FCMH Health Care Management Model Pilot Sample Clauses

FCMH Health Care Management Model Pilot. The PIHP may develop a pilot to test alternative staffing models to meet the FCMH care management requirements detailed in Article III A-F. The Department must review and approve the pilot prior to implementation. 1. The following conditions of approval for the pilot health care management structure apply: a. The PIHP must align any change in staffing approach with the level of need of the children and to optimally meet the care management requirements detailed in Article III A-F. b. Pilot approval will be granted for a one calendar year period and may be extended per Department discretion. c. The Department reserves the right to suspend and/or end a pilot at any point during the contract year and, may take action with less than a 30-day notice if the Department determines that it would be in the best interest of the children enrolled in the pilot or of the Department. d. Any material changes to the approved pilot health care management structure during the contract year must be submitted in writing to the Department for approval prior to implementation. e. Approval is limited to the structure of the PIHP health care management team. The PIHP must continue to comply with all existing FCMH health care management activities as defined in Article III A-F. 2. Monitoring and evaluation of the pilot health care management structure The PIHP is required to regularly monitor and evaluate the pilot health care management structure to determine the impact of the pilot on the delivery of care management services. The PIHP must report findings to the Department during the approved period of the pilot. Required activities may include monitoring and evaluation of: program operations; cost; utilization; quality measures defined in Addendum VII; and other agreed upon outcomes. The PIHP must participate in regularly scheduled status calls and deliver written monitoring and evaluation reports at an agreed upon schedule.
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