CRITERIA FOR REIMBURSEMENT. In the event County refers and pays for the provision of Medical Respite Care for qualifying CalOptima Medi-Cal members, County may seek reimbursement from CalOptima for such Medical Respite Care services subject to the terms and conditions below and this Amendment.
1. County shall have agreements in place with Recuperative Care Services providers to provide the Medical Respite Care services hereunder.
2. County shall pay the Recuperative Care Services providers for Medical Respite Care services rendered. CalOptima shall not have liability to Recuperative Care Services providers for any services.
3. The Medical Respite Care Fund is that Fund that was established by the CalOptima Board of Directors through reallocating $250,000.00 from the Intergovernmental Transfer (IGT) funds allocated to the County’s Whole Person Care Recuperative Care program. Funding for Medical Respite Care Services is limited to those funds remaining in the Medical Respite Care Fund. No payments may be made under this Agreement for Medical Respite Care services other than from the Medical Respite Care Fund.
CRITERIA FOR REIMBURSEMENT. This program is not intended to finance degree programs or enhance an employee's personal growth and development other than as related to an employee's competencies and/or preparation for promotional opportunities within the District. Therefore, the definitions of "job-related" and "non-job-related" are relative to the opportunities and technology existing, or anticipated to exist, within the District.
1. Job-related" is defined as increasing an employee's abilities, knowledge, and skills to directly improve performance in the present job or to enhance one's opportunity for jobs in their immediate line of progression.
2. Employees receiving a grade of C or better or, in those instances where grades are not given, the accompanying certification or certificate of successful completion will be for 100% of the tuition for an approved "job- related" course subject to the maximum allowable.
3. Non-job-related" is defined as water-industry-related or related to a profession or career field existing at the District.
4. Employees receiving a grade of C or better, or in those instances where grades are not given, the accompanying certification or certificate of successful completion, will be for 75% of the tuition for an approved "non- job-related" course subject to the maximum allowable.
5. The maximum allowable reimbursement per employee for tuition, course fees and lab fees is 12 semester hours, or the equivalent thereof, per calendar year.
a. Classes taken through institutions of higher learning (whether on-line or on-site) for which credit or semester hours are earned will be reimbursed at a rate not to exceed the applicable resident undergraduate or graduate rate in effect at UNLV for the semester when first enrolled.
b. Education or training for which continuing education units (CEU’s) or certificates are awarded will be reimbursed at the rate paid up to a maximum equivalent to the dollar amount established through the undergraduate rate in paragraph (a) above.
6. Only tuition, lab and technology fees will be reimbursed. Books, late registration fees or any other costs associated with the course are the responsibility of the employee.
CRITERIA FOR REIMBURSEMENT. A. County shall have agreements in place with the WPC Providers to provide targeted engagement services, and housing services.
B. County shall pay the WPC Providers for the select WPC services rendered. CalOptima shall not have liability to WPC Providers for any services.
C. County shall not claim reimbursement from DHCS for HHP housing supportive services that are provided through HHP and billed to CalOptima. As per DHCS’ HHP Program Guide Appendix K, Joint Medi-Cal Managed Care Health Plan and WPC Guidance, the WPC pilot may not claim WPC reimbursement for care coordination services that are duplicative of HHP care coordination services that are provided during the same month.
D. CalOptima’s reimbursement for targeted engagement services and housing services is subject to the continuation of its contract with DHCS for the HHP.
CRITERIA FOR REIMBURSEMENT. 1. One of the following must apply:
(a) Course work involved in completing a General Equivalency Diploma (GED).
(b) Courses directly related to current position.
(c) Courses related to an accredited degree-seeking program.
2. The training offered shall be evaluated to determine whether the content duplicates that which the employee has had in previous courses.
3. Employee’s performance rating is satisfactory or higher.
4. Employee must have permanent status and must be full-time.
5. Courses must be completed with a “pass” or “C” or better grade.
6. Courses will be reimbursed for tuition only and not books, fees or other expenses incurred in the cost of taking the course.
