Comprehensive Assessments and Individualized Care Plan. Comprehensive Assessment The Contractor must complete Comprehensive Assessments for each new Enrollee on an ongoing basis, including: Within ninety (90) days of each Enrollee’s Effective Enrollment Date into the Contractor’s plan, including subsequent attempts if the initial attempt to contact the Enrollee is unsuccessful, and at least annually thereafter; or Whenever an Enrollee experiences a major change that is: Not temporary or episodic; Impacts on more than one area of health status; and Requires interdisciplinary review or revision of the ICP. The Contractor is not required to newly conduct a Comprehensive Assessment for individuals who were enrolled in the Contractor’s One Care Plan prior to January 1, 2022 and for whom that Comprehensive Assessment is still current. The Contractor must record Comprehensive Assessment results in the Centralized Enrollee Record. The Comprehensive Assessment must include completion of an assessment tool, developed by the Contractor and informed by at least one in‑person meeting covering expanded domains as may be relevant for each Enrollee to creation of his or her ICP. This activity may be conducted at the same time as the MDS‑HC assessment or at a different time, and must be completed within the continuity of care period. As appropriate to the Enrollee’s needs and preferences, the Contractor‑developed assessment tool will include the following domains and special considerations, which may be updated by EOHHS during the Contract period: Immediate needs and current services, including preventive health, preferred providers, what is working well for the Enrollee and what can be improved; Health conditions, including conditions of known prevalence among subpopulations, such as seizures, aspiration, constipation, dehydration, and pica for individuals with intellectual disabilities; Current medications, including how long the Enrollee has been taking each medication, and any need for immunizations or vaccines; The ability of the individual to communicate their concerns or symptoms, including if the individual can verbalize issues and/or whether physical symptoms are manifested through behavior; Functional Status, including ADL and IADL limitations, and what the Enrollee identifies as his/her strengths, weaknesses, interests, and choices about daily routine; Current mental health and substance use, and history of mental health and substance use treatment, including consideration of: Type, duration and frequency of services...
Comprehensive Assessments and Individualized Care Plan. A. Comprehensive Assessment The Contractor must complete Comprehensive Assessments for each new Enrollee on an ongoing basis, including:
Comprehensive Assessments and Individualized Care Plan
