Read HSF_Participant_Handbook_ENG.pdf text version

Healthy San Francisco Customer Service (415) 615-4555 www.healthysanfrancisco.org

City and County of San Francisco Department of Public Health Updated July 2009

©2009 Healthy San Francisco 1130HSF 0709

www.healthysanfrancisco.org

Table of Contents

Welcome to Healthy San Francisco About this Handbook.................................................4 What is Healthy San Francisco?..................................4 Healthy San Francisco is Not Health Insurance............5 How Healthy San Francisco Works Your Medical Home ...................................................6 Your Participant ID Card.............................................7 Medical Home ID Card...............................................7 How to Make a Medical Appointment .......................8 Customer Service.......................................................8 Reasons to Call Customer Service ...........................8 Reasons to Call Your Medical Home........................9 Reasons to Call Your Application Assistor................9 Reporting a Complaint...............................................9 Health Care Services Provided by Healthy San Francisco Preventive and Routine Care ....................................10 Specialty Care..........................................................10 Urgent Care.............................................................11 Ambulance Service...................................................11 Emergency Care.......................................................12 Mental Health Care .................................................13 Alcohol and Drug Abuse Care..................................13 Hospital Care or Services.....................................14-15 Family Planning........................................................16 Durable Medical Equipment.....................................16 Laboratory Services/Tests..........................................17 Prescription Medicine...............................................17

Health Care Services Not Provided by Healthy San Francisco......................................18-19 Staying Healthy Before Visiting Your Medical Home...........................20 While You are at Your Medical Home........................21 Before Leaving Your Medical Home...........................21 Healthy San Francisco Program Fees Participant Fee..........................................................22 Point of Service Fees.................................................23 How to Stay in Healthy San Francisco ...........24-25 Resources and Records San Francisco Department of Public Health...............26 3-1-1........................................................................27 Doctor Visit Record...................................................28 Illness and Injury Record ...........................................29 Important Contacts Your Medical Home..................................................30 Healthy San Francisco Customer Service ...................30 San Francisco Community Behavioral Health Services.........................................31 9-1-1 ........................................................................31 3-1-1 ........................................................................31

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Healthy San Francisco

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Welcome to Healthy San Francisco

About this Handbook On the following pages, you'll find helpful information for getting the services you need that are provided by Healthy San Francisco. This Handbook was written to help make this program easy to understand and easy to use. Please read it before making your first doctor's appointment. What is Healthy San Francisco? Healthy San Francisco is a program created by the City to provide affordable medical care to uninsured people living in San Francisco. What makes this program special is that you get to choose a Medical Home to go to not only when you're sick, but for regular and preventive care to help you stay healthy. With Healthy San Francisco: · You can choose your own Medical Home · You will have your own Medical Home doctor or provider who will get to know you and your health history · You have a Medical Home and Customer Service Center to call when you need help · You know how much your services will cost before you receive them · You have an easy way to re-enroll in the program by completing a renewal application once a year · You don't have to wait until you're sick to get medical care

Healthy San Francisco is Not Health Insurance While Healthy San Francisco provides basic and ongoing medical care to San Franciscans without health insurance, the program is not health insurance. Healthy San Francisco offers you a limited network of health care providers. If you use other services or other providers, you will likely get billed. Most importantly, you will get billed if you need emergency care or hospitalization outside of San Francisco. You may also be billed for emergency care or hospitalization from San Francisco hospitals that are not partnered with your medical home, unless you are eligible for their charity care program. So if you have health insurance, do not drop it. Insurance is always a better choice. Healthy San Francisco is not insurance. Where you can go for medical services, what services are included in the program, how much the participant fees and medical services cost, and who can participate in the program may change based on City guidelines. For these, and many other reasons, if you can get health insurance, you should do so. Healthy San Francisco is a program of last resort for San Francisco residents who cannot get health insurance. The City is proud to create a program that takes care of San Francisco residents who cannot otherwise afford health insurance. Program rules, including who is eligible to enroll, what services are included, the cost of participation, the availability of various Medical Homes, and the cost of medical services may change without notice as deemed appropriate by the City. Should changes to eligibility, fees, or services occur, program participants are collectively notified once a year.

