Common use of Comprehensive Health Assessment Clause in Contracts

Comprehensive Health Assessment. The Contractor shall conduct a comprehensive health assessment of all members initially stratified into care management, complex case management or RCP following the initial screening in order to further identify the appropriate level of care coordination services. The comprehensive health assessment will be all-inclusive and identify the clinical, psychosocial, functional and financial needs of the member. The comprehensive health assessment shall be completed within one hundred and fifty (150) calendar days of enrollment, and will be used to develop and implement a comprehensive care plan to meet the member’s needs. The Contractor shall develop efficient processes and collaborative relationships with Indiana DCS to encourage caregivers of wards or xxxxxx children to complete the comprehensive health assessment. The Contractor will develop a Comprehensive Health Assessment to be approved by FSSA. The Contractor’s Comprehensive Health Assessment must contain, at a minimum, elements prescribed by FSSA and may be augmented with condition specific and/or Contractor specific elements. The assessment tool may differ for children/adolescents and adults. The Contractor shall use the Child and Adolescent Needs and Strength (CANS) assessment process to prospectively or retrospectively assess the behavioral health needs and strengths of children and adolescents and support an outcomes-based quality management process. The results of CANS should inform the child’s treatment plan, provide level of care decision support, serve as an outcome measurement and facilitate communication between agencies. The Contractor will collect and review medical and educational information, as well as family and caregiver input, as appropriate, to identify the member’s care strengths, health needs and available resources. The comprehensive assessment may include, but is not limited to, a review of the member’s claims history and/or contact with the member, member’s family, PMP (if applicable), or other significant providers. A clinician on the Contractor’s care management team will review the findings of the health assessment and provide the findings to the member’s primary providers, including the member’s PMP and/or behavioral health care providers, if applicable. Respondents must explain methods to be used to maximize contacts with members in order to complete the comprehensive health assessments required in this Section 5.1.2.

Appears in 5 contracts

Samples: Contract, Contract, Contract #0000000000000000000018225

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Comprehensive Health Assessment. In accordance with 42 CFR 438.208(c)(1)-(2), the Contractor shall implement mechanisms to comprehensively assess each member identified as having special health care and/or long-term services and supports (LTSS) needs to identify any ongoing special conditions of the member that require a course of treatment, program change, or regular care monitoring. The Contractor shall conduct a comprehensive health assessment of all members initially stratified into care management, complex case management or RCP following the initial screening in order to further identify the appropriate level of care coordination services. The comprehensive health assessment will be all-inclusive and identify the clinical, psychosocial, functional and financial needs of the membermember to ensure appropriate referrals to MCE program and community-based organizations. The comprehensive health assessment shall be completed within one hundred and fifty (150) calendar days of enrollment, and will be used to develop and implement a comprehensive care plan to meet the member’s needs. The Contractor shall develop efficient processes and collaborative relationships with Indiana DCS to encourage caregivers of wards or xxxxxx children to complete the comprehensive health assessment. The Contractor will develop and maintain a Comprehensive Health Assessment to be approved by FSSA. The Contractor’s Comprehensive Health Assessment must contain, at a minimum, elements prescribed by FSSA and may be augmented with condition specific and/or Contractor specific elements. The assessment tool may differ for children/adolescents and adults. The Contractor shall use Results of the Child and Adolescent Needs and Strength (CANS) assessment process to prospectively or retrospectively assess the behavioral health needs and strengths of children and adolescents and support an outcomes-based quality management process. The results of CANS should inform the child’s treatment plan, provide level of care decision support, serve as an outcome measurement and facilitate communication between agencies. The Contractor will collect and review medical and educational information, as well as family and caregiver input, as appropriate, to identify the member’s care strengths, health needs and available resources. The comprehensive assessment may include, but is not limited to, a review of the member’s claims history and/or contact with the member, member’s family, PMP (if applicable), or other significant providers. A clinician on the Contractor’s care management team will review the findings of the health assessment and provide the findings to the member’s primary providers, including the member’s PMP and/or behavioral health care providers, if applicable. Respondents must explain methods to be used to maximize contacts with members in order to complete the comprehensive health assessments required in this Section 5.1.2.management

