Common use of General Care Delivery Requirements Clause in Contracts

General Care Delivery Requirements. In accordance with all other applicable Contractor requirements, the Contractor shall ensure that all Enrollees receive care that is timely, accessible, and Linguistically and Culturally Competent. The Contractor shall: 1. Ensure that all Enrollees may access: a. Primary Care or Urgent Care during extended hours; b. Same-day appointments for certain services; c. Medical and diagnostic equipment that is accessible to Enrollees; d. Care that is Linguistically and Culturally Competent. The Contractor shall regularly evaluate the population of Enrollees to identify language needs, including needs experienced by Enrollees who are deaf or hard of hearing, and needs related to health literacy, and to identify needs related to cultural appropriateness of care (including through the Care Needs Screening as described in Section 2.5.B). The Contractor shall identify opportunities to improve the availability of fluent staff or skilled translation services in Enrollees’ preferred languages and opportunities to improve the cultural appropriateness of Enrollees’ care; e. All Medically Necessary Services, including Behavioral Health Services and other specialty services, in accordance with the Enrollee’s wishes and in a timely, coordinated, and person-centered manner. Contractor shall make best efforts to ensure timely, coordinated, and person-centered access to all such services for the Enrollee in accordance with the Enrollee’s wishes, including any other services delivered to the Enrollee by entities other than the Contractor, as necessary and appropriate; 2. Ensure each Enrollee’s access to Providers with expertise in treating the full range of medical conditions of the Enrollee, including but not limited to Enrollees with Special Health Care Needs;

General Care Delivery Requirements. ‌ In accordance with all other applicable Contractor requirements, the Contractor shall ensure that all Enrollees receive care that is timely, accessible, and Linguistically and Culturally Competent. The Contractor shall: 1. Ensure that all Enrollees may access: a. Primary Care or Urgent Care during extended hours; b. Same-day appointments for certain services; c. Medical and diagnostic equipment that is accessible to Enrollees; d. Care that is Linguistically and Culturally Competent. The Contractor shall regularly evaluate the population of Enrollees to identify language needs, including needs experienced by Enrollees who are deaf or hard of hearing, and needs related to health literacy, and to identify needs related to cultural appropriateness of care (including through the Care Needs Screening as described in Section 2.5.B). The Contractor shall identify opportunities to improve the availability of fluent staff or skilled translation services in Enrollees’ preferred languages and opportunities to improve the cultural appropriateness of Enrollees’ care; e. All Medically Necessary Services, including Behavioral Health Services and other specialty services, in accordance with the Enrollee’s wishes and in a timely, coordinated, and person-centered manner. Contractor shall make best efforts to ensure timely, coordinated, and person-centered access to all such services for the Enrollee in accordance with the Enrollee’s wishes, including any other services delivered to the Enrollee by entities other than the Contractor, as necessary and appropriate; 2. Ensure each Enrollee’s access to Providers with expertise in treating the full range of medical conditions of the Enrollee, including but not limited to Enrollees with Special Health Care Needs;

General Care Delivery Requirements. In accordance with all other applicable Contractor requirements, the The Contractor shall ensure that all Enrollees receive care that is timely, accessible, and Culturally and Linguistically and Culturally Competent. The Contractor shall: 1. Ensure that all Enrollees may access: a. As further specified by EOHHS, Primary Care or Urgent Care during extended hourshours to reduce avoidable inpatient admissions and emergency department visits; b. Same-day appointments for certain services; c. Medical and diagnostic equipment that is accessible to Enrolleesthe Enrollee; d. c. Care that is Culturally and Linguistically and Culturally Competent. The Contractor shall regularly evaluate the population of Enrollees to identify language needs, including needs experienced by Enrollees who are deaf or hard of hearing, and needs related to health literacy, and to identify needs related to cultural appropriateness of care (including through the Care Needs Screening as described in Section 2.5.B2.3.B). The Contractor shall identify opportunities to improve the availability of fluent staff or skilled translation services in Enrollees’ preferred languages and opportunities to improve the cultural appropriateness of Enrollees’ care;; and e. d. All Medically Necessary Servicesservices, including Behavioral Health Services and Services, other specialty services, in accordance with the Enrollee’s wishes and in a timely, coordinated, and person-centered manner. Contractor shall make best efforts to ensure timely, coordinated, and person-centered access to all such services for the Enrollee in accordance with the Enrollee’s wishes, including any other services delivered to the Enrollee by entities other than the Contractor, in a timely, coordinated, and person-centered manner and in accordance with the Enrollee’s wishes, as necessary and appropriate; 2. Ensure that each Enrollee’s , including but not limited to Enrollees with Special Health Care Needs, has access to Providers with expertise in treating the full range of medical conditions of the Enrollee, including but not limited ; 3. Perform coordination to assist Enrollees with Special Health Care Needsaccessing transportation to medical appointments, where Medically Necessary, for the Enrollee to access medical care;