Care Coordination and Collaboration Sample Clauses
Care Coordination and Collaboration a. MCP and LHD must coordinate to ensure Members receiving services through MCAH Programs have access to prevention and wellness information and services. LHD is encouraged to assist Members with accessing prevention and wellness services covered by MCP, by sharing resources and information to with Members about services for which they are eligible, to address needs identified by MCAH Programs’ assessments.
b. MCP must screen Members for eligibility for care management programs such as CCM and ECM, and must, as needed, provide care management services for Members enrolled in MCAH Programs, including for comprehensive perinatal services, high-risk pregnancies, and children with special health care needs. MCP must engage LHD, as needed, for care management and care coordination.
c. MCP should collaborate with MCAH Programs on perinatal provider technical support and communication regarding perinatal issues and service delivery and to monitor the quality of care coordination. 17 CDPH, Local MCAH Programs Policies and Procedures, available at: xxxxx://xxx.xxxx.xx.xxx/Programs/CFH/DMCAH/LocalMCAH/CDPH%20Document%20Library/ MCAH-Policies-and-Procedures.pdf 18 CDPH, Local MCAH Programs Policies and Procedures, available at xxxxx://xxx.xxxx.xx.xxx/Programs/CFH/DMCAH/LocalMCAH/CDPH%20Document%20Library/ MCAH-Policies-and-Procedures.pdf DocuSign Envelope ID: F79290DD-ECCE-476E-A29A-E6F42D469B6D
Care Coordination and Collaboration a. Care Coordination. 1 CalAIM Population Health Management Policy Guide, available at xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/2023‐PHM‐Policy‐Guide.pdf.
i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the requirements set forth in this MOU.
ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly.
iii. MCP must have policies and procedures in place to maintain cross- system collaboration with DMC-ODS and to identify strategies to monitor and assess the effectiveness of this MOU.
iv. The Parties must implement policies and procedures that align for coordinating Members’ care that address:
1. The requirement for DMC-ODS to refer Members to MCP to be assessed for care coordination and other similar programs and other services for which they may qualify provided by MCP including, but not limited to, ECM, CCM, or Community Supports;
2. The specific point of contact from each Party, if someone other than each Party’s Responsible Person, to act as the liaison between Parties and be responsible for initiating, providing, and maintaining ongoing care coordination for all Members under this MOU;
3. A process for how MCP and DMC-ODS will engage in collaborative treatment planning to ensure care is clinically appropriate and non- duplicative and considers the Member’s established therapeutic relationships;
4. A process for coordinating the delivery of Medically Necessary Covered Services with the Member’s Primary Care Provider, including without limitation transportation services, home health services, and other Medically Necessary Covered Services for eligible Members;
5. A process for how MCP and DMC-ODS will help to ensure the Member is engaged and participates in their care program and a process for ensuring the Members, caregivers, and providers are engaged in the development of the Member’s care;
6. A process for reviewing and updating a Member’s problem list, as clinically indicated. The process must describe circumstances for updating problem lists and coordinating with outpatient SUD providers;
7. A process for how the Parties will engage in collaborative treatment planning and ensure communication among providers, including procedures for exchanges of medical information; and
8. Processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined b...
Care Coordination and Collaboration