Comprehensive Assessments Sample Clauses

Comprehensive Assessments a. The Contractor shall provide, at a minimum, a Comprehensive Assessment to at least the following Enrollees: 1) Enrollees with Special Health Care Needs; 2) High- or rising-risk Enrollees enrolled in enhanced care coordination as described in Section 2.4.C; 3) BH CP or LTSS CP Enrollees. For any such BH CP or LTSS CP Enrollee, the Contractor shall require its BH CPs and LTSS CPs to provide comprehensive assessments for such Enrollees; 4) Provided, however, that unless clinically appropriate, the Contractor shall not conduct a new Comprehensive Assessment if an Enrollee has had a Comprehensive Assessment within the last calendar year that includes all domains and considerations described in Section 2.3.B.4.b. b. The Contractor shall ensure Comprehensive Assessments meet the following requirements: 1) The Comprehensive Assessment shall inform the Enrollee’s care, including but not limited to any Care Coordination activities; 2) The Comprehensive Assessment shall be a person-centered assessment of an Enrollee’s care needs and, as applicable and clinically appropriate, the Enrollee’s functional needs, accessibility needs, goals, and other characteristics; 3) The Contractor shall ensure that Enrollees requiring a Comprehensive Assessment are comprehensively assessed in a timely manner to inform the development of the member-centered Care Plan as described in this Section; 4) The Contractor shall record Comprehensive Assessments in the Enrollee’s medical record; 5) The Contractor shall ensure that the Comprehensive Assessment is completed by an individual who is not financially or otherwise conflicted, as further specified by EOHHS; 6) Comprehensive Assessments shall be appropriate to the Enrollee, shall be Enrollee-centered, and shall take place in a location that meets the Enrollee’s needs, including home-based assessments as appropriate; 7) Comprehensive Assessments shall include domains and considerations appropriate for the population receiving the Comprehensive Assessment, as further specified by EOHHS, and shall include, but may not be limited to, the following: a) Immediate care needs and current services, including but not limited to any care coordination or management activities and any services being provided by state agencies; b) Health conditions; c) Medications; provided, however, for CP Enrollees, medications shall be included as further specified in Appendix G; d) Enrollee’s ability to communicate concerns, symptoms, or care goals; e) Functiona...
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Comprehensive Assessments. Each Enrollee shall receive, and be an active participant in, a timely Comprehensive Assessment of medical, behavioral health, community-based or facility-based LTSS, and social needs completed by the Care Management team. For Enrollees identified as high-risk, the CICO must use SCDHHS’s automated Case Management system, to record the Comprehensive Assessments (as described in Section 2.6.4). For Enrollees identified as high-risk, the Comprehensive Assessment will be performed using the state’s uniform assessment tools. For all other Enrollees, the CICO may utilize internal Comprehensive Assessment tools. Assessment domains will include, but not be limited to, social, functional, medical, behavioral, wellness and prevention domains, caregiver status and capabilities, as well as the Enrollee’s preferences, strengths, and goals. The CICO will complete the Comprehensive Assessment by using information from comprehensive data sources, input from the Enrollee, Providers, and family/caregivers. Assessments will be completed by qualified, trained health professionals who possess a professional scope of practice, licensure, and/or credentials appropriate for responding to or managing the Enrollee’s needs. Examples of health professionals who may complete portions or all of the assessment include, but are not limited to: Registered nurses, Licensed practical nurses (under the supervision of registered nurses), Social workers, Medicaid case managers, Certified geriatric care managers, Certified community health workers The CICO will use the results of the Comprehensive Assessment to confirm the appropriate acuity or risk stratification level for the Enrollee and as the basis for developing the integrated ICP. The Enrollee will continue to receive any community-based or facility-based LTSS (i.e., respite care) in any existing Waiver Service Plan(s) prior to the Comprehensive Assessment or reassessment. The CICO will adhere to all transition requirements for services, as outlined in Section 2.6.8..
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Comprehensive Assessments. (1) Criteria for Referrals: DCYF will authorize the referral of cases to Harborview when DCYF Social Service Specialists, shared planning staffings, or Fostering Well-Being documentation determines that an eligible individual is a dependent in out-of-home care, and the DCYF FCAP Lead has approved the referral. Criteria for Referrals: Two (2) or more of the following factors must be present in the case; however, priority shall be given to those cases where three (3) or more factors are present: (a) Multiple out-of-home placements; (b) Chronic behavioral, emotional, physical, or educational problems; (c) More than two years spent in out-of-home care; (d) Assessments and evaluations have been completed, but recommendations differ as to the service plan delivery and best treatment and placement options are unknown; (e) Child or youth is prescribed five or more psychotropic medications or any antipsychotic medications; (f) Repetitive criminal acts or offenses by the child (including inability to comply with court order, treatment, or with conditions of probation or parole); (g) The child has been or is returning to care subsequent to a disrupted or dissolved adoption (h) Reunification is a primary permanency plan but cannot proceed due to: (i) One or both parents have made minimal or no progress or; (j) Parents have borderline capabilities with regard to caring for an exceptional needs child. An assessment will assist with determining whether the abilities match the needs or; (k) A successful reunification is highly unlikely, due to intractable problems with the parents, but grounds for termination are not present; or (l) Parents are partially or wholly compliant with services, but concerns remain about their capability. (m) The family has been the subject of one or more prior dependencies.
