Common use of Comprehensive Health Assessment Clause in Contracts

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 member 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 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. Results of the Child and Adolescent Needs and Strength (CANS) assessment process should inform the child’s treatment plan, provide level of care decision support, serve as an outcome measurement and facilitate communication between agencies.