7. Reimbursement will not be made for any “Incompletes”. Employees who take “Incompletes” are eligible for reimbursement when course work is completed and a grade has been issued, provided they notify the Department Head of their intent to complete the course.
8. Courses must be taken for credit. No auditing of course content is acceptable.
9. Reimbursement approvals are for one semester at a time, and are not guaranteed for future semesters. Requests must be re-approved for each subsequent semester.
CRITERIA FOR REIMBURSEMENT. County may seek reimbursement from CalOptima for Targeted Engagement and Housing Services provided on or before December 31, 2021, subject to the terms and conditions of this Contract.
A. County shall have agreements in place with the WPC Providers to provide targeted engagement services, and housing services.
B. County shall pay the WPC Providers for the select WPC services rendered. CalOptima shall not have liability to WPC Providers for any services.
C. County shall not claim reimbursement from DHCS for HHP housing supportive services that are provided through HHP and billed to CalOptima. As per DHCS’ HHP Program Guide Appendix K, Joint Medi-Cal Managed Care Health Plan and WPC Guidance, the WPC pilot may not claim WPC reimbursement for care coordination services that are duplicative of HHP care coordination services that are provided during the same month.
D. CalOptima’s reimbursement for targeted engagement services and housing services is subject to the continuation of its contract with DHCS for the HHP.
CRITERIA FOR REIMBURSEMENT. A. County shall have Staff to provide Transition Coordination Services for CalOptima Members transitioning from WPC to CalAIM Program for a smooth and orderly conversion of CalOptima Members and services.
B. County shall not claim reimbursement from DHCS for CalAIM Transition Coordination Services that are provided by County and billed to CalOptima.
C. CalOptima’s reimbursement for Transition Coordination Services is subject to the continuation of CalOptima’s contract with DHCS for CalAIM.
D. CalOptima shall reimburse County for ECM provided to a CalOptima Member, subject to authorization from the Health Network to which the CalOptima Member is assigned.
CRITERIA FOR REIMBURSEMENT. In the event County refers and pays for the provision of Housing Navigation and Supportive Services for qualifying CalOptima Medi-Cal members who are not enrolled in CalOptima’s Health Homes Program, County may seek reimbursement from CalOptima for such Housing Navigation and Supportive Services subject to the terms and conditions below and this Grant Agreement.
a. County shall have agreements in place with Housing Navigation and Supportive Services providers.
b. County shall pay the Housing Navigation and Supportive Services providers for services rendered. CalOptima shall not have liability to Housing Navigation and Supportive Services providers for any services.
c. Funding for Housing Navigation and Supportive Services is limited to those funds remaining in the Housing Navigation and Supportive Services Fund, which consists of those funds allocated from Intergovernmental Transfer Funds for Housing Navigation and Supportive Services. No payments may be made under this Grant Agreement for Housing Navigation and Supportive Services other than from the Housing Navigation and Supportive Services Fund.
CRITERIA FOR REIMBURSEMENT. The Board shall provide financial assistance to personnel covered by this agreement according to the following criteria.
19:1.1 Personnel must be employed by the Board at least one-half time for that fiscal year.
19:1.2 Such courses shall be taken at an accredited college or university and approved in writing by the chief school administrator prior to registration.
19:1.3 Such courses shall improve the teacher’s knowledge and/or skill in the school, be related to the field of the employee, or help to prepare the employee for future programs planned within the school.
CRITERIA FOR REIMBURSEMENT. 42 Tuition reimbursement will take place after the following steps are completed by the employee:
CRITERIA FOR REIMBURSEMENT. A. Upon completion of the coursework, the employee must submit the following items to receive reimbursement:
1. A copy of the grade report evidencing completion of the coursework with a grade of C or better. For non-graded courses, seminars or certificate programs, documentation from the institution evidencing satisfactory completion of the course or program will be sufficient.
2. Itemized receipts showing items claimed for reimbursement.