Sample 1
Comprehensive Assessments. This service is designed to establish eligibility for OhioRISE and subsequently determine the level of care coordination necessary for individuals who are determined to be eligible for OhioRISE. CANS assessments performed for potentially eligible members on an ongoing basis will be covered by the MMC or FFS programs, until the day after OhioRISE enrollment. The July 2022 MMC capitation rates include the portion of projected CANS assessment benefit expense anticipated to be covered by the MMC program during the rating period. We utilized monthly OhioRISE CANS enrollment information from ODM to project the utilization of CANS assessments covered under the MMC program. We estimated the total volume of CANS assessments by grossing up the OhioRISE enrollment projections, to account for members who failed to meet the threshold score for OhioRISE eligibility. The average unit cost was developed based on the CANS assessment rates in the OhioRISE New and Enhanced Services Fee Schedule8. Adjustment factors were developed for policy and program changes estimated to materially affect the managed care program during the July 2022 rating period that are not fully reflected in the SFY 2021 Experience Adjusted data. Program adjustments were made in the rate development process to the extent a policy or reimbursement change is deemed to have a material cost impact to the MCOs. We defined a program adjustment to be ‘material’ if the total benefit expense for any individual rate cell is impacted by more than 0.1%. In addition, program adjustments that were determined to be material in prior rate setting activities, or are material to the MyCare Ohio program, are considered material. The following is a list of program adjustments deemed immaterial based on our review of the experience data and policy change. • Medication Reviews for Children in Custody. ODM requires a consistent approach to medication reviews for children in custody. The goal is for these medication reviews is to create a meaningful way the public children services association of Ohio (PCSAs) and MCOs can collaborate to provide better care for the youth they serve, as well as provide a way to assist PCSAs in tracking antipsychotics and other prescriptions in their population. We anticipate that this change is immaterial to the MMC program. • Pharmacists as Providers. ODM implemented ORC 5164.14 effective January 15, 2021, which permits Medicaid to provide payment for health care services provided by pharmacis...
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Comprehensive Assessments. Upon notification from the Agency of availability of an open 1915 (c) waiver slot, the Contractor shall conduct a comprehensive assessment, in accordance with 42 C.F.R. § 438.208(c)(2), as described, using a tool and process prior approved by the Agency, for the waitlisted Enrolled Member. The Contractor shall refer individuals who are identified as potentially eligible for LTSS to the Agency or its designee for level of care determination, if applicable.
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Comprehensive Assessments. ‌ 2.6.3.1. Each Enrollee shall receive, and be an active participant in, a timely Comprehensive Assessment of medical, behavioral health, community-based or facility-based LTSS, and social needs completed by the Care Management team. 2.6.3.2. The CICO must use Phoenix, SCDHHS’s automated Case Management system, to record the Comprehensive Assessments and to track the Long Term Care Assessments (as described in Section 2.6.4 Long Term Care Assessments). 2.6.3.3. The Comprehensive Assessment will be performed using the state’s uniform assessment tools. 2.6.3.3.1. Assessment domains will include, but not be limited to, the following: social, functional, medical, behavioral, wellness and prevention domains, caregiver status and capabilities, as well as the Enrollee’s preferences, strengths, and goals. 2.6.3.4. The CICO will complete the Comprehensive Assessment using information from the initial health screen (described in Section 2.6.2 Initial Health Screen), comprehensive data sources, and input from the Enrollee, Providers, and family/caregivers. 2.6.3.5. Assessments will be completed by qualified, trained health professionals who possess a professional scope of practice, licensure, and/or credentials appropriate for responding to or managing the Enrollee’s needs. Examples of health professionals who may complete portions or all of the assessment include, but are not limited to: 2.6.3.5.1. Registered nurses, 2.6.3.5.2. Licensed practical nurses (under the supervision of registered nurses), 2.6.3.5.3. Social workers, 2.6.3.5.4. Medicaid case managers, 2.6.3.5.5. Certified geriatric care managers, 2.6.3.5.6. Certified community health workers 2.6.3.6. The CICO will use the results of the Comprehensive Assessment to confirm the appropriate acuity or risk stratification level for the Enrollee and as the basis for developing the integrated ICP. 2.6.3.7. The Enrollee will continue to receive any community-based or facility- based LTSS (i.e., respite care) in any existing waiver service plan (s) prior to the Comprehensive Assessment or reassessment. The CICO will adhere to all transition requirements for services, as outlined in Section 2.6.9.
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Comprehensive Assessments 
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Related to Comprehensive Assessments

