Common use of Care Plan Clause in Contracts

Care Plan. the plan of care developed by the Enrollee and other individuals involved in the Enrollee’s care or Care Management, as described in Section 2.3.D.2. Care Team Point of Contact – A member of a BH CP-Engaged Enrollee’s care team responsible for ongoing communication with the care team. The Care Team Point of Contact may be the Enrollee’s PCP or PCP Designee, or the Contractor’s staff member that has face-to-face contact with the PCP or the care team. Chief Financial Officer – one of the Contractor’s Key Personnel roles, as described in Section 2.4.A. Chief Medical Officer/Medical Director – one of the Contractor’s Key Personnel roles, as described in Section 2.4.A. Child and Adolescent Needs and Strengths (CANS) Tool – a tool that provides a standardized way to organize information gathered during Behavioral Health Clinical Assessments and during the Discharge Planning process from Inpatient Mental Health Services and Community Based Acute Treatment Services as described in Appendix A. A Massachusetts version of the CANS Tool has been developed and is intended to be used as a treatment decision support tool for Behavioral Health Providers serving Enrollees under the age of 21. Children’s Behavioral Health Initiative (CBHI) -- an interagency undertaking by EOHHS and MassHealth whose mission is to strengthen, expand and integrate Behavioral Health Services for Members under the age of 21 into a comprehensive system of community-based, culturally competent care. Children’s Behavioral Health Initiative Services (CBHI Services) – any of the following services: Intensive Care Coordination (ICC), Family Support and Training, In-Home Behavioral Services (including Behavior Management Therapy and Behavior Management Monitoring) and Therapeutic Mentoring Services, In-Home Therapy Services (including Therapeutic Clinical Intervention and Ongoing Therapeutic Training and Support), and Mobile Crisis Intervention. Clinical Advice and Support Line – a phone line that provides Enrollees with information to support access to and coordination of appropriate care, as described in Section 2.3.C.3. Clinical Care Manager – a licensed Registered Nurse or other individual, employed by the Contractor or an Enrollee’s PCP and licensed to provide clinical care management, including intensive monitoring, follow-up, and care coordination, and clinical management of high-risk Enrollees, as further specified by EOHHS. Clinical Quality Measures – clinical information from Enrollees’ medical records used to determine the overall quality of care received by Enrollees or Members. Clinical Quality Measures are a subset of Quality Measures and are set forth in Appendix B. Cold-call Marketing – any unsolicited personal contact by the Contractor, its employees, Providers, agents or Material Subcontractors with a Member who is not enrolled in the Contractor’s plan that EOHHS can reasonably interpret as influencing the Member to enroll in the Contractor’s plan or either not to enroll in, or to disenroll from, another MassHealth-contracted Accountable Care Organization, MassHealth-contracted MCO, or the PCC Plan. Cold-call Marketing shall not include any personal contact between a Provider and a Member who is a prospective, current or former patient of that Provider regarding the provisions, terms or requirements of MassHealth as they relate to the treatment needs of that particular member.