Community Treatment of Patients Discharged from State Mental Hospitals Sample Clauses

Community Treatment of Patients Discharged from State Mental Hospitals. The Health Plan shall provide Medically Necessary Behavioral Health Services to Enrollees who have been discharged from any State mental Hospital, including, but not limited to, follow-up services and care. All Enrollees who have previously received services at the State mental Hospital must receive follow up care.

Community Treatment of Patients Discharged from State Mental Hospitals. The plan shall provide medically necessary behavioral health services to enrollees who have been discharged from any state mental hospital. All enrollees who have previously received services at the state mental hospital must receive follow-up and care. The plan of care shall be aimed at encouraging the enrollees to achieve a high quality of life while living in the community in the least restrictive environment which is medically appropriate; and reducing the likelihood that these enrollees shall be readmitted to a state mental hospital. Beneficiaries who were enrolled in the plan prior to admission to the state mental hospital must be followed by the plan during their stay until the 60th day after disenrollment from the plan. A mental health targeted case manager must attend and participate in discharge planning activities at the facility. Targeted case managers are responsible for working with the former enrollee prior to discharge from the state facility to assure that benefits are reinstated as soon as possible and that a community behavioral health service is received within 24 hours of discharge from the state facility. If the beneficiary remains in the state facility more than 60 days after disenrollment from the plan, the plan shall cooperate in transferring care and enrolling the beneficiary with a Department of Children and Families funded case management provider who will bear the responsibility of ongoing monthly follow-up care and discharge planning until such time that the beneficiary is again eligible for benefits and enrolled in managed care. The plan must develop a cooperative agreement with the hospital to enable the plan to anticipate beneficiaries who were plan enrollees prior to admission who will be soon discharged from the institution. The cooperative agreement must address arrangements for persons who are to be discharged but for whom re-enrollment may not take effect immediately.

Community Treatment of Patients Discharged from State Mental Hospitals a. The Health Plan shall provide Medically Necessary Behavioral Health Services to Enrollees who have been discharged from any State mental Hospital, including, but not limited to, follow-up services and care. All Enrollees who have previously received services at the State mental Hospital must receive follow up care. b. The plan of care shall be aimed at encouraging Enrollees to achieve a high quality of life while living in the community in the least restrictive environment that is medically appropriate and reducing the likelihood that the Enrollees will be readmitted to a State mental Hospital. c. The Health Plan shall follow the progress of all Enrollees enrolled in the Health Plan prior to admission to a State mental Hospital until the one hundred eightieth (180th) day after Disenrollment from the Health Plan. The Health Plan shall use behavioral health targeted case managers to follow the progress of Enrollees. The behavioral health targeted case manager must attend and participate in the discharge planning activities at the facility. Targeted case managers are responsible for working with the former Enrollee before discharge from the State facility to assure that Benefits are reinstated as soon as possible, and that the Enrollee receives community Behavioral Health Services within twenty-four (24) hours of his/her discharge from the State facility. d. If the Enrollee remains in the State facility more than one hundred eighty (180) days after Disenrollment, the Health Plan shall cooperate with DCF and the Enrollee to ensure that the Enrollee is assigned a DCF funded Case Management provider who will bear the responsibility of ongoing monthly follow-up care and discharge planning until such time that the Enrollee is again eligible for, and enrolled in, a Health Plan. e. The Health Plan shall develop a cooperative agreement with the behavioral health care facility to enable the Health Plan to anticipate those Medicaid Recipients who were Enrollees of the Health Plan prior to admission to the Facility, and will be soon discharged from the Facility. The cooperative agreement must address arrangements for Medicaid Recipients, whom the Facility is discharging, but who are not eligible for immediate re-enrollment.