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Healthy San Francisco

How Healthy San Francisco Works

Your Medical Home When you enrolled in Healthy San Francisco, you chose a Medical Home. This is the medical facility (in most cases, a clinic) that will provide your basic medical care, which may include: · Wellness check-ups and preventive services · Care for when you are sick or injured · Care for ongoing health issues, such as asthma or diabetes · Prescriptions for medicine you may need Your Medical Home is the first place you should call when you need care. The address and telephone number are printed on your Healthy San Francisco Participant ID Card. Once you enroll in Healthy San Francisco, you may not receive services from any health care provider other than from your Medical Home, unless your Medical Home refers you to another Healthy San Francisco approved provider. Always check with your Medical Home first when you need services.

Your Participant ID Card All new Healthy San Francisco participants are mailed an identification card, called a Participant ID Card. This lets your Medical Home know that you are enrolled in Healthy San Francisco. Always bring your card with you when: · Visiting your Medical Home · Accessing medical services of any kind You should carry your Healthy San Francisco Participant ID Card with you at all times. Above is a sample of what your Healthy San Francisco Participant ID Card looks like. We'll send you a new one at no charge if: · Any information is incorrect · Your card is lost or stolen · You change your Medical Home · Your Medical Home address or other information changes Medical Home ID Card Some Healthy San Francisco Medical Homes issue their own medical home ID Card. If you receive an additional ID Card in the mail from your Medical Home, carry both this card and your Healthy San Francisco ID Card with you at all times, and present both when accessing services or picking up prescription medication.

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How Healthy San Francisco Works

How to Make a Medical Appointment It's simple ­ just call your Medical Home. The phone number and address are printed on your Healthy San Francisco Participant ID Card. If you need help finding your Medical Home, call Healthy San Francisco Customer Service at (415) 615-4555, Monday through Friday, 8:30am to 5:30pm. Be sure to bring your Participant ID Card to your medical appointment. If you can't keep the appointment, call your Medical Home and cancel or reschedule at least 48 hours in advance. Customer Service Healthy San Francisco Customer Service is ready to help you in the language you prefer speaking. They can answer your questions about Healthy San Francisco services. They can also help you solve most problems. Customer Service representatives are available Monday through Friday from 8:30am to 5:30pm and can be reached at the following numbers: · Healthy San Francisco Participants: (415) 615-4555 · TDD for People who are Deaf, Hard-of-Hearing, or have Speech Disabilities: (415) 547-7830 Reasons to Call Customer Service: · You have questions about how Healthy San Francisco works · You need a new Participant ID Card · You need to change your address · You have billing questions · You have a complaint or problem

8 Healthy San Francisco

Some Medical Homes offer additional customer support. If your Medical Home issues its own ID card, refer to it for additional Customer Service support and contact information. Reasons to Call Your Medical Home (the phone number is on your ID Card): · You have questions about medical services, including prescription medicine · You want to make an appointment to see a doctor or Medical Home provider Reasons to Call Your Application Assistor (the person who helped you fill out your Healthy San Francisco application): · You want to find out the status of your application or renewal · You need to make an appointment to renew your participation in the program · You need to know what documents to bring when you re-enroll in the program Reporting a Complaint If you have a problem with the program or services you receive, try talking about it with your doctor or someone at your Medical Home when it happens. This may be the best way to resolve the problem quickly. If you still haven't reached a solution, call Healthy San Francisco Customer Service for help. If after that the problem is still not resolved, you may file a formal complaint by asking Customer Service to submit a complaint or by sending a letter to: Healthy San Francisco Attn: Complaint Coordinator 201 3rd Street, 7th Floor, San Francisco, CA 94103 You won't be dropped from the program for filing a complaint.

