Common use of Care Coordination Clause in Contracts

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the specific requirements set forth in this MOU and for MHP’s to ensure Medically Necessary NSMHS and SMHS provided concurrently are coordinated and non-duplicative. ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. The Parties must establish policies and procedures to maintain collaboration with MHP/DMC-ODS each other and to identify strategies to monitor and assess the effectiveness of this MOU. The MHP policies and procedures must ensure coordination of inpatient and outpatient medical and mental health care for all Members enrolled in MCP and receiving SMHS through MHP, and must comply with federal and State law, regulations, and guidance, including Cal. Welf. & Inst. Code Section 5328. iv. The Parties must establish and 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 coordinating care for MHP individuals who meet access criteria for and are concurrently receiving NSMHS and SMHS consistent with the No Wrong Door for Mental Health Services Policy described in APL 22-005 and BHIN 22- 011 to ensure the care is clinically appropriate and non-duplicative and considers the Member’s established therapeutic relationships; Also, 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. For MHP only, permitting Members to concurrently receive NSMHS and SMHS when clinically appropriate, coordinated, and not duplicative consistent with the No Wrong Door for Mental Health Services Policy described in APL 22-005 and BHIN 22-011. 6. For DMC-ODS only, 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 a Member’s care;- 7. MHP only, a process for ensuring that Members and Network Providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside normal business hours, as well as providing or arranging for 24/7 emergency access to admission to psychiatric inpatient hospital. 8. For DMC-ODS only, 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 9. For DMC-ODS only, processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the specific requirements set forth in this MOU and for MHP’s to ensure Medically Necessary NSMHS and SMHS provided concurrently are coordinated and non-duplicative. ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. The Parties must establish policies and procedures to maintain collaboration with MHP/DMC-ODS each other and to identify strategies to monitor and assess the effectiveness of this MOU. The MHP policies and procedures must ensure coordination of inpatient and outpatient medical and mental health care for all Members enrolled in MCP and receiving SMHS through MHP, and must comply with federal and State law, regulations, and guidance, including Cal. Welf. & Inst. Code Section 5328. iv. The Parties must establish and 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.; 32. A process for coordinating care for MHP individuals who meet access criteria for and are concurrently receiving NSMHS and SMHS consistent with the No Wrong Door for Mental Health Services Policy described in APL 22-005 and BHIN 22- 22-011 to ensure the care is clinically appropriate and non-duplicative and considers the Member’s established therapeutic relationships; Also, 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;1 CalAIM Population Health Management Policy Guide available at: xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/PHM-Policy-Guide.pdf 43. A process for coordinating the delivery of medically necessary Covered Services with the Member’s Primary Care ProviderPCP, including including, without limitation limitation, transportation services, home health services, and other Medically Necessary Covered Services for eligible members.Members; 54. For MHP only, permitting Permitting Members to concurrently receive NSMHS and SMHS when clinically appropriate, coordinated, and not duplicative consistent with the No Wrong Door for Mental Health Services Policy described in APL 22-005 and BHIN 22-011. 65. For DMC-ODS only, 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 a Member’s care;- 7. MHP only, a A process for ensuring that Members and Network Providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside normal business hours, as well as providing or arranging for 24/7 emergency access to admission to psychiatric inpatient hospital. 8. For DMC-ODS only, 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 9. For DMC-ODS only, processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the specific requirements set forth in this MOU and for MHP’s to ensure Medically Necessary NSMHS and SMHS provided concurrently are coordinated and non-duplicative. ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. The Parties must establish policies and procedures to maintain collaboration with MHP/DMC-ODS each other and to identify strategies to monitor and assess the effectiveness of this MOU. The MHP policies and procedures must ensure coordination of inpatient and outpatient medical and mental health care for all Members enrolled in MCP and receiving SMHS through MHP, and must comply with federal and State law, regulations, and guidance, including Cal. Welf. & Inst. Code Section 5328. iv. The Parties must establish and 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.; 32. A process for coordinating care for MHP individuals who meet access criteria for and are concurrently receiving NSMHS and SMHS consistent with the No Wrong Door for Mental Health Services Policy described in APL 22-005 and BHIN 22- 011 to ensure the care is clinically appropriate and non-duplicative and considers the Member’s established therapeutic relationships; Also, 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; 43. A process for coordinating the delivery of medically necessary Covered Services with the Member’s Primary Care ProviderPCP, including including, without limitation limitation, transportation services, home health services, and other Medically Necessary Covered Services for eligible members.Members; 54. For MHP only, permitting Permitting Members to concurrently receive NSMHS and SMHS when clinically appropriate, coordinated, and not duplicative consistent with the No Wrong Door for Mental Health Services Policy described in APL 22-005 and BHIN 22-22- 011. 