Common use of Community LTSS Clause in Contracts

Community LTSS. Enrollees who are eligible for LTSS and who reside in the community will receive an in-person CFNA in their homes (with Enrollee consent). 2.6.2.4.3.2.1. During the first six (6) months of the Demonstration, for Enrollees eligible for community-based LTSS who were not enrolled in the Contractor’s RHO plan immediately prior to the Demonstration, the CFNA will be completed no later than one hundred-eighty (180) calendar Days after the effective Enrollment date. After the first six months (6) of the Demonstration, the CFNA must be completed no later than fifteen (15) calendar Days after the effective Enrollment date, or sooner if required based on the Enrollee’s condition, needs or circumstances. Reassessments will be conducted in-person, or by phone if needed or requested by the Enrollee, at least every ninety (90) calendar Days, or sooner if required based on the Enrollee’s condition or needs or the circumstances described in Section 2.6.2.4.8. 2.6.2.4.3.2.2. Previous RHO: For community-based Enrollees eligible for LTSS who were enrolled in the Contractor’s RHO plan immediately prior to the Demonstration, the previous assessment conducted by the RHO plan will be shared with the ICT within thirty (30) Days of Demonstration Enrollment. If the RHO assessment was completed within the one hundred eighty (180) calendar Days prior to Enrollment in the Demonstration, the Enrollee will be reassessed according to the applicable timeframe for that Enrollee, using the RHO assessment date as the starting point.

Community LTSS. Enrollees who are eligible for LTSS and who reside in the community will receive an in-person CFNA in their homes (with Enrollee consent). 2.6.2.4.3.2.1. During the first six (6) months of the Demonstration, for Enrollees eligible for community-based LTSS who were not enrolled in the Contractor’s RHO plan immediately prior to the Demonstration, the CFNA will be completed no later than one hundred-eighty (180) calendar Days after the effective Enrollment date. After the first six months (6) of the Demonstration, for Enrollees eligible for LTSS with an existing LTSS care plan from the State, the CFNA must be completed no later than fifteen ninety (1590) calendar Days after the effective Enrollment date, or sooner if required based on the Enrollee’s condition, needs or circumstances. Reassessments will be conducted in-in- person, or by phone if needed or requested by the Enrollee, at least every ninety one hundred-eighty (90180) calendar Days, or sooner if required based on the Enrollee’s condition or needs or the circumstances described in Section 2.6.2.4.8. 2.6.2.4.3.2.2. Previous RHO: For community-based Enrollees eligible for LTSS who were enrolled in the Contractor’s RHO plan immediately prior to the Demonstration, the previous assessment conducted by the RHO plan will be shared with the ICT within thirty (30) Days of Demonstration Enrollment. If the RHO assessment was completed within the one hundred hundred-eighty (180) calendar Days prior to Enrollment in the Demonstration, the Enrollee will be reassessed according to the applicable timeframe for that Enrollee, using the RHO assessment date as the starting point.

Community LTSS. Enrollees who are eligible for LTSS and who reside in the community will receive an in-person CFNA in their homes (with Enrollee consent). 2.6.2.4.3.2.1. During the first six (6) months of the Demonstration, for Enrollees eligible for community-based LTSS who were not enrolled in the Contractor’s RHO plan immediately prior to the Demonstration, the CFNA will be completed no later than one hundred-eighty (180) calendar Days after the effective Enrollment date. After the first six months (6) of the Demonstration, the CFNA must be completed no later than fifteen (15) calendar Days after the effective Enrollment date, or sooner if required based on the Enrollee’s condition, needs or circumstances. Reassessments will be conducted in-person, or by phone if needed or requested by the Enrollee, at least every ninety (90) calendar Days, or sooner if required based on the Enrollee’s condition or needs or the circumstances described in Section 2.6.2.4.8. 2.6.2.4.3.2.2. Previous RHO: For community-based Enrollees eligible for LTSS who were enrolled in the Contractor’s RHO plan immediately prior to the Demonstration, the previous assessment conducted by the RHO plan will be shared with the ICT within thirty (30) Days of Demonstration Enrollment. If the RHO assessment was completed within the one hundred eighty (180) calendar Days prior to Enrollment in the Demonstration, the Enrollee will be reassessed according to the applicable timeframe for that Enrollee, using the RHO assessment date as the starting point.