator. Diagnoses include, but are not limited to gestational diabetes, failure to thrive, diabetes, and obesity. BAKERSFIELD MEMORIAL HOSPITAL (BMH): Diabetes Management Classes (English only) Classes are held at: th Street Bakersfield, CA 9331 Classes are on the 3 rd Wednesday of every month between 2-4 p.m. Class discussions include, but are not limited to medications, portion control, meal planning, food label reading, and carbohydrate counting. Heart Healthy Classes (English only) Classes are held at: th Street Bakersfield, CA 9331 Classes are on the 1 st Wednesday of every month between 2-4 p.m. Class discussions include, but are not limited to healthy eating and meal planning, how to use food labels in making food choices, what to eat and avoid, cooking ideas, healthy snacks, and eating out and eating healthy. COMMUNITY WELLNESS PROGRAM (CWP): Individual Asthma, Diabetes or Nutrition Education CWP contacts the member within 7 business days to schedule an appointment. Education is given in the privacy of the member s home, CWP s office or a mutually agreed location: 2634 G Street Bakersfield, CA 9331 Discussion topics include, but are not limited to asthma control and medication use, weight management, diabetes management, meal planning, food label reading, and physical activity. 4 th Quarter 212 Page 4 of 14

15 CLINICA SIERRA VISTA WIC: Diabetes Management Classes Classes are held at: KERN HEALTH SYSTEMS FOURTH QUARTER 212 Central Bakersfield Community Health Center 31 Brundage Lane Bakersfield, CA 9334 Delano Community Health Center 158 Garces Highway, Suite 1 Delano, CA East Bakersfield Community Health Center 1125 E. California Avenue Bakersfield, CA 9337 Classes are held monthly in English and Spanish. Class discussions include, but are not limited to medications, portion control, meal planning, food label reading, and carbohydrate counting. Heart Healthy Classes Classes are held at: Central Bakersfield Community Health Center 31 Brundage Lane Bakersfield, CA 9334 Delano Community Health Center 158 Garces Highway, Suite 1 Delano, CA East Bakersfield Community Health Center 1125 E. California Avenue Bakersfield, CA 9337 Classes are held monthly in English and Spanish. Class discussions include, but are not limited to healthy eating and meal planning, how to use food labels in making food choices, what to eat and avoid, cooking ideas, healthy snacks, and eating out and eating healthy. CALIFORNIA SMOKERS HELPLINE (CSH): Telephone Smoking Cessation Counseling Members are instructed to call: (English) (Spanish) A certificate of completion is mailed to the member that allows them to fill a prescription for the nicotine patch. 4 th Quarter 212 Page 5 of 14

16 KERN HEALTH SYSTEMS FOURTH QUARTER 212 Out of the 326 members who accepted health educational services, 217 were referred to CWP for services, 78 to a KFHC class or individual appointment, 15 to CSH, 2 to BMH, and 14 to CSV. Where Members are Referred CWP 66% Other 24% Class 19% Individual Appt. 5% CSH 5% CSV 4% BMH 1% Referral outcomes revealed that 193 members attended their scheduled appointment, 63 did not show for their appointment, 43 were not successfully contacted by CWP, 26 refused services after the initial acceptance, and 1 member became ineligible due to disenrollment. Referrals Outcomes Disenrolled % CWP not able to contact 13% No Show 2% Attend 59% Refused 8% Note: % represents less than 1% 4 th Quarter 212 Page 6 of 14

17 KERN HEALTH SYSTEMS FOURTH QUARTER 212 Effectiveness of Health Education Services To evaluate the effectiveness of the health education services provided to members, a 3-month follow up call was conducted on randomly selected members who received services during the previous quarter of 212. Findings revealed that for weight management education, 44% stated that they reduced their weight by 5% or greater. Demographics of Members Served KHS HE department provides services to a culturally and linguistically diverse member population. KHS language threshold is English and Spanish and all services and materials are available in these languages. For non-threshold languages, interpreters are available through Language Line and American Sign Language (ASL) interpreters are available through Life Signs. Findings revealed that zero members requested interpreting services during this quarter. Out of the 326 members who attended health education services, the largest gender-age groups were female ages 2-34 years (18%) and male ages 5-12 years (11%). The following is a breakdown of member classifications by age and gender Total Female Male Total A breakdown of member classifications by race and language preferences revealed that 64% of members who accepted services were Hispanic and the majority of these members preferred to speak English. Hispanic Caucasian African Asian/Pacific Native Other Member Unknown Total American Islander American Declined English Spanish Total th Quarter 212 Page 7 of 14

18 KERN HEALTH SYSTEMS FOURTH QUARTER 212 Referrals by language and race were assessed during this quarter. Findings revealed that 39% of members who attended services were English speaking and referred for weight management education to manage obesity. Referrals by Language English Spanish Unknown Other Asthma Diabetes Gestational Diabetes Nutrition Counseling Smoking Cessation 7 Weight Mgmt Note: % represents less than 1% Additionally, 44% of the members who attended services were of the Hispanic race and referred for weight management education to manage obesity Asthma Diabetes Gestational Diabetes Note: % represents less than 1% Referrals by Race Afr. Amer. Asian/PI Caucasian Hispanic Nat. Amer. Other Unknown Declined to State Nutrition Counseling Smoking Cessation Weight Mgmt 4 th Quarter 212 Page 8 of 14