65. For DMC-ODS only, 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 a Member’s care;- 7. MHP only, a A process for ensuring that Members and Network Providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside normal business hours, as well as providing or arranging for 24/7 emergency access to admission to psychiatric inpatient hospital. 8. For DMC-ODS only, 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 9. For DMC-ODS only, processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.1 CalAIM Population Health Management Policy Guide available at xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/2023-PHM-Policy-Guide.pdf

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the specific requirements set forth in this MOU and for MHP’s to ensure Medically Necessary NSMHS and SMHS provided concurrently are coordinated and non-duplicative. ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. The Parties must establish policies and procedures to maintain collaboration with MHP/DMC-ODS each other and to identify strategies to monitor and assess the effectiveness of this MOU. The MHP policies and procedures must ensure coordination of inpatient and outpatient medical and mental health care for all Members enrolled in MCP and receiving SMHS through MHP, and must comply with federal and State law, regulations, and guidance, including Cal. Welf. & Inst. Code Section 5328. iv. 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. v. The Parties must establish and 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 coordinating care for MHP individuals who meet access criteria for and are concurrently receiving NSMHS and SMHS consistent with the No Wrong Door for Mental Health Services Policy described in APL 22-005 and BHIN 22- 011 to ensure the care is clinically appropriate and non-duplicative and considers the Member’s established therapeutic relationships; Also, a ; 4. A process for how MCP and DMC- 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; 45. A process for coordinating the delivery of medically necessary Medically Necessary Covered Services with the Member’s Primary Care Provider, including including, without limitation limitation, transportation services, home health services, and other Medically Necessary Covered Services for eligible members.Members; 56. For MHP onlyA process for how MCP and DMC-ODS will help to ensure the Member is engaged in participates in their care program and a process for ensuring the Members, permitting caregivers, and providers are engaged in the development of the Member’s care; 7. Permitting Members to concurrently receive NSMHS and SMHS when clinically appropriate, coordinated, and not duplicative consistent with the No Wrong Door for Mental Health Services Policy described in APL 22-005 and BHIN 22-011. 68. For DMC-ODS only, 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 a Member’s care;- 7. MHP only, a A process for ensuring that Members and Network Providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside normal business hours, as well as providing or arranging for 24/7 emergency access to admission to psychiatric inpatient hospital. 89. For DMC-ODS onlyA process for reviewing and updating a Member’s problem list, a as clinically indicated. The process must describe circumstances for updating problem lists and coordinating with outpatient SUD providers; 10. 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 911. For DMC-ODS only, processes Processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the specific requirements set forth in this MOU and for MHP’s to ensure Medically Necessary NSMHS and SMHS provided concurrently are coordinated and non-duplicative. ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. The Parties must establish policies and procedures to maintain collaboration with MHP/DMC-ODS each other and to identify strategies to monitor and assess the effectiveness of this MOU. The MHP policies and procedures must ensure coordination of inpatient and outpatient medical and mental health care for all Members enrolled in MCP and receiving SMHS through MHP, and must comply with federal and State law, regulations, and guidance, including Cal. Welf. & Inst. Code Section 5328. iv. The Parties must establish and 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.; 32. A process for coordinating care for MHP individuals who meet access criteria for and are concurrently receiving NSMHS and SMHS consistent with the No Wrong Door for Mental Health Services Policy described in APL 22-005 and BHIN 22- 22-011 to ensure the care is clinically appropriate and non-duplicative and considers the Member’s established therapeutic relationships; Also, a process for how MCP and DMC- ODS will engage in collaborative treatment planning to ensure care is clinically appropriate and non1 CalAIM Population Health Management Policy Guide available at xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/2023-PHM-Policy-Guide.pdf DocuSign Envelope ID: C977AC65-duplicative and considers the Member’s established therapeutic relationships;61FC-46C9-BACA-08CFF903E6C6 43. A process for coordinating the delivery of medically necessary Covered Services with the Member’s Primary Care ProviderPCP, including including, without limitation limitation, transportation services, home health services, and other Medically Necessary Covered Services for eligible members.Members; 54. For MHP only, permitting Permitting Members to concurrently receive NSMHS and SMHS when clinically appropriate, coordinated, and not duplicative consistent with the No Wrong Door for Mental Health Services Policy described in APL 22-005 and BHIN 22-011. 