Palliative Care Provider Resources
In 2018, Gold Coast Health Plan implemented a palliative care benefit called MyGoldCare™.
GCHP strives to build a strong provider network of qualified, multidisciplinary teams dedicated to providing patient- and family-centered care that addresses the physical, intellectual, emotional, social and spiritual needs of the Plan’s population in the most compassionate way possible. The MyGoldCare palliative care program will be available for any member who qualifies. This does not result in a reduction in benefits for members.
No prior authorization is required for palliative care services. Referring providers may refer directly to a MyGoldCare palliative care provider to ensure timely access. A list of contracted outpatient and in-home palliative care providers can be found in the GCHP Provider Directory.
View Frequently Asked Questions About Palliative Care Services for GCHP Members.
What is the difference between palliative care and hospice?
Palliative care is used while patients continue active treatment for their medical conditions. Hospice care is reserved for terminally ill patients when treatment is no longer curative during the last six months of life. A patient can receive curative treatment and palliative care treatment at the same time.
Members who may benefit from palliative care may have the following conditions or problems, but not limited to:
- Advanced cancer
- Liver failure
- COPD
- Congestive heart failure
- Kidney failure
- Prognosis of death within a year would not be unexpected based on clinical status
- Neurodegenerative disease like Alzheimer's disease, ALS, dementia, Parkinson’s disease
Reasons for the referral may be, but not limited to:
- Pain management
- Spiritual support
- Functional decline of ADLs
- Emotional support
- Caregiver support
- Lack of social support
- Member is not eligible for hospice, or member declined hospice
- Member is using ED / hospital to manage their advanced illness
- Coordination of care
- Difficult side effects from treatments
- Advance care planning / POLST assistance
Palliative care provides additional “eyes and ears” on the patient by trained staff to assist patients in:
- Articulating goals and preferences
- Completing advance directives and similar documents
- Screening, assessing, and helping manage difficult symptoms
- Providing spiritual and emotional support to patients and families / caregivers
Palliative care also saves other treating clinicians time while improving patient satisfaction with care, and improves quality of life and reduce symptom burden. If you feel you have a member who may benefit from palliative care, please call GCHP Care Management at 805-437-5656 or email us at CareManagement@goldcp.org.
- Advance healthcare directive form. Names a medical decision-maker if you cannot speak for yourself. You can also say when you would and wouldn't want particular kinds of treatment.
- Help for healthcare agents: A companion piece to the advance healthcare directive to help you understand your role as the spokesperson for your loved one.
- A palliative care approach to navigating the family meeting: An approach toward more effective family meetings during a medical crisis, or introducing end-of-life discussions that may provoke anxiety and fear among providers and families.
- Advance care planning resources in other languages.
- California POLST Form: A physician order that gives seriously ill patients more control over their end-of-life care by specifying the types of medical treatment they wish to receive.
- POLST- Frequently Asked Clinical Questions for Providers
- POLST- Frequently Asked General Questions for Providers
- POLST- Frequently Asked Questions for Consumers: A resource for providers to help them answer questions from their patients regarding the POLST form.
- Facing Serious Illness: Making Your Wishes Known: A guide to the POLST form.
- Other resources for the POLST form
- Palliative care education: The California State University Institute for Palliative Care receives funding from the state Department of Health Care Services to support the education of Medi-Cal providers in how to deliver palliative care.
- Ventura County Coalition of Compassionate Care (VCCCC): VCCCC is a local coalition dedicated to promoting education to healthcare professionals and the public regarding advance care planning and the understanding of life-sustaining treatments for those with serious illnesses. You can connect with other professions dedicated to compassionate care and stay up-to-date on relevant resources, policies and legislation that may affect you and your organization.
- Centers to Advance Palliative Care: The Center to Advance Palliative Care is a national organization dedicated to increasing the availability of quality palliative care services for people facing serious illnesses.
- National Hospice and Palliative Care Organization: An organization that represents hospice and palliative care programs and professionals in the United States.
- Palliative Care and Senate Bill 1004: SB 1004 requires the state Department of Health Care Services to "establish standards and provide technical assistance for Medi-Cal managed care plans to ensure delivery of palliative care services."
- Ventura County Health Care Agency's In Home Support Services: This program helps seniors and people with disabilities, including children, to stay in their homes. Help is available for qualified applicants to pay for support services, such as light domestic help, nonmedical personal care, and assistance to and from medical appointments.
- Ventura County Health Care Agency's Whole Person Care: The program helps members facing complex medical and social challenges to secure necessities, such as housing, food and reliable transportation to doctor's appointments. For more information, contact the Ventura County Health Care Agency at 1.805.339.1122.