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Health Care Services Provided by Healthy San Francisco

Preventive and Routine Care Regular check-ups and health screenings help prevent illness and are an important part of your ongoing health care treatment. All of these services are provided by your Medical Home. Be sure to make appointments with your Medical Home doctor for regular check-ups. Specialty Care Specialists are doctors who see patients with special problems, such as asthma, diabetes, or heart problems. Your Medical Home will refer you to a specialist if you need expert advice or treatment for a specific problem. Some Medical Homes have specialists on staff who can treat you. Others will refer you to specialists partnered with your Medical Home. You may not see a specialist without a referral from your Medical Home. If you see a specialist without a referral from your Medical Home, Healthy San Francisco will not pay for the treatment you receive. You will be required to pay for any care received from a specialist without a referral. Urgent Care If you need to see a doctor right away because you're sick, have a fever, or are in pain, check first with your Medical Home to see if they can see you. To find what If they can't, you can visit hospitals are the Urgent Care Center at partnered with the hospital partnered with your Medical your Medical Home.

Home, see pages 14-15.

Ambulance Service Healthy San Francisco includes transportation by ambulance only for life-threatening emergencies, and only within San Francisco. If transportation by ambulance is for anything other than a lifethreatening emergency, or if transportation is outside of San Francisco for any reason, Healthy San Francisco will not pay for the ambulance. If you have a life-threatening emergency, call 9-1-1 to get an ambulance.

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Health Care Services Provided by Healthy San Francisco

Emergency Care You might have a medical emergency if you are experiencing: · Difficulty breathing and/or shortness of breath · Chest or upper stomach pain, or feel pressure in your chest · Fainting spells or sudden dizziness or weakness · Uncontrolled bleeding · Severe vomiting or diarrhea · Feelings that you want to hurt yourself or others If you have a life-threatening emergency, dial 911 or go to the nearest hospital. If you are being treated at a hospital other than a hospital partnered with your Medical Home, ask to be considered for their free or reduced-cost emergency care program. You may be able to receive free or discounted emergency services at other San Francisco hospitals depending on your income and assets. Use the chart below to determine if you qualify for NO FEE or REDUCED FEE emergency services. Mental Health Care Do you need someone you can talk to? As a Healthy San Francisco participant, you have access to confidential mental health care services, such as counseling for anxiety or help with other emotional problems. This help is available to you through either your Medical Home, or by contacting San Francisco Community Behavioral Health Services at: · Local Callers: (415) 255-3737 · Toll-Free Callers: (888) 246-3333 · TDD for People who are Deaf, Hard-of-Hearing, or have Speech Disabilities: (888) 484-7200 Alcohol and Drug Abuse Care If using alcohol or other drugs is causing problems in your life, you can get help from the health care professionals at San Francisco Community Behavioral Health Services. Your communication with them will be kept strictly confidential. · Local Callers: (415) 255-3737 · Toll-Free Callers: (888) 246-3333 · TDD for People who are Deaf, Hard-of-Hearing, or have Speech Disabilities: (888) 484-7200

M O N T H lY I N D I v I D U A l A D j U S T E D I N C O M E A N D A S S E T S *

$0 to $904 SF General Hospital St. Francis Hospital St. Mary's Hospital UCSF Chinese Hospital Kaiser Permanente CPMC 12 Healthy San Francisco www.healthysanfrancisco.org | (415) 615-4555 13 $905 to $1,806 $1,807 to $2,708 $2,709 to $3,159 $3,160 to $3,610 $3,611 to $4,515

At some hospitals you may be required to pay full price for physician fees, laboratory, x-ray, and other specialty care received at the hospital while getting emergency services.

REDUCED FEE NO FEE

emergency care is provided at no cost. emergency care is provided at a discounted cost based on income and assets.

* To qualify for NO FEE

or REDUCED FEE services at some hospitals, additional proof of income and/or assets may be required.