65. For DMC-ODS only, 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 a Member’s care;- 7. MHP only, a A process for ensuring that Members and Network Providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside normal business hours, as well as providing or arranging for 24/7 emergency access to admission to psychiatric inpatient hospital. 8. For DMC-ODS only, 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 9. For DMC-ODS only, processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the specific requirements set forth in this MOU and for MHP’s to ensure Medically Necessary NSMHS and SMHS provided concurrently are coordinated and non-duplicative. ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. The Parties must establish policies and procedures to maintain collaboration with MHP/DMC-ODS each other and to identify strategies to monitor and assess the effectiveness of this MOU. The MHP policies and procedures must ensure coordination of inpatient and outpatient medical and mental health care for all Members enrolled in MCP and receiving SMHS through MHP, and must comply with federal and State law, regulations, and guidance, including Cal. Welf. & Inst. Code Section 5328. iv. The Parties must establish and 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.; 32. A process for coordinating care for MHP individuals who meet access criteria for and are concurrently receiving NSMHS and SMHS consistent with the No Wrong Door for Mental Health Services Policy described in APL 22-005 and BHIN 22- 22-011 to ensure the care is clinically appropriate and non-duplicative and considers the Member’s established therapeutic relationships; Also, 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; 43. A process for coordinating the delivery of medically necessary Covered Services with the Member’s Primary Care ProviderPCP, including including, without limitation limitation, transportation services, home health services, and other Medically Necessary Covered Services for eligible members.Members; 54. For MHP only, permitting Permitting Members to concurrently receive NSMHS and SMHS when clinically appropriate, coordinated, and not duplicative consistent with the No Wrong Door for Mental Health Services Policy described in APL 22-005 and BHIN 22-011. 65. For DMC-ODS only, 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 a Member’s care;- 7. MHP only, a A process for ensuring that Members and Network Providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside normal business hours, as well as providing or arranging for 24/7 emergency access to admission to psychiatric inpatient hospital. 8. For DMC-ODS only, 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 9. For DMC-ODS only, processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.1 CalAIM Population Health Management Policy Guide available at xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/2023-PHM-Policy-Guide.pdf

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the specific requirements set forth in this MOU and for MHP’s to ensure Medically Necessary NSMHS and SMHS provided concurrently are coordinated and nonMOU. Docusign Envelope ID: F0807EFB-43F7-duplicative.4245-B7BE-BF3615C8374B ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. The Parties MCP must establish have policies and procedures in place to maintain cross- system collaboration with MHP/DMC-ODS each other and to identify strategies to monitor and assess the effectiveness of this MOU. The MHP policies and procedures must ensure coordination of inpatient and outpatient medical and mental health care for all Members enrolled in MCP and receiving SMHS through MHP, and must comply with federal and State law, regulations, and guidance, including Cal. Welf. & Inst. Code Section 5328. iv. The Parties must establish and 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.; 1 CalAIM Population Health Management Policy Guide, available at Docusign Envelope ID: F0807EFB-43F7-4245-B7BE-BF3615C8374B 3. A process for coordinating care for MHP individuals who meet access criteria for and are concurrently receiving NSMHS and SMHS consistent with the No Wrong Door for Mental Health Services Policy described in APL 22-005 and BHIN 22- 011 to ensure the care is clinically appropriate and non-duplicative and considers the Member’s established therapeutic relationships; Also, a process for how MCP and DMC- DMC-ODS will engage in collaborative treatment planning to ensure care is clinically appropriate and non-non- duplicative and considers the Member’s established therapeutic relationships; 4. A process for coordinating the delivery of medically necessary 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.Members; 5. For MHP only, permitting Members to concurrently receive NSMHS and SMHS when clinically appropriate, coordinated, and not duplicative consistent with the No Wrong Door for Mental Health Services Policy described in APL 22-005 and BHIN 22-011. 6. For DMC-ODS only, a A process for how MCP AND 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 care;-problem list, as clinically indicated. The process must describe circumstances for updating problem lists and coordinating with outpatient SUD providers; 7. MHP only, a process for ensuring that Members and Network Providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside normal business hours, as well as providing or arranging for 24/7 emergency access to admission to psychiatric inpatient hospital. 8. For DMC-ODS only, a 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 98. For DMC-ODS only, processes Processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.