INDIVIDUAL PLAN OF CARE HEALTH RISK REASSESSMENT. 5.16.1 Contractor shall review IPoCs of complex risk and high risk DCFS Youth Enrollees at least every thirty (30) days, and of moderate risk DCFS Youth Enrollees at least every ninety (90) days, and conduct reassessments as necessary based upon such reviews. At a minimum, Contractor shall conduct a health risk reassessment annually for each DCFS Youth Enrollee who has an IPoC. Contractor shall make available an updated IPoC through the Enrollee and Provider portals.
INDIVIDUAL PLAN OF CARE HEALTH RISK REASSESSMENT. Contractor will analyze predictive-modeling reports and other surveillance data of all Enrollees monthly to identify risk-level changes. As risk levels change, reassessments will be completed as necessary and IPoCs updated. Contractor shall review IPoCs of high-risk (Level 3) Enrollees at least every thirty (30) days, and of moderate-risk (Level 2) Enrollees at least every ninety (90) days, and conduct reassessments as necessary based upon such reviews. At a minimum, Contractor shall conduct a health-risk reassessment annually for each Enrollee who has an IPoC. In addition, Contractor shall conduct a face-to-face health-risk reassessment for Enrollees receiving HCBS Waiver services or residing in NFs each time there is a significant change in the Enrollee’s condition or an Enrollee requests reassessment. Contractor will provide updated IPoCs to Providers that are involved in providing Covered Services to Enrollee within no more than five (5) Business Days.
