Comprehensive Tobacco Cessation Services and Screening for Medi-Cal Patients
The United States Preventive Services Task Force (USPSTF) recommends that health care providers ask all individuals ages 18 years and older about tobacco use and that providers offer tobacco cessation interventions to those who use tobacco products. Providers should also offer tailored counseling to pregnant women who smoke. Finally, interventions, education or brief counseling should be offered to prevent initiation of tobacco use in school-aged children and adolescents.
What does this mean to me?
Beginning November 1, 2014, is responsible for ensuring that Primary Care Physicians and their qualified staff implement the interventions outlined in MMCD Policy Letter 14-006.
ALL PLAN LETTER 16-014. COMPREHENSIVE TOBACCO PREVENTION AND CESSATION SERVICES FOR MEDI-CAL BENEFICIARIES (Department of Health Care Services - State of California-Health and Human Services Agency).
What are the tobacco cessation interventions I need to implement?
- Identify (initially and annually) all members of any age who use tobacco products or are exposed to tobacco smoke and document this information in the member's medical record. This can be done through using the Staying Healthy Assessment (SHA) or equivalent approved assessment.
- Offer FDA approved tobacco cessation medications to non-pregnant adults of any age. The medications include: Bupropion SR (without prior authorization), Varenicline, nicotine gum, nicotine inhaler, nicotine lozenge, nicotine nasal spray, and nicotine patch. Members qualify for:
a. A 90-day treatment regimen of medications without other restrictions.
b. Medication for at least two separate quit attempts per year with no mandatory break required.
c. Medication without counseling if the member does not want counseling.
- Refer tobacco users of any age to available individual, group, and telephone counseling. Members qualify for four counseling sessions of at least ten minutes for at least two separate quit attempts each year without prior authorization. You may:
- Ask all pregnant women if they use tobacco or are exposed to tobacco smoke. If a smoker, offer at least one face-to-face counseling session per quit attempt and refer to a tobacco cessation quit line. Counseling services will be covered for 60 days after delivery plus any additional days needed to end the respective month. Smoking cessation medications are not recommended during pregnancy.
- Provide education including brief counseling to children and adolescents to prevent initiation of tobacco in school-aged children and adolescents in accordance with AAP Bright Futures periodicity schedule and anticipatory guidance.
- Review the following provider training information:
b. Special requirements for providing services for pregnant tobacco users - - "Smoking Cessation During Pregnancy: Committee Opinion".
c. Counseling using the "5A's" model" or other validated model for treating tobacco use and dependence.
Where can I find additional provider training resources?
- Continuing Medical Education (CME)-accredited training on tobacco cessation and behavioral health: https://www.cmecalifornia.com/Activity/3439569/Detail.aspx.
- University of California San Francisco’s (UCSF) Smoking Cessation Leader Center's tools and resources: http://smokingcessationleadership.ucsf.edu/.
- UCSF's Smoking Cessation Leadership Center Webinars for CME/Continuing Education Unit credit: http://smokingcessationleadership.ucsf.edu/webinars.
- Other cessation trainings: https://www.nobutts.org/online-training.
Where can I find other resources?
- CA Smokers Helpline (available in English, Spanish, Chinese, Vietnamese and Korean)
- Los Angeles County Tobacco Cessation and Education Resources
- San Diego County Quit Smoking Help & Resources
What resources are available to my patients?
- Download and print: You Can Stop Smoking (English and Spanish)
- For additional resources, patients should call Member Services and ask for the Health Education Department.
Where do I go for more information?
E-mail the Health Education Department at firstname.lastname@example.org or call (323) 889-6638 and ask for the Health Education Department.