Appears in 4 contracts

Samples: Professional Services, Professional Services, Professional Services

Comprehensive Health Assessment. In accordance with 42 CFR 438.208(c)(1)-(2), the Contractor shall implement mechanisms to comprehensively assess each member identified as having special health care and/or long term services and supports needs to identify any ongoing special conditions of the member that require a course of treatment, program change, or regular care monitoring. The Contractor shall conduct a comprehensive health assessment of all members initially stratified into care management, complex case management or RCP following the initial screening in order to further identify the appropriate level of care coordination services. The comprehensive health assessment will be all-inclusive and identify the clinical, psychosocial, functional and financial needs of the membermember to ensure appropriate referrals to MCE program and community-based organizations. The comprehensive health assessment shall be completed within one hundred and fifty (150) calendar days of enrollment, and will be used to develop and implement a comprehensive care plan to meet the member’s needs. The Contractor shall develop and maintain efficient processes and collaborative relationships with Indiana DCS to encourage caregivers of wards or xxxxxx children to complete the comprehensive health assessment. The Contractor will develop and maintain a Comprehensive Health Assessment to be approved by FSSA. The Contractor’s Comprehensive Health Assessment must contain, at a minimum, elements prescribed by FSSA and may be augmented with condition specific and/or Contractor specific elements. The assessment tool may differ for children/adolescents and adults. The Contractor shall use the Child and Adolescent Needs and Strength (CANS) assessment process to prospectively or retrospectively assess the behavioral health needs and strengths of children and adolescents and support an outcomes-based quality management process. The results of CANS should inform the child’s treatment plan, provide level of care decision support, serve as an outcome measurement and facilitate communication between agencies. The Contractor will collect and review medical and educational information, as well as family and caregiver input, as appropriate, to identify the member’s care strengths, health needs and available resources. The comprehensive assessment may include, but is not limited to, a review of the member’s claims history and/or contact with the member, member’s family, PMP (if applicable), or other significant providers. A clinician on the Contractor’s care management team will review the findings of the health assessment and provide the findings to the member’s primary providers, including the member’s PMP and/or behavioral health care providers, if applicable. Respondents The Contractor must explain maintain methods to be used to maximize contacts with members in order to complete the comprehensive health assessments required in this Section 5.1.2.

Appears in 3 contracts

Samples: Contract, Contract, Contract

Comprehensive Health Assessment. In accordance with 42 CFR 438.208(c)(1)-(2), the Contractor shall implement mechanisms to comprehensively assess each member identified as having special health care and/or long-term services and supports (LTSS) needs to identify any ongoing special conditions of the member that require a course of treatment, program change, or regular care monitoring. The Contractor shall conduct a comprehensive health assessment of all members initially stratified into care management, complex case management or RCP following the initial screening in order to further identify the appropriate level of care coordination services. The comprehensive health assessment will be all-inclusive and identify the clinical, psychosocial, functional and financial needs of the membermember to ensure appropriate referrals to MCE program and community-based organizations. The comprehensive health assessment shall be completed within one hundred and fifty (150) calendar days of enrollment, and will be used to develop and implement a comprehensive care plan to meet the member’s needs. The Contractor shall develop efficient processes and collaborative relationships with Indiana DCS to encourage caregivers of wards or xxxxxx children to complete the comprehensive health assessment. The Contractor will develop and maintain a Comprehensive Health Assessment to be approved by FSSA. The Contractor’s Comprehensive Health Assessment must contain, at a minimum, elements prescribed by FSSA and may be augmented with condition specific and/or Contractor specific elements. The assessment tool may differ for children/adolescents and adults. The Contractor shall use Results of the Child and Adolescent Needs and Strength (CANS) assessment process to prospectively or retrospectively assess the behavioral health needs and strengths of children and adolescents and support an outcomes-based quality management process. The results of CANS should inform the child’s treatment plan, provide level of care decision support, serve as an outcome measurement and facilitate communication between agencies. The Contractor will collect and review medical and educational information, as well as family and caregiver input, as appropriate, to identify the member’s care strengths, health needs and available resources. The comprehensive assessment may include, but is not limited to, a review of the member’s claims history and/or contact with the member, member’s family, PMP (if applicable), or other significant providers. A clinician on the Contractor’s care management team will review the findings of the health assessment and provide the findings to the member’s primary providers, including the member’s PMP and/or behavioral health care providers, if applicable. Respondents The Contractor must explain maintain methods to be used to maximize contacts with members in order to complete the comprehensive health assessments required in this Section 5.1.2section.