Health Care Services Provided by Healthy San Francisco

Hospital Care or Services Healthy San Francisco provides hospital care or services only at hospitals partnered with your Medical Home. Except in an emergency, you'll need a doctor, partnered with your Medical Home, to refer you for hospital care or services. Always check with your medical home if you are unsure about where to go for hospital care or services. See your Participant ID card for your Medical Home contact information. Hospital care or services at hospitals or clinics not partnered with your Medical Home are not provided by Healthy San Francisco. Below is a list of hospitals partnered with your Medical Home. Medical Homes All Medical Homes unless otherwise noted. Hospitals San Francisco General Hospital 1001 Potrero Avenue (415) 206-8000 Medical Homes Glide Health Services Hospitals St. Francis Memorial Hospital (by Medical Home referral only) 900 Hyde Street (415) 353-6000 Kaiser Foundation Hospital San Francisco 2425 Geary Boulevard (415) 833-2000 California Pacific Medical Center (CPMC) (by Medical Home referral only) St. luke's Campus 3555 Cesar Chavez St (415) 647-8600 Pacific Campus 2333 Buchanan Street (415) 600-6000 Davies Campus 45 Castro Street (415) 600-6000 Chinese Community Health Care Association (CCHCA)/ Chinese Hospital Chinese Hospital 845 Jackson Street (415) 982-2400 St. Francis Memorial Hospital (by Medical Home referral only) 1199 Bush Street (415) 353-6000 Sister Mary Philippa Clinic California Campus 3700 California Street (415) 600-6000 St. Mary's Medical Center (by Medical Home referral only) 450 Stanyan Street (415) 668-1000

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Kaiser Permanente San Francisco Medical Center

North East Medical Services (NEMS)

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Health Care Services Provided by Healthy San Francisco

Family Planning Family Planning services are available at most Healthy San Francisco Medical Homes. These may include: · Birth control · Pregnancy testing · Sexually transmitted disease testing Female Healthy San Francisco participants can make an appointment for family planning services with someone who specializes in women's health (called an OB/GYN provider). Call your Medical Home to make an appointment for OB/GYN and other family planning services. laboratory Services/Tests If you need medical tests, they may be performed either at your Medical Home or at the hospital partnered with your Medical Home. Not all Medical Homes provide testing or laboratory work. To find out if yours does, call your Medical Home or ask your doctor when the tests are ordered. Prescription Medicine As a Healthy San Francisco participant, you can get prescription medicines. They'll be prescribed when you need them by your Medical Home doctor. Healthy San Francisco provides certain medications that have been approved for use. Any medications that have not been approved are not paid for by Healthy San Francisco. Your Medical Home has a designated pharmacy or other resource for picking up prescription medicines. To find out if your Medical Home has a pharmacy, call your Medical Home at the number listed on your Healthy San Francisco Participant ID Card, or visit your Medical Home online at www.healthysanfrancisco.org.

Durable Medical Equipment If you need it, your Medical Home doctor will write a prescription for medical equipment such as a wheelchair or crutches. This is called durable medical equipment. Check with your Medical Home about where to take a prescription for durable medical equipment. The telephone number for your Medical Home is located on your Healthy San Francisco Participant ID Card.

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Health Care Services Not Provided by Healthy San Francisco

Healthy San Francisco is a health care program provided by the City and County of San Francisco to uninsured residents only. Healthy San Francisco is not health insurance and does not provide everything that insurance does. There are certain services that are not included in Healthy San Francisco. The list on the next page is a partial list of services that are not included in Healthy San Francisco.

Services not included in Healthy San Francisco The following is a non-exclusive list of services that are not provided by Healthy San Francisco: · · · · · · · · · · · · · · Acupuncture Allergy testing and injections Chiropractic Cosmetic Dental Gastric by-pass surgery and services Genetic testing and counseling Infertility Long-term care Organ transplants Travel immunizations Sexual reassignment surgery Non-emergency transportation Vision

For a complete list of services not provided by Healthy San Francisco, visit the program online at www.healthysanfrancisco.org. Remember, Healthy San Francisco is not insurance. If you have insurance, do not drop it to join Healthy San Francisco. Insurance is always the better choice.

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Staying Healthy

Here's how to make the most of your next doctor's visit: Before visiting Your Medical Home When making the appointment, tell them about your concerns so the right amount of time will be scheduled for your visit. If it's your first visit to your Medical Home or with a new doctor, be prepared to provide your medical history. · Provide information about any diseases that may run in your family · Describe all of your current and past health problems and treatments · Bring the containers for any prescription and over-the-counter medicines, herbs, supplements, or vitamins you are taking

