Care Plans for Enrollees with Special Health Care Needs shall. 1) Be based on an Enrollee’s approved assessment as described in Section 2.3.D.1, and developed under the direction of the Enrollee (or the Enrollee’s representative, if applicable); 2) Reflect the Enrollee’s preference and needs; 3) Be updated at least every 12 months, or when the Enrollee’s circumstances or needs change significantly, or at the request of the Enrollee. The Enrollee shall be at the center of the care planning process; 4) Designate the Enrollee’s care team, as applicable, including participants of the Enrollee’s choosing; 5) Be signed or otherwise approved by the Enrollee. The Contractor shall establish and maintain policies and procedures to ensure an Enrollee can sign or otherwise convey approval of his or her Care Plan when it is developed or subsequently modified. Such policies and procedures shall include: a) Informing an Enrollee of his or her right to approve the Care Plan; b) Providing the Enrollee with a copy of the Care Plan; c) Providing mechanisms for the Enrollee to sign or otherwise convey approval of the Care Plan. Such mechanisms shall meet the Enrollee’s accessibility needs; and d) Informing an Enrollee of the availability of and access to Ombudsman services; and 6) Be approved and signed by the Enrollee’s PCP or PCP Designee in a timely manner, as further specified by EOHHS.
Appears in 7 contracts
Samples: Primary Care Accountable Care Organization Contract, Primary Care Accountable Care Organization Contract, Primary Care Accountable Care Organization Contract