Appears in 3 contracts

Samples: Professional Services, Amendment to Contract, Contract

Comprehensive Health Assessment. In accordance with 42 CFR 438.208(c)(1)-(2), the Contractor shall implement mechanisms to comprehensively assess each member identified as having special health care and/or long-term services and supports (LTSS) needs to identify any ongoing special conditions of the member that require a course of treatment, program change, or regular care monitoring. The Contractor shall conduct a comprehensive health assessment of all members initially stratified into care management, complex case management or RCP following the initial screening in order to further identify the appropriate level of care coordination services. The comprehensive health assessment will be all-inclusive and identify the clinical, psychosocial, functional and financial needs of the membermember to ensure appropriate referrals to MCE program and community-based organizations. The comprehensive health assessment shall be completed within one hundred and fifty (150) calendar days of enrollment, enrollment and will be used to develop and implement a comprehensive care plan to meet the member’s needs. The Contractor shall develop efficient processes and collaborative relationships with Indiana DCS to encourage caregivers of wards or xxxxxx children to complete the comprehensive health assessment. The Contractor will develop and maintain a Comprehensive Health Assessment to be approved by FSSA. The Contractor’s Comprehensive Health Assessment must contain, at a minimum, elements prescribed by FSSA and may be augmented with condition specific and/or Contractor specific elements. The assessment tool may differ for children/adolescents and adults. The Contractor shall use Results of the Child and Adolescent Needs and Strength (CANS) assessment process to prospectively or retrospectively assess the behavioral health needs and strengths of children and adolescents and support an outcomes-based quality management process. The results of CANS should inform the child’s treatment plan, provide level of care decision support, serve as an outcome measurement and facilitate communication between agencies. The Contractor will collect and review medical and educational information, as well as family and caregiver input, as appropriate, to identify the member’s care strengths, health needs and available resources. The comprehensive assessment may include, but is not limited to, a review of the member’s claims history and/or contact with the member, member’s family, PMP (if applicable), or other significant providers. A clinician on the Contractor’s care management team will review the findings of the health assessment and provide the findings to the member’s primary providers, including the member’s PMP and/or behavioral health care providers, if applicable. Respondents The Contractor must explain maintain methods to be used to maximize contacts with members in order to complete the comprehensive health assessments required in this Section 5.1.2section.

Appears in 2 contracts

Samples: Contract, Contract

Comprehensive Health Assessment. The Contractor shall conduct a comprehensive health assessment of all members initially stratified into care management, complex case management or RCP following the initial screening in order to further identify the appropriate level of care coordination services. The comprehensive health assessment will be all-inclusive and identify the clinical, psychosocial, functional and financial needs of the membermember to ensure appropriate referrals to MCE program and community-based organizations. The comprehensive health assessment shall be completed within one hundred and fifty (150) calendar days of enrollment, and will be used to develop and implement a comprehensive care plan to meet the member’s needs. The Contractor shall develop and maintain efficient processes and collaborative relationships with Indiana DCS to encourage caregivers of wards or xxxxxx children to complete the comprehensive health assessment. The Contractor will develop and maintain a Comprehensive Health Assessment to be approved by FSSA. The Contractor’s Comprehensive Health Assessment must contain, at a minimum, elements prescribed by FSSA and may be augmented with condition specific and/or Contractor specific elements. The assessment tool may differ for children/adolescents and adults. The Contractor shall use the Child and Adolescent Needs and Strength (CANS) assessment process to prospectively or retrospectively assess the behavioral health needs and strengths of children and adolescents and support an outcomes-based quality management process. The results of CANS should inform the child’s treatment plan, provide level of care decision support, serve as an outcome measurement and facilitate communication between agencies. The Contractor will collect and review medical and educational information, as well as family and caregiver input, as appropriate, to identify the member’s care strengths, health needs and available resources. The comprehensive assessment may include, but is not limited to, a review of the member’s claims history and/or contact with the member, member’s family, PMP (if applicable), or other significant providers. A clinician on the Contractor’s care management team will review the findings of the health assessment and provide the findings to the member’s primary providers, including the member’s PMP and/or behavioral health care providers, if applicable. Respondents The Contractor must explain maintain methods to be used to maximize contacts with members in order to complete the comprehensive health assessments required in this Section 5.1.2.