While You are at Your Medical Home When talking with your doctor, remember that your health is worth his or her time. · Clearly describe your health concern (symptoms, when it started, where it is, what it feels like). Writing information down in advance of your visit is always helpful · Ask questions until you are sure that the doctor understands your concerns and completely answers your questions · Ask for written information if you are not sure you will be able to remember everything · Don't forget about your emotional health; it affects your physical health. So mention all mental health concerns, not just physical ones · Make sure your doctor is aware of the prescription and over-the-counter medicines, herbs, supplements and vitamins you're taking · Make sure you know which hospitals and pharmacies are partnered with your Medical Home Before leaving Your Medical Home, find out: · If and when you should return for another visit · Whether you need to call in for any test results or for a report on your condition · If there are certain warning signs you should watch for · Whether there are materials you could take home or a website you should visit to learn more about your diagnosis or treatment It's a good idea to write as much down during and after your appointment because most people have trouble remembering everything their doctor said. Never leave your Medical Home uncertain about your diagnosis or treatment.

Writing a few things down before you go to the doctor will make a big difference. · A short description of your health problem should include a list of symptoms and details on when the problem started, where it is, what it feels like, and if there is anything you do that makes it worse or better · A list of all medications you are taking should include how much and how often you take prescription and over-the-counter medicine, as well as herbs, supplements and vitamins · Any questions you would like to ask your doctor

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Healthy San Francisco Program Fees

As a Healthy San Francisco participant, there are some fees you may need to pay. Participant Fee The Healthy San Francisco Participant Fee is based on a "sliding scale." This means that the program will cost participants more or less depending on their place on the Federal Poverty Level. Simply put: participants who earn less will pay less; participants who earn more will pay more. Use the chart below to determine where you may be on the Federal Poverty Level. If you must pay a Participant Fee, you'll receive a bill every three months. You must pay this bill to remain in the program. If you do not pay, you will be disenrolled from Healthy San Francisco.

Point of Service Fees A Point of Service fee is what you pay for medical services at the time you receive them. For example, you may need to pay a fee each time you visit the doctor, go to the emergency room, or have a prescription filled. This amount will depend on your Medical Home, household income, and what medical service you are getting. If your income is below a certain amount, you may not have to pay a Point of Service Fee for most services. For more information on specific fees, please contact your Medical Home. The number is on your Participant ID Card.

Your Family Size 1 2 3 4 5 $0 - $ 904 $0 - $1,216 $0 - $1,527 $0 - $1,839 $0 - $2,151 $0 $ 905

Your Monthly Family

Income

- $1,806

$1,807 - $2,708 $2,431 - $3,643 $3,054 - $4,578 $3,677 - $5,513 $4,301 - $6,448 $150

$2,709 - $3,610 $3,644 - $4,857 $4,579 - $6,104 $5,514 - $7,350 $6,449 - $8,597 $300

$3,611 - $4,515 $4,858 - $6,075 $6,105 - $7,630 $7,351 - $9,190 $8,598 - $10,750 $450

$1,217 - $2,430 $1,528 - $3,053 $1,840 - $3,676 $2,152 - $4,300 $60

This income chart is designed to give you an idea of what your quarterly participant fee may be. A possibly different, but more accurate determination is made by the Application Assistor at the time you apply or reapply for the program. Valid April 1, 2009 ­ March 31, 2010

Your Participant Fee ­ Paid

four times a year

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How to Stay in Healthy San Francisco

To continue receiving services provided by Healthy San Francisco, you must pay your Participant Fees every three months, and you must reapply for the program every twelve months. This means that every year, you must fill out a new application and submit recent copies of some documents. There are three easy steps to renew your participation in Healthy San Francisco: 1. Watch for your yearly renewal notification letter in the mail. 2. Once you receive your renewal notice, make an appointment with an Application Assistor. Their contact information will be in the renewal notification letter you receive. 3. If you move, be sure to call Healthy San Francisco Customer Service right away at (415) 615-4555. If we do not have your most current address, you may not receive the renewal notification and you risk being disenrolled from the program. The day you are accepted into Healthy San Francisco is called your anniversary date. You will receive a renewal notice in the mail about one month before your anniversary date each year that you participate in the program. If you are unable to receive notices by mail, call your Application Assistor for help. It is your responsibility to make sure that you renew before your anniversary date each year. Failure to renew each year will result in your disenrollment from Healthy San Francisco. During the year, you may be disenrolled from Healthy San Francisco if you: · Move outside of San Francisco · Obtain health insurance · Become eligible for government-sponsored health insurance such as Medi-Cal or Medicare · Are found to have made untrue statements in your application or renewal materials · Abuse the program Participation in Healthy San Francisco is based on the availability of funding from the City and County of San Francisco. Program rules, including who can enroll, what services are included, the cost of participation, the availability of various Medical Homes, and the cost of medical services may change without notice as deemed appropriate by the City. Should changes to eligibility, fees, or services occur, program participants are notified once a year.

