Common use of ACCESS TO SPECIALTY MENTAL HEALTH SERVICES Clause in Contracts

ACCESS TO SPECIALTY MENTAL HEALTH SERVICES. 2.2.1. In collaboration with the COUNTY, CONTRACTOR will work to ensure that individuals to whom the CONTRACTOR provides SMHS meet access criteria, as per DHCS guidance specified in BHIN 21-073. Specifically, the CONTRACTOR will ensure that the clinical record for each member includes information as a whole indicating that member’s presentation and needs are aligned with the criteria applicable to their age at the time-of-service provision as specified below. 2.2.2. For enrolled members under 21 years of age, CONTRACTOR shall provide all medically necessary SMHS required pursuant to Section 1396d(r) of Title 42 of the United States Code. Covered SMHS shall be provided to enrolled members who meet either of the following criteria, (4.2.1) or (4.2.2) below. If a member under age 21 meets the criteria as described in (4.2.1) below, the member meets criteria to access SMHS; it is not necessary to establish that the member also meets the criteria in (4.2.2) below. 2.2.2.1. The member has a condition placing them at high risk for a mental health disorder due to experience of trauma evidenced by any of the following: scoring in the high-risk range under a trauma screening tool approved by DHCS, involvement in the child welfare system, juvenile justice involvement, or experiencing homelessness. 2.2.2.2. The member meets both of the following requirements in 4.2.2.1 and 4.2.2.2 below: 2.2.2.2.1. The member has at least one of the following: 2. 2.2.2.1.1. A significant impairment

ACCESS TO SPECIALTY MENTAL HEALTH SERVICES. 2.2.1. In collaboration with the COUNTY, CONTRACTOR will work to ensure that individuals to whom the CONTRACTOR provides SMHS meet access criteria, as per DHCS guidance specified in BHIN 21-073. Specifically, the CONTRACTOR will ensure that the clinical record for each member includes information as a whole indicating that member’s presentation and needs are aligned with the criteria applicable to their age at the time-of-of- service provision as specified below. 2.2.2. For enrolled members under 21 years of age, CONTRACTOR shall provide all medically necessary SMHS required pursuant to Section 1396d(r) of Title 42 of the United States Code. Covered SMHS shall be provided to enrolled members who meet either of the following criteria, (4.2.1) or (4.2.2) below. If a member under age 21 meets the criteria as described in (4.2.1) below, the member meets criteria to access SMHS; it is not necessary to establish that the member also meets the criteria in (4.2.2) below. 2.2.2.1. The member has a condition placing them at high risk for a mental health disorder due to experience of trauma evidenced by any of the following: scoring in the high-risk range under a trauma screening tool approved by DHCS, involvement in the child welfare system, juvenile justice involvement, or experiencing homelessness. 2.2.2.2. The member meets both of the following requirements in 4.2.2.1 and 4.2.2.2 below: 2.2.2.2.1. The member has at least one of the following: 2. 2.2.2.1.1. A significant impairment