Advisory Board: Contra Costa Health Plan Community Advisory Committee (CAC) Members
Subject: Helping Members To Know What To Do Next
Presenter: Maybelle Stone, Advice Nurse Supervisor
BACKGROUND
Contra Costa Health Plan (CCHP) is required to gather Medi-Cal member feedback through the CAC on several topics mandated by the California Department of Health Care Services (DHCS).
Advice Nurse Service is a required area of review to ensure CCHP services are accessible, culturally competent, and meet the needs of our members. The purpose of this item is to inform the Committee about services and solicit member feedback on this topic.
SUMMARY / DISCUSSION
Presentation Overview:
Advice Nurse Unit: A guide on how to help members understand what to do next and where to get care.
What does the Advice Nurse Unit do?
• Registered Nurse assessment - the nurse focused questions about symptoms and listens
for warning signs.
• Right level of care - the nurse helps determine whether home care, an appointment,
urgent care, emergency department or 911 is appropriate.
• 24/7 Guidance any time - the nurses are available by telephone 24 hours a day, 7 days a
week.
When calling the Advice Nurse?
When the members are not sure what to do that is exactly when calling the Advice Nurse.
• Call when you have a health concern and are not sure what the next step should be
• New, worsening, or concerning symptoms
• Questions about whether you need a clinic visit, urgent care, the Emergency Department, or 911
• Home-care advice for common symptoms
• Questions about lab or diagnostic test results
• Medication refill questions for chronic conditions
• Health education and follow-up guidance
What happens when the member calls?
A nurse-led triage process helps guide your next step. If symptoms sound life-threatening, the nurse will direct the member to emergency care.
When to call the Advice Nurse Unit
24/7 - the Advice Nurse Unit is available by telephone 24 hours a day, 7 days a week.
Requested Feedback: Request members’ feedback regarding assess to the Advice Nurse Unit.
RECOMMENDATION & NEXT STEPS
This is an informational item only; no formal action or vote is requested.
The presenter will collect CAC member comments during the meeting and incorporate feedback into program or policy development, as applicable. All feedback will be recorded in the meeting minutes to maintain a public record of advisory input.