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Compassionate Care, Accessible to All, for a Healthy Community

Member Services Phone Number 888.301.1228

Resources

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Beacon Health Options

Mental Health

Beginning January 1, 2014, your Medi-Cal coverage will now include some Mental Health care benefits. Please refer to your Evidence of Coverage (EOC) for more information regarding these new benefits.

Gold Coast Health Plan (GCHP) will provide these services through Beacon Health Options.  If you need mental health services, you can call Beacon Health Options at 1-855-765-9702, TTY 1-800-735-2929. If your doctor works with GCHP, you can keep your doctor.

If your doctor doesn’t work with GCHP, and you want to keep that doctor, you can call Member Services at 1-888-301-1228, TTY 1-888-310-7347 for help. We will let you keep the doctor for up to 12 months, if the doctor agrees to work with us.

Benefit Information

Apply for Medi-Cal and other social service programs at www.mybenefitscalwin.org.

California Children’s Services

California Children’s Services (CCS) and Gold Coast Health Plan (GCHP) work together for the benefit of children and young adults residing in Ventura County. CCS provides services for children with physical disabilities or conditions that are costly, chronic or catastrophic.

If you have questions about CCS eligibility, GCHP Care Managers may be able to assist you.

Click here to access the CCS website where you can access information about eligibility, benefits, how to apply and all CCS programs.

The CCS office in Ventura County is located at:
2240 East Gonzales Road, Suite 260
Oxnard, CA 93036
Phone: (805) 981-5281
Fax: (805) 658-4580

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Care Management

Care Management is a service that is available to you as a Gold Coast Health Plan member. Your doctor can ask us to assist you, or you can contact us yourself for a health-related concern.

GCHP Care Managers are Registered Nurses and Social Workers and are ready to work with you should you require assistance with:

  • Understanding and managing your benefits
  • Communicating with your doctors
  • Establishing a Medical Home
  • Learning about Community Resources that may be available to you
  • Setting goals and making plans for improving your health
  • A new diagnosis that is causing you concern
  • Learning about your condition
  • Problems with your pregnancy
  • Organ transplant questions
  • Managing multiple medications

To reach the GCHP Care Management Department, please call 805-437-5656 or email: caremanagement@goldchp.org. If emailing, please include your telephone call back number and GCHP Identification Number for a prompt response. Deaf and hard of hearing members can call our TYY line at 1-888-310-7347.

Community-Based Adult Services Program (CBAS)

The Community-Based Adult Services Program (CBAS) transitions from a fee-for-service program to a Medi-Cal managed care benefit, on October 1, 2012. CBAS replaces the state’s Adult Day Health Care (ADHC) program and will be managed by Gold Coast Health Plan. Go here to learn more about CBAS.

Community Advisory Committee (CAC)

The Community Advisory Committee (CAC) gives GCHP information about important issues that affect Medi-Cal members in Ventura County to further enhance the quality of the experience between the members and the Plan. The 10 voting members represent various constituencies served by the Plan. They include:

  • Beneficiaries with chronic medical conditions
  • County Health Care Agency
  • County Human Services Agency
  • Foster children
  • Medi-Cal beneficiaries
  • Persons with disabilities
  • Persons with special needs
  • Seniors

The Health Care Agency and the Human Services Agency are standing seats. With the exception of those positions, each of the appointed members serves a two-year term; however, committee members may reapply for additional terms as there are no term limits. The committee meets at least quarterly.

Rita Duarte-Weaver, Committee Chair

Ventura County Public Health Department

Rita Duarte WeaverRita Duarte-Weaver is the Community Advisory Committee (CAC) committee chair. She is the daughter and caretaker of a current Gold Coast Health Plan (GCHP) member. For the last 17 years, Ms. Duarte-Weaver has worked for the Ventura County Public Health Department where she serves as the community services coordinator for the Health Care for All program. Ms. Duarte-Weaver conducts regular presentations on Medi-Cal, the Ventura County Self-Discount Program and Health Care for All. She has extensive knowledge of Medi-Cal and knows how to assist GCHP’s members with their needs.

Ruben Juarez, Vice-Chairperson

Ventura County Health Care Agency, Whole Person Care

Ruben JuarezRuben Juarez is the Community Advisory Committee (CAC) vice-chairperson. Mr. Juarez is a community services worker with Ventura County’s Whole Person Care (WPC) program. The program facilitates the coordination of health, behavioral health, and social services. WPC helps all patients with their goals and improvement of their overall health and well-being through more efficient and effective use of resources. In his role with the WPC program, Mr. Juarez supports all Medi-Cal beneficiaries identified as high users of services who continue to be in poor health. He connects members with public and private entities, providing comprehensive care and follow up to help those who are experiencing homelessness.

Estelle Cervantes

Beneficiary Member

Estelle CervantesEstelle Cervantes is the beneficiary member serving on the Community Advisory Committee (CAC).  Her son is also a Gold Coast Health Plan (GCHP) member. Ms. Cervantes has been a volunteer for the United Way Volunteer Income Tax Assistance program, is currently serving as a Conejo Valley Unified Board District Advisory Council member, and is a Conejo Valley High School council member. In 2016, she was recognized by the “Latino American Who’s Who” for her achievements in advancing the culture of the Latino American business community. As a two-time cancer survivor, her goal is to be an advocate and speak out in support of women.