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Resources and Records

San Francisco Department of Public Health Healthy San Francisco is provided through the San Francisco Department of Public Health. The mission of the San Francisco Department of Public Health is to protect and promote the health of all San Franciscans.

3-1-1 Call 3-1-1 for information on all San Francisco services. 3-1-1 is an easy-to-remember telephone number that connects you with highly trained Customer Service Representatives ready to help with non-emergency San Francisco concerns. 3-1-1 can help you: · · · · · · · · · Get information on local health programs Request litter removal service Determine Muni route information Report a pothole Find out the requirements for purchasing a marriage license Report a graffiti problem Ask about a department's office hours Get information on starting a business in San Francisco And much more

In addition, the San Francisco 3-1-1 Customer Service Center understands and is sensitive to people of all cultures and all abilities, offering assistance in over 145 languages as well as TTY access for those who are Deaf, Hard-of-Hearing, or have Speech Disabilities. 3-1-1 is available 24 hours a day, 7 days a week, 365 days a year.

For more information on the San Francisco Department of Public Health and other public health care programs, visit them online at www.sfdph.org, or call (415) 554-2500.

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Resources and Records

Doctor visit Record Use this chart to track doctor names and phone numbers. Also keep track of past and future visits.

DATE OF vISIT: DOCTOR OR ClINIC: PHONE: NEXT vISIT:

Illness and Injury Record Use this chart to track illness, injuries, reactions to medicatIons, hospitalizations, surgeries, etc.

DATE OF vISIT: IllNESS/INjURY: DOCTOR OR ClINIC: MEDICINE: RESUlT:

DATE OF vISIT: DOCTOR OR ClINIC: PHONE: NEXT vISIT: DATE OF vISIT: IllNESS/INjURY: DOCTOR OR ClINIC: MEDICINE: DATE OF vISIT: DOCTOR OR ClINIC: PHONE: DATE OF vISIT: NEXT vISIT: IllNESS/INjURY: DOCTOR OR ClINIC: DATE OF vISIT: MEDICINE: SPECIAlIST: RESUlT: PHONE: NEXT vISIT: DATE OF vISIT: DATE OF vISIT: SPECIAlIST: PHONE: NEXT vISIT: IllNESS/INjURY: DOCTOR OR ClINIC: MEDICINE: RESUlT: RESUlT:

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Important Contacts

Call Your Medical Home to: · Schedule a medical appointment · Ask about refills for prescription medicine · Get a referral to a specialist Your Medical Home telephone numbers are located on your Healthy San Francisco Participant ID Card. Call Healthy San Francisco Customer Service to: · · · · · Ask about how Healthy San Francisco works Get a new Participant ID Card Change your address Get help with billing questions Report a complaint or problem

Call San Francisco Community Behavioral Health Services to: · Get counseling for anxiety · Get help with emotional problems · Speak with a counselor about alcohol or drug abuse Help is available to you through either your Medical Home, or by contacting San Francisco Community Behavioral Health Services at: · Local Callers: (415) 255-3737 · Toll-Free Callers: (888) 246-3333 · TDD for People who are Deaf, Hard-of-Hearing, or have Speech Disabilities: (888) 484-7200

Customer Service representatives are available Monday through Friday from 8:30am to 5:30pm and can be reached at the following numbers: · Healthy San Francisco Participants: (415) 615-4555 · TDD for People who are Deaf, Hard-of-Hearing, or have Speech Disabilities: (415) 547-7830

Call 9-1-1 to: · Get an ambulance · Report a life-threatening emergency Call 3-1-1 to: · Get information about other community health resources · Get information on all non health-related resources such as public recreation programs and other City services

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