  • Comprehensive general liability and property damage insurance, insuring against all liability of the Contractor related to this Agreement, with a minimum combined single limit of One Million Dollars ($1,000,000.00) per occurrence, One Million Dollars ($1,000,000) Personal & Advertising Injury, Two Million Dollars ($2,000,000) Products/Completed Operations Aggregate, and Two Million Dollars ($2,000,000) general aggregate;

  • Risk Assessments a. Risk Assessment - DST shall, at least annually, perform risk assessments that are designed to identify material threats (both internal and external) against Fund Data, the likelihood of those threats Schedule 10.2 p.2 occurring and the impact of those threats upon DST organization to evaluate and analyze the appropriate level of information security safeguards (“Risk Assessments”). b. Risk Mitigation - DST shall use commercially reasonable efforts to manage, control and remediate threats identified in the Risk Assessments that it believes are likely to result in material unauthorized access, copying, use, processing, disclosure, alteration, transfer, loss or destruction of Fund Data, consistent with the Objective, and commensurate with the sensitivity of the Fund Data and the complexity and scope of the activities of DST pursuant to the Agreement. c. Security Controls Testing - DST shall, on approximately an annual basis, engage an independent external party to conduct a review (including information security) of DST’s systems that are related to the provision of services. DST shall have a process to review and evaluate high risk findings resulting from this testing.

  • Comprehensive Evaluation The Comprehensive evaluation is a growth-oriented, teacher/evaluator collaborative process that requires teachers to be evaluated on the eight (8) state criteria. A teacher must complete a Comprehensive evaluation once every six (6) years. During subsequent years, teachers will be evaluated on a Focused evaluation unless a comprehensive is requested by administration or the teacher.

  • Ergonomic Assessments ‌ At the request of the employee, the Employer will ensure that an ergonomic assessment of the employee’s workstation is completed. Solutions to identified issues will be implemented within available resources.

  • Risk Assessment An assessment of any risks inherent in the work requirements and actions to mitigate these risks.

  • Environmental Assessments Foreclose on or take a deed or title to any commercial real estate without first conducting a Phase I environmental assessment of the property or foreclose on any commercial real estate if such environmental assessment indicates the presence of a Hazardous Substance in amounts which, if such foreclosure were to occur, would be material.

  • Comprehensive Automobile Liability Insurance for coverage of owned and non-owned and hired vehicles, trailers or semi-trailers designed for travel on public roads, with a minimum, combined single limit of One Million Dollars ($1,000,000) per occurrence for bodily injury, including death, and property damage.

  • Comprehensive Automobile Liability Insurance for coverage of owned and non-owned and hired vehicles, trailers or semi-trailers licensed for travel on public roads, with a minimum combined single limit of One Million Dollars ($1,000,000) each occurrence for bodily injury, including death, and property damage.

  • Workplace Safety Insurance 20.1 Each member covered by this Agreement who is absent on account of injuries received while on duty and who is receiving a pension, salary or wage award from the Workplace Safety and Insurance Board shall be entitled to be paid the difference between the pension wage and salary award from the Workplace Safety and Insurance Board and his or her current net salary as long as such member remains in the employ of the Niagara Police Board. This shall be applied such that the combination of any WSIB salary or wage award plus the employer top-up shall, in total, equal the net pay of the member's current salary. The non- economic loss portion of any WSIB pension payments shall not be considered as being a salary or wage award, and hence shall not form part of these calculations. Any member who does not comply with the provisions of the Workplace Safety & Insurance Act or Regulations thereto and subsequently receives a salary or wage award or an amount less than the prevailing maximum payable, due to such non-compliance, shall not receive from the Niagara Police Board the difference between the wage or salary award paid by the Workplace Safety & Insurance Board and his or her current net salary. For the purpose of this Clause, net pay shall be the pay for the rank of the member as shown in Appendix "A" less those deductions required under Government Statutes, pension plans and as provided for in this Agreement. 20.2 Subject to the terms of this Article, each member covered by this Agreement who is injured as a result of carrying out his/her duties shall not be deprived of his/her vacations or statutory holidays as a result thereof, and shall accumulate such vacation credits and statutory holidays as he/she might otherwise receive. 20.2.1 Each member shall be entitled to accumulate the float time that he/she might otherwise receive for a period of three (3) months following the injury. 20.2.2 In respect of members who have been off work and receiving WSIB benefits for less than two