Norma Gomez

Mixteco / Indígena Community Organization Project (MICOP)

Norma GomezNorma Gomez has worked as an interpreter, educator, and case manager with the Mixteco / Indígena Community Organization Project (MICOP) in Oxnard since 2000. As an educator to the Mixtec community, she leads workshops and group activities to provide information on nutrition, health, and parenting. Ms. Gomez also provides case management and conducts follow-up home visits with the Mixtec community and assists residents with completing applications for disability, unemployment, school, Medi-Cal, Cal-Fresh, passport applications, etc. Ms. Gomez facilitates “Aprendiendo con Mama y Papa” (“Learning with Mom and Dad”) educational workshops for Mixteco and Latino migrant farm worker children.

Frisa Herrera

Casa Pacifica

Frisa HerreraFrisa Herrera has been employed at Casa Pacifica since March 1999 as both the clinic manager and Medi-Cal biller. Casa Pacifica serves abused, neglected, and severely emotionally disturbed children and adolescents from the tri-county region of Southern California. Ms. Herrera has a unique understanding and familiarity with the needs of foster children and is deeply committed to serving this population. Her goal is to “be the voice for the foster community in Ventura County.”

Laurie Hall Jordan

Rainbow Connection Family Resource Center

Laurie JordanLaurie Hall Jordan works for the Rainbow Connection Family Resource Center at Tri-Counties Regional Center. She has been with Rainbow Connection for nearly 30 years providing information, training and support for children and adults with developmental disabilities and their families. Ms. Jordan serves as a community representative on the Improving State Systems subcommittee for the state Interagency Coordinating Council on Early Intervention. She is currently chairwoman of the Community Advisory Committee for the Special Education Local Plan Area. She also serves on the Behavioral Health Advisory Board Youth & Family Committee. Ms. Jordan’s son and granddaughter are Gold Coast Health Plan (GCHP) members.

Paula Johnson

The Arc of Ventura County

Paula JohnsonPaula Johnson is the director of clinical services at The Arc of Ventura County. She has many years of experience working with individuals and families of adults with intellectual and developmental disabilities. Her educational background includes a master’s degree in education and a bachelor’s degree in behavioral psychology. Ms. Johnson is a certified instructor for the Crisis Prevention Institute and American Heart Association.

Curtis Updike

Ventura County Human Services Agency

Curtis UpdikeCurtis Updike currently serves as the deputy director of the Ventura County Human Services Agency (HSA) where he oversees Medi-Cal and CalFresh eligibility determination. Prior to his selection as deputy director in 2005, he served as manager of the county's East County Intake and Eligibility Center (IEC) from 2002 to 2005. The East County IEC processes intake and continuing cases in Medi-Cal and CalFresh. Before joining HSA, he served as chief of staff for former Ventura County Supervisor Kathy Long and field deputy for former Supervisor Maggie Kildee. Mr. Updike holds an associate degree in business administration, a bachelor's degree in mass communications, and a master's degree in public administration.

Pablo Velez

Amigo Baby, Inc.

Pablo VelezPablo Velez is the CEO / President / Founder of Amigo Baby, Inc. He has a medical doctoral degree from Colombia where he developed several county-based services. Upon moving to the U.S., he began working with special needs children, lectured in several community organizations and, in 2004, created Amigo Baby, Inc. to serve the Ventura County community. Mr. Velez brings more than 20 years of medical and special needs experience to infants and children with developmental delays.

Community Advisory Committee Meetings

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Contracted Hospitals

Los Robles Hospital and Medical Center
215 W. Janss Road
Thousand Oaks, CA 91360
805.497.2727
www.losrobleshospital.com

Ojai Valley Community Hospital (CMH)
1306 Maricopa Highway
Ojai, CA 93023
805.646.1401
www.cmhshealth.org

Santa Paula Hospital (VCMC)
825 N. 10th St.
Santa Paula, CA 93060
805.933.8600
www.vchca.org/hospitals/santa-paula-hospital

Simi Valley Hospital and Health Care Services
2975 N. Sycamore Drive
Simi Valley, CA 93065
805.955.6000
www.simivalleyhospital.com

St. John's Pleasant Valley Hospital
2309 Antonio Ave.
Camarillo, CA 93010
805.389.5800
www.stjohnshealth.org

St. John's Regional Medical Center
1600 N. Rose Ave.
Oxnard, CA 93030
805.988.2500
www.stjohnshealth.org

Ventura County Medical Center (VCMC)
3291 Loma Vista Road
Ventura, CA 93003
805.652.6000
www.vchca.org/hospitals/ventura-county-medical-center

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Denti-Cal Program

Dental Services for Medi-Cal beneficiaries under 21 years of age are currently provided as a carved out benefit through the Denti-Cal Program. Click here to search for dentists in your  local area and throughout the State if you are a Denti-Cal beneficiary or contact the Denti-Cal Service Center for additional help at 1-800-322-6384.