Appears in 2 contracts

Samples: Contract, Contract

Comprehensive Health Assessment. In accordance with 42 CFR 438.208(c)(1)-(2), the Contractor shall implement mechanisms to comprehensively assess each member identified as having special health care and/or long-term services and supports (LTSS) needs to identify any ongoing special conditions of the member that require a course of treatment, program change, or regular care monitoring. The Contractor shall conduct a comprehensive health assessment of all members initially stratified into care management, complex case management or RCP following the initial screening in order to further identify the appropriate level of care coordination services. The comprehensive health assessment will be all-inclusive and identify the clinical, psychosocial, functional and financial needs of the membermember to ensure appropriate referrals to MCE program and community-based organizations. The comprehensive health assessment shall be completed within one hundred and fifty (150) calendar days of enrollment, and will be used to develop and implement a comprehensive care plan to meet the member’s needs. The Contractor shall develop efficient processes and collaborative relationships with Indiana DCS to encourage caregivers of wards or xxxxxx children to complete the comprehensive health assessment. The Contractor will develop and maintain a Comprehensive Health Assessment to be approved by FSSA. The Contractor’s Comprehensive Health Assessment must contain, at a minimum, elements prescribed by FSSA and may be augmented with condition specific and/or Contractor specific elements. The assessment tool may differ for children/adolescents and adults. The Contractor shall use Results of the Child and Adolescent Needs and Strength (CANS) assessment process to prospectively or retrospectively assess the behavioral health needs and strengths of children and adolescents and support an outcomes-based quality management process. The results of CANS should inform the child’s treatment plan, provide level of care decision support, serve as an outcome measurement and facilitate communication between agencies. The Contractor will collect and review medical and educational information, as well as family and caregiver input, as appropriate, to identify the member’s care strengths, health needs and available resources. The comprehensive assessment may include, but is not limited to, a review of the member’s claims history and/or and/ or contact with the member, member’s family, PMP (if applicable), or other significant providers. A clinician on the Contractor’s care management team will review the findings of the health assessment and provide the findings to the member’s primary providers, including the member’s PMP and/or behavioral health care providers, if applicable. Respondents The Contractor must explain maintain methods to be used to maximize contacts with members in order to complete the comprehensive health assessments required in this Section 5.1.2section.