19 KERN HEALTH SYSTEMS FOURTH QUARTER 212 KHS serves members in the Kern County area with the exception of Ridgecrest. During this quarter, 76% of the members who attended services reside in Bakersfield and the majority of these members were in the 9337 area. 7 6 Referrals by Bakersfield Zip Codes Additionally, 24% of the members who attended services reside in the outlying areas of Kern County and the majority of these members reside in Delano Referrals by Outlying Areas of Kern County th Quarter 212 Page 9 of 14

20 KERN HEALTH SYSTEMS FOURTH QUARTER 212 Transportation Assistance KHS provides transportation assistance for Medi-Cal members, when requested. KHS MS department determines the appropriate transportation method while taking into consideration each member s individual needs. During this quarter, there was 1 request for transportation assistance. HEALTH EDUCATION MAILINGS In addition to referrals, the HE department mails out a variety of educational material in an effort to assist members with gaining knowledge on their specific diagnosis or health concern. During this quarter, the HE department mailed 3,5 educational packets to members on the following health topics: Education Topic English Spanish Total Anemia Asthma Breast Cancer Cholesterol Diabetes High Blood Pressure Immunization 2 2 Nutrition Postpartum Care PPD Risk 1 1 Prenatal Care Smoking Cessation Weight Management WIC Information 2 2 Total 2, ,5 PM16 PROCESSING KHS Primary Care Providers (PCP) is required to document pediatric preventive care services on a PM16 and submit these forms to KHS. On a daily basis, the HE department reviews these forms for referral follow-up and to evaluate for possible health education interventions. During this quarter, a total of 18,29 PM16s were reviewed by the department and 2 referral followup letters were mailed to providers informing them that an outpatient specialty referral may be warranted. 4 th Quarter 212 Page 1 of 14

21 KERN HEALTH SYSTEMS FOURTH QUARTER 212 INCENTIVE PROJECTS In an effort to promote newborn and postpartum health, KHS provides members a forehead thermometer for newborn initial health assessments (IHA) completed within 1 week after hospital discharge. During this quarter, 9 thermometers were mailed to members for the newborn IHA. TOPICAL FLUORIDE VARNISH TREATMENTS Fluoride varnish treatments are effective in preventing tooth decay and more practical and safer to use with young children. KHS covers up to three topical fluoride varnish treatments in a 12-month period for all members younger than 6 years. During the fourth quarter, KHS received claims for fluoride varnish treatment Fluoride Varnish Claims Received st Qtr 2nd Qtr 3rd Qtr 4th *Note: Due to claims lag, data will be reported one quarter behind. OB CASE MANAGEMENT PROJECT The HE department case manages all members identified as being pregnant or postpartum. Please note the following OB Case Management findings are based upon member responses and have not been verified. Prenatal Care During this quarter, the HE department created 762 prenatal cases for pregnant members and 855 prenatal cases were completed. Of the completed cases, 425 members were successfully contacted, 16 were disenrolled, 5 refused to participate in the call and 49 were not successfully contacted. Members who are not successfully contacted by phone and are at least 18 years of age or older are mailed letter asking them to contact KHS HE department as soon 4 th Quarter 212 Page 11 of 14

22 KERN HEALTH SYSTEMS FOURTH QUARTER 212 as possible. Of the members who were mailed a letter, 38 contacted the HE department. Additional findings revealed that 15 members had experienced a miscarriage and 2 had terminated their pregnancy. Prenatal Case Findings 1% 9% 8% 7% 6% 5% 4% 3% 2% 1% % 69% Aware of Contracted Hopitals 21% OB Discussed Breastfeeding 5% Plans to Exclusively Breastfeed 3% Appt. Scheduling Issue 81% Enrolled in WIC 89% 6% Seeking Received Prenatal Care Dental Clearance from OB The HE department also tracks the start of prenatal care among pregnant members. Out of the 425 members who participated in the prenatal case management call, 32 members claimed to have started prenatal care in their first trimester, 59 in the second trimester, 7 in the third trimester, and 39 were unknown. 3rd Trimester 2% Start of Prenatal Care Unknown 9% 2nd Trimester 14% 1st Trimester 75% 4 th Quarter 212 Page 12 of 14

23 KERN HEALTH SYSTEMS FOURTH QUARTER 212 Postpartum Care The HE department created postpartum cases for 334 members that gave birth and 358 postpartum cases were completed in this quarter. Of the completed cases, 239 members were successfully contacted, 14 were disenrolled and 15 were not successfully contacted. Members who were not successfully contacted by phone were mailed a letter asking them to contact KHS HE department as soon as possible. Of the members who were mailed a letter, 17 contacted the HE department. Additional findings revealed that 5 members refused to participate. 1% 9% 8% 7% 6% 5% 4% 3% 2% 1% % 95% Enrolled in WIC Postpartum Case Findings 22% Breastfeeding Exclusively 95% Newborn IHA completed 83% Postpartum Exam Scheduled 55% OB Discussed Birth Control 85% Medi-Cal Worker Contacted 4 th Quarter 212 Page 13 of 14

24 KERN HEALTH SYSTEMS FOURTH QUARTER 212 HEALTH EDUCATION CALLS The HE department receives and facilitates calls to members, KHS providers and partnering community resources on a daily basis. During this quarter, 518 calls were received and 3,36 calls were made by the HE department. Health Education Calls Incoming Calls Outgoing Calls ,143 1,23 1, October November December PCP CHANGES During every member call, the PCP on file is confirmed. The HE department assists members in need of changing their PCP by communicating these changes to the MS department. During this quarter, the HE department received 33 requests for a PCP change. 4 th Quarter 212 Page 14 of 14