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Staying Healthy Assessment

All Gold Coast Health Plan (GCHP) members are required to have a Staying Healthy Assessment (SHA) within 120 days of enrollment. The SHA can help providers identify high-risk behavior, set priorities for behavior change and refer patients for appropriate services.

Below is a current schedule and protocol for administering the SHA tool.

GCHP members will be asked to fill out the age/language specific Staying Healthy Assessment form at your Initial Health Assessment (IHA), within 120 days of enrollment or well-care visits at your office.

Staying Healthy Assessment

Children

One assessment for each age group, completed by parent or guardian, signed and dated by Primary Care Provider (PCP). Reviewed, dated and initialed by PCP annually thereafter.

Pre-Adolescents

Adolescents

12 to 17 years of age

Self-administer. Reviewed, dated and initialed by PCP annually thereafter.

Adults

Self-administered, every three to five years up through age 55.

Seniors

After age 65, self-administer per recommendation by PCP.

A complete set of SHA forms is available at www.dhcs.ca.gov.