Appears in 1 contract

Samples: Contract

Comprehensive Health Assessment. The Contractor shall conduct a comprehensive health assessment of all members initially stratified into care management, complex case management or RCP following the initial screening in order to further identify the appropriate level of care coordination services. The comprehensive health assessment will be all-inclusive and identify the clinical, psychosocial, functional and financial needs of the member. The comprehensive health assessment shall be completed within one hundred and fifty (150) calendar days of enrollment, and will be used to develop and implement a comprehensive care plan to meet the member’s needs. The Contractor shall develop efficient processes and collaborative relationships with Indiana DCS to encourage caregivers of wards or xxxxxx children to complete the comprehensive health assessment. The Contractor will develop a Comprehensive Health Assessment to be approved by FSSA. The Contractor’s Comprehensive Health Assessment must contain, at a minimum, elements prescribed by FSSA and may be augmented with condition specific and/or Contractor specific elements. The assessment tool may differ for children/adolescents and adults. The Contractor shall use the Child and Adolescent Needs and Strength (CANS) assessment process to prospectively or retrospectively assess the behavioral health needs and strengths of children and adolescents and support an outcomes-based quality management process. The results of CANS should inform the child’s treatment plan, provide level of care decision support, serve as an outcome measurement and facilitate communication between agencies. The Contractor will collect and review medical and educational information, as well as family and caregiver input, as appropriate, to identify the member’s care strengths, health needs and available resources. The comprehensive assessment may include, but is not limited to, a review of the member’s claims history and/or contact with the member, member’s family, PMP (if applicable), or other significant providers. A clinician on the Contractor’s care management team will review the findings of the health assessment and provide the findings to the member’s primary providers, including the member’s PMP and/or behavioral health care providers, if applicable. Respondents must explain methods to be used to maximize contacts with members in order to complete the comprehensive health assessments required in this Section 5.1.2.. EXHIBIT 1.M SCOPE OF WORK

Appears in 1 contract

Samples: Contract #0000000000000000000018225

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Comprehensive Health Assessment. In accordance with 42 CFR 438.208(c)(1)-(2), the Contractor shall implement mechanisms to comprehensively assess each member identified as having special health care and/or long- term services and supports (LTSS) needs to identify any ongoing special conditions of the member that require a course of treatment, program change, or regular care monitoring. The Contractor shall conduct a comprehensive health assessment of all members initially stratified into care management, complex case management or RCP following the initial screening in order to further identify the appropriate level of care coordination services. The comprehensive health assessment will be all-inclusive and identify the clinical, psychosocial, functional and financial needs of the membermember to ensure appropriate referrals to MCE program and community-based organizations. The comprehensive health assessment shall be completed within one hundred and fifty (150) calendar days of enrollment, and will be used to develop and implement a comprehensive care plan to meet the member’s needs. The Contractor shall develop efficient processes and collaborative relationships with Indiana DCS to encourage caregivers of wards or xxxxxx children to complete the comprehensive health assessment. The Contractor will develop and maintain a Comprehensive Health Assessment to be approved by FSSA. The Contractor’s Comprehensive Health Assessment must contain, at a minimum, elements prescribed by FSSA and may be augmented with condition specific and/or Contractor specific elements. The assessment tool may differ for children/adolescents and adults. The Contractor shall use Results of the Child and Adolescent Needs and Strength (CANS) assessment process to prospectively or retrospectively assess the behavioral health needs and strengths of children and adolescents and support an outcomes-based quality management process. The results of CANS should inform the child’s treatment plan, provide level of care decision support, serve as an outcome measurement and facilitate communication between agenciesagencies . The Contractor will collect and review medical and educational information, as well as family and caregiver input, as appropriate, to identify the member’s care strengths, health needs and available resources. The comprehensive assessment may include, but is not limited to, a review of the member’s claims history and/or contact with the member, member’s family, PMP (if applicable), or other significant providers. A clinician on the Contractor’s care management team will review the findings of the health assessment and provide the findings to the member’s primary providers, including the member’s PMP and/or behavioral health care providers, if applicable. Respondents The Contractor must explain maintain methods to be used to maximize contacts with members in order to complete the comprehensive health assessments required in this Section 5.1.2section.