Starting May 1, 2014, certain adult dental benefits will be restored in accordance with Assembly Bill 82. Note: these services are not a benefit for beneficiaries 21 years of age and over until May 1, 2014. Click here for a full description of restored services and procedures from Section 5 of the “Manual of Criteria and Schedule of Maximum Allowances.”

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Dialysis Transportation

Do you need a ride to your dialysis appointment?

Members who need dialysis can get free rides to and from appointments. Gold Coast Health Plan (GCHP) offers Non-Emergency Medical Transportation (NEMT) for eligible members. Call your doctor and ask about these services.

Once you have your ride scheduled, it is important to call the transit company if your appointment changes or if you need to cancel.  To plan a ride or to cancel an appointment, call 1-855-628-7433 or TTY 711 (California Relay Services).

Click here for some helpful tips when scheduling your next ride.

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Disease Management

Gold Coast Health Plan (GCHP) cares about you and your family! That’s why the Plan offers Disease Management Programs for Asthma, Diabetes and Pre-Diabetes. The programs are for members and their families with asthma, diabetes and pre-diabetes. The programs are a free GCHP benefit. They offer resources and educational materials in both English and Spanish.

The Disease Management Program for asthma or diabetes can connect you with a nurse coach to:

  • Answer your specific questions.
  • Help you create a plan of action for you and your family.

GCHP can connect you with English and Spanish classes in Ventura County near your home or work. The classes can help you learn ways to stay healthy and be active. Classes include information about managing many chronic conditions.

The classes can also teach you ways to keep your family healthier and more active.

For members with asthma, your doctor can create or change an Asthma Action Plan (AAP) for you. An AAP can help you keep your asthma controlled. If you do not have an AAP, click the link below for a sample to show your doctor. Your doctor may use this sample or your doctor may have a preferred AAP. Bring the sample below to your next doctor visit if you need a plan.

  • Sample asthma action plans in English and Spanish from the National Heart, Lung, and Blood Institute (NHLBI).

Partnering with GCHP is easy. All you need to do is call 1-805-437-5588/TTY 1-888-310-7347 and tell us how we can help you and the best way to reach you. You can stop the program at any time.

Click here to learn more.

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Grievance & Appeals (G&A)

Gold Coast Health Plan’s grievance & appeals (G&A) process provides a mechanism for members to report complaints regarding their health care benefits. Please use the Member Grievance & Appeals Form to submit your complaint.

Submit your completed forms to:

Gold Coast Health Plan
Attn: Member Grievance & Appeals
P.O. Box 9176
Oxnard, CA 93031

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Human Services Agency

The County of Ventura Human Services Agency (HSA) provides a broad array of services that include the protection of children and vulnerable adults and support for those needing assistance with food, housing, health care and employment. Click here to access the Medi-Cal site.

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Member Rewards

Gold Coast Health Plan (GCHP) values the health of its members. To encourage healthy behavior, GCHP is offering rewards to members who complete these preventive care exams:

  • Postpartum Care Exam
    New mothers who complete a postpartum care exam within 3 to 8 weeks after delivery can receive a large pack of diapers.
    Click here for the form to apply for the member reward. (Updated October 29, 2018)
  • Annual Well-Child Exam (3- to 6-Year Old Children)

    GCHP wants to give your child a $15 gift card for getting a well-child check-up in 2019. The child must have a well-child exam between January 1, 2019 and December 31, 2019.
    Click here to download the form.

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Member Services Information and Resource Guide

Gold Coast Health Plan (GCHP) has a brochure to help you answer some questions about Medi-Cal and GCHP benefits.
 
This brochure has important phone numbers and information about services. It also talks about member rights and responsibilities. Click here to view the brochure.

Staying Healthy Assessment Tool

You can download the Staying Healthy Assessment Tool in English or Spanish.

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Tri-Counties Regional Center (TCRC)

Tri-Counties Regional Center helps people with developmental disabilities of any age with services and support for living, working, learning and recreating in our community.

If you are receiving TCRC services and need help with getting care for a medical problem, talk to your primary care doctor (PCP).  Your PCP can ask Gold Coast Health Plan’s Care Management nurses to work with TCRC and the PCP to help get your care needs met.

TCRC offices in Ventura County:
Oxnard
2401 East Gonzales Road, Suite 100
Oxnard, CA 93036
(805) 485-3177 or (800) 664-3177
FAX (805) 988-9521
Simi Valley
1900 E. Los Angeles Ave. Second Floor
Simi Valley, CA 93065
(805) 522-8030 or (800) 517-2524
FAX (805) 522-8142

Click here to access the Tri-Counties Regional Center website.

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Urgent Care Services

Gold Coast Health Plan (GCHP) offers urgent care services to members at no cost. If you need to see the doctor and it is not a life-threatening condition, go to a contracted urgent care center near you. GCHP members may go to any contracted urgent care center. If you think it’s an emergency, call 911 or call your doctor to receive medical care.

For a list of contracted urgent care centers, click here.

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