  • Environmental Review (a) Buyer shall have the right to conduct or cause a consultant (“Buyer’s Environmental Consultant”) to conduct an environmental review of the Assets and Seller’s records pertaining to the Assets (as set forth in Section 3.01) prior to the expiration of the Examination Period (“Buyer’s Environmental Review”). The cost and expense of Buyer’s Environmental Review, if any, shall be borne solely by Buyer. The scope of work comprising Buyer’s Environmental Review shall not include any intrusive test or procedure without the prior written consent of Seller. Buyer shall (and shall cause Buyer’s Environmental Consultant to): (i) consult with Seller before conducting any work comprising Buyer’s Environmental Review, (ii) perform all such work in a safe and workmanlike manner and so as to not unreasonably interfere with Seller’s operations and (iii) comply with all applicable laws, rules, and regulations. Seller shall use commercially reasonable efforts to obtain any Third Party consents and otherwise cooperate with Buyer in conducting Buyer’s Environmental Review and any activities related thereto. Seller shall have the right to have a representative or representatives accompany Buyer and Buyer’s Environmental Consultant at all times during Buyer’s Environmental Review. With respect to any samples taken in connection with Buyer’s Environmental Review, Buyer shall take split samples, providing one of each such sample, properly labeled and identified, to Seller. The Parties shall execute a “common undertaking” letter regarding the confidentiality for the Environmental Review where appropriate. Buyer hereby agrees to release, defend, indemnify and hold harmless Seller from and against all claims, losses, damages, costs, expenses, causes of action and judgments of any kind or character (INCLUDING THOSE RESULTING FROM SELLER’S SOLE, JOINT, COMPARATIVE OR CONCURRENT NEGLIGENCE OR STRICT LIABILITY) to the extent arising out of Buyer’s Environmental Review. Buyer hereby covenants and agrees that it will have at least $2,000,000 of general liability insurance to cover its indemnification hereunder prior to the commencement of the Environmental Review. (b) Unless otherwise required by applicable law, Buyer shall (and shall cause Buyer’s Environmental Consultant to) treat confidentially any matters revealed by Buyer’s Environmental Review and any reports or data generated from such review (the “Environmental Information”), and Buyer shall not (and shall cause Buyer’s Environmental Consultant to not) disclose any Environmental Information to any Governmental Authority or other Third Party without the prior written consent of Seller unless otherwise required by law. Unless otherwise required by law, prior to the Closing, Buyer may use the Environmental Information only in connection with the transactions contemplated by this Agreement. If Buyer, Buyer’s Environmental Consultant, or any Third Party to whom Buyer has provided any Environmental Information become legally compelled to disclose any of the Environmental Information, Buyer shall, as soon as reasonably practicable, provide Seller with good faith notice prior to any such disclosure so as to allow Seller to attempt to file any protective order, or seek any other remedy, as it deems appropriate under the circumstances. If this Agreement is terminated prior to the Closing, Buyer shall deliver the Environmental Information to Seller, which Environmental Information shall become the sole property of Seller. Buyer shall provide two (2) copies of the Environmental Information to Seller without charge. (c) Buyer acknowledges that the Assets have been used for exploration, development, and production of oil and gas and that there may be petroleum, produced water, wastes, or other substances or materials located in, on or under or associated with the Assets. Equipment and sites included in the Assets may contain asbestos, hazardous substances, or naturally occurring radioactive material (“NORM”). NORM may affix or attach itself to the inside of wxxxx, materials, and equipment as scale, or in other forms. The wxxxx, materials, and equipment located on the Assets may contain NORM and other wastes or hazardous substances. NORM containing material and/or other wastes or hazardous substances may have come in contact with various environmental media, including without limitation, water, soils or sediment. Special procedures may be required for the assessment, remediation, removal, transportation, or disposal of environmental media, wastes, asbestos, hazardous substances and NORM from the Assets.

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