Appears in 1 contract

Samples: Professional Services

Comprehensive Health Assessment. In accordance with 42 CFR 438.208(c)(1)-(2), the Contractor shall implement mechanisms to comprehensively assess each member identified as having special health care and/or long-term services and supports (LTSS) needs to identify any ongoing special conditions of the member that require a course of treatment, program change, or regular care monitoring. The Contractor shall conduct a comprehensive health assessment of all members initially stratified into care management, complex case management or RCP following the initial screening in order to further identify the appropriate level of care coordination services. The comprehensive health assessment will be all-inclusive and identify the clinical, psychosocial, functional and financial needs of the membermember to ensure appropriate referrals to MCE program and community-based organizations. The comprehensive health assessment shall be completed within one hundred and fifty (150) calendar days of enrollment, enrollment and will be used to develop and implement a comprehensive care plan to meet the member’s needs. The Contractor shall develop efficient processes and collaborative relationships with Indiana DCS to encourage caregivers of wards or xxxxxx children to complete the comprehensive health assessment. The Contractor will develop and maintain a Comprehensive Health Assessment to be approved by FSSA. The Contractor’s Comprehensive Health Assessment must contain, at a minimum, elements prescribed by FSSA and may be augmented with condition specific and/or Contractor specific elements. The assessment tool may differ for children/adolescents and adults. The Contractor shall use Results of the Child and Adolescent Needs and Strength (CANS) assessment process to prospectively or retrospectively assess the behavioral health needs and strengths of children and adolescents and support an outcomes-based quality management process. The results of CANS should inform the child’s treatment plan, provide level of care decision support, serve as an outcome measurement and facilitate communication between agencies. The Contractor will collect and review medical and educational information, as well as family and caregiver input, as appropriate, to identify the member’s care strengths, health needs and available resources. The comprehensive assessment may include, but is not limited to, a review of the member’s claims history and/or contact with the member, member’s family, PMP (if applicable), or other significant providers. A clinician on the Contractor’s care management team will review the findings of the health assessment and provide the findings to the member’s primary providers, including the member’s PMP and/or behavioral behavi oral health care providers, if applicable. Respondents The Contractor must explain maintain methods to be used to maximize contacts with members in order to complete the comprehensive health assessments required in this Section 5.1.2section.

Appears in 1 contract

Samples: Contract

Comprehensive Health Assessment. The Contractor shall conduct a comprehensive health assessment of all members initially stratified into care management, complex case management or RCP following the initial EXHIBIT 1.M SCOPE OF WORK screening in order to further identify the appropriate level of care coordination services. The comprehensive health assessment will be all-inclusive and identify the clinical, psychosocial, functional and financial needs of the member. The comprehensive health assessment shall be completed within one hundred and fifty (150) calendar days of enrollment, and will be used to develop and implement a comprehensive care plan to meet the member’s needs. The Contractor shall develop efficient processes and collaborative relationships with Indiana DCS to encourage caregivers of wards or xxxxxx children to complete the comprehensive health assessment. The Contractor will develop a Comprehensive Health Assessment to be approved by FSSA. The Contractor’s Comprehensive Health Assessment must contain, at a minimum, elements prescribed by FSSA and may be augmented with condition specific and/or Contractor specific elements. The assessment tool may differ for children/adolescents and adults. The Contractor shall use the Child and Adolescent Needs and Strength (CANS) assessment process to prospectively or retrospectively assess the behavioral health needs and strengths of children and adolescents and support an outcomes-based quality management process. The results of CANS should inform the child’s treatment plan, provide level of care decision support, serve as an outcome measurement and facilitate communication between agencies. The Contractor will collect and review medical and educational information, as well as family and caregiver input, as appropriate, to identify the member’s care strengths, health needs and available resources. The comprehensive assessment may include, but is not limited to, a review of the member’s claims history and/or contact with the member, member’s family, PMP (if applicable), or other significant providers. A clinician on the Contractor’s care management team will review the findings of the health assessment and provide the findings to the member’s primary providers, including the member’s PMP and/or behavioral health care providers, if applicable. Respondents must explain methods to be used to maximize contacts with members in order to complete the comprehensive health assessments required in this Section 5.1.2.

Appears in 1 contract

Samples: Contract

Comprehensive Health Assessment. In accordance with 42 CFR 438.208(c)(1)-(2), the Contractor shall implement mechanisms to comprehensively assess each member identified as having special health care and/or long-term services and supports (LTSS) needs to identify any ongoing special conditions of the member that require a course of treatment, program change, or regular care monitoring. The Contractor shall conduct a comprehensive health assessment of all members initially stratified stratifi ed into care management, complex case management or RCP following the initial screening in order to further identify the appropriate level of care coordination services. The comprehensive health assessment will be all-inclusive and identify the clinical, psychosocial, functional and financial needs of the membermember to ensure appropriate referrals to MCE program and community-based organizations. The comprehensive health assessment shall be completed within one hundred and fifty (150) calendar days of enrollment, enrollment and will be used to develop and implement a comprehensive care plan to meet the member’s needs. The Contractor shall develop efficient processes and collaborative relationships with Indiana DCS to encourage caregivers of wards or xxxxxx children to complete the comprehensive health assessment. The Contractor will develop and maintain a Comprehensive Health Assessment to be approved by FSSA. The Contractor’s Comprehensive Health Assessment must contain, at a minimum, elements prescribed by FSSA and may be augmented with condition specific and/or Contractor specific elements. The assessment tool may differ for children/adolescents and adults. The Contractor shall use Results of the Child and Adolescent Needs and Strength (CANS) assessment process to prospectively or retrospectively assess the behavioral health needs and strengths of children and adolescents and support an outcomes-based quality management process. The results of CANS should inform the child’s treatment plan, provide level of care decision support, serve as an outcome measurement and facilitate communication between agencies. The Contractor will collect and review medical and educational information, as well as family and caregiver input, as appropriate, to identify the member’s care strengths, health needs and available resources. The comprehensive assessment may include, but is not limited to, a review of the member’s claims history and/or contact with the member, member’s family, PMP (if applicable), or other significant providers. A clinician on the Contractor’s care management team will review the findings of the health assessment and provide the findings to the member’s primary providers, including the member’s PMP and/or behavioral health care providers, if applicable. Respondents The Contractor must explain maintain methods to be used to maximize contacts with members in order to complete the comprehensive health assessments required in this Section 5.1.2section.

Appears in 1 contract

Samples: Contract

Comprehensive Health Assessment. In accordance with 42 CFR 438.208(c)(1)-(2), the Contractor shall implement mechanisms to comprehensively assess each member identified as having special health care and/or long- term services and supports (LTSS) needs to identify any ongoing special conditions of the member that require a course of treatment, program change, or regular care monitoring. The Contractor shall conduct a comprehensive health assessment of all members initially stratified into care management, complex case management or RCP following the initial screening in order to further identify the appropriate level of care coordination services. The comprehensive health assessment will be all-inclusive and identify the clinical, psychosocial, functional and financial needs of the membermember to ensure appropriate referrals to MCE program and community-based organizations. The comprehensive health assessment shall be completed within one hundred and fifty (150) calendar days of enrollment, and will be used to develop and implement a comprehensive care plan to meet the member’s needs. The Contractor shall develop efficient processes and collaborative relationships with Indiana DCS to encourage caregivers of wards or xxxxxx children to complete the comprehensive health assessment. The Contractor will develop and maintain a Comprehensive Health Assessment to be approved by FSSA. The Contractor’s Comprehensive Health Assessment must contain, at a minimum, elements prescribed by FSSA and may be augmented with condition specific and/or Contractor specific elements. The assessment tool may differ for children/adolescents and adults. The Contractor shall use Results of the Child and Adolescent Needs and Strength (CANS) assessment process to prospectively or retrospectively assess the behavioral health needs and strengths of children and adolescents and support an outcomes-based quality management process. The results of CANS should inform the child’s treatment plan, provide level of care decision support, serve as an outcome measurement and facilitate communication between agencies. The Contractor will collect and review medical and educational information, as well as family and caregiver input, as appropriate, to identify the member’s care strengths, health needs and available resources. The comprehensive assessment may include, but is not limited to, a review of the member’s claims history and/or contact with the member, member’s family, PMP (if applicable), or other significant providers. A clinician on the Contractor’s care management team will review the findings of the health assessment and provide the findings to the member’s primary providers, including the member’s PMP and/or behavioral health care providers, if applicable. Respondents The Contractor must explain maintain methods to be used to maximize contacts with members in order to complete the comprehensive health assessments required in this Section 5.1.2section.

Appears in 1 contract

Samples: Professional Services

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