Intake Assessment. Contractor shall require the Enrollee’s Medical Home to provide an intake assessment of each new Enrollee’s general health status.
Intake Assessment i. The Contractor shall provide a written intake assessment report by secure email to the DCYF Social Service Specialist for each client referred by DCYF within thirty (30) days from the time of the initial intake appointment. Information and conclusions contained in intake assessment reports must include the following:
(A) Source and reason for referral;
(B) Contacts with the client, including dates and duration of contact, and location where intake assessment was conducted;
(C) Client background information and the source of the information;
(D) An account of the client’s self-reporting, including how the client views their present situation and history;
(E) Types of assessment tools utilized, by whom, dates given, results, interpretation, and
(F) Diagnosis;
(G) Conclusions, including prognosis, needs and strengths; and
(H) Specific and detailed recommendations for services and treatment and the basis for the recommendations.
Intake Assessment. CONTRACTOR shall conduct an Intake Assessment, 23 in a collaborative manner with CLIENTS, which includes clinical evaluation and 24 assessment of social family history, mental status exam, substance abuse, 25 domestic violence, Danger Statements, defined in Subparagraph 2.7, Harm 26 Statements, defined in Subparagraph 2.8, Safety fioal defined in Subparagraph 27 2.11, and Network of Support/Family Connections defined in Subparagraph 2.9. 28 If domestic violence, danger, harm, safety concerns, suicidal ideation, or CDA1018-00 Page 5 of 24 April 20, 2018 1 substance abuse are identified, CONTRACTOR shall develop a safety plan with 2 CLIENT to address any immediate and/or ongoing safety concerns.
3 4.3.1 CONTRACTOR shall also identify behaviors and problems 4 classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM)- 5 5, which could endanger or place child(ren) at risk of abuse and/or neglect.
6 4.3.1.1 CONTRACTOR shall determine appropriate 7 treatment plan for identified DSM-5 behaviors.
8 4.3.2 CONTRACTOR shall develop a treatment plan from the Intake 9 Assessment, as described in Subparagraphs 4.3 through 4.3.1.1, and ensure the 10 plan includes and is aligned with CLIENT treatment goals in the resulting 11 Assessment and Treatment Plan (ATP) described in Subparagraph 6.1
12 4.3.3 CONTRACTOR may use a maximum of up to three (3), fifty 13 (50) minute sessions per CLIENT to complete the Intake Assessment.
14 4.3.4 The initial pre-authorized six (6) month service period 15 begins with the date of the first Intake Assessment interview, and ends six 16 (6) months later.
17 4.3.5 CONTRACTOR shall begin the Intake Assessment within 18 thirty (30) days of the referral stamp date, and shall ensure the resulting 19 ATP is received by ADMINISTRATOR within sixty (60) calendar days of the 20 referral stamp date. If ADMINISTRATOR does not receive the ATP within sixty 21 (60) calendar days of the referral stamp date, the Authorization Number as 22 defined in Subparagraph 2.3 will no longer be valid and CONTRACTOR shall not 23 be compensated for any services provided under said Authorization Number.
Intake Assessment. Referral Services - contracting on behalf of Seller’s managed entities with governments to screen inquiries regarding need and eligibility for government-sponsored social services, arranging face-to-face interviews and conducting benefit eligibility reviews.
Intake Assessment. If you want to become a participant in Rocky Mountain PACE, you will begin the assessment process. • One of the XX XXXX Home Care nurses will meet with you in your home to complete your initial assessment. As well, a home safety assessment will be completed by another member of the Home Care department, who will most likely accompany the Home Care nurse on this home visit. The goal of the home safety assessment will include determining what your needs are, if any, for durable medical equipment or supplies. • The Intake Specialist will discuss your health care needs with the team and arrangements will be made for you to come to the PACE Center to meet with some of the other members of the Interdisciplinary Team. • The local Single Entry Point case management agency will decide whether you meet the criteria for admission into the program, that is, whether your problems and needs appear to meet the functional eligibility criteria for nursing facility level-of-care and whether you are found to be able to remain safely in your home or in the community with support. • During the entire Intake Assessment process, the Interdisciplinary Team is assessing whether Rocky Mountain PACE can meet your medical, nursing, psychological and social needs, whether you have a family or informal support network, and whether remaining in your home or the community would jeopardize your health and safety. At the time of enrollment, an individual must be able to live in a community setting without jeopardizing his or her safety. The following constitutes unsafe behaviors that may cause a denial of enrollment if they cannot be remediated:
Intake Assessment. Intake Assessment is a multi-step process that takes place in your home and at one of our PACE Day Health Centers. The process is designed to help you decide whether EB ESP is right for you at the same time that we learn about you and your needs. The first part of this process is the home visit. An assessment team consisting of a nurse and an occupational or physical therapist will meet with you at home to talk about how you manage your medical concerns and activities of daily living at home. The assessment team will gather information about your medical, nursing, psychological and social needs, whether your have family or an informal support network, and whether you are able to remain safely in your home or community. The second part of this process is your visit to the PACE Day Health Center. During this visit, you will have the opportunity to meet with the PACE Center doctor and other members of the PACE Center team. You will also have the opportunity to experience PACE Center activities and speak with our program participants about their experiences in the program. After your visit to the PACE Center, the assessment team may conduct an additional home visit to answer any questions that came up during the PACE site visit and to gather additional information that may be needed to determine eligibility or to develop your care plan. In some instances, additional site visit(s) may be required to determine eligibility or to help you decide if EB ESP is right for you. You may be denied enrollment if the team determines that remaining in your home or community would jeopardize your health and safety. In such cases, EB ESP staff will contact MassHealth and provide the appropriate information before taking any action. If MassHealth agrees with our determination, your enrollment will be denied. A prospective participant may also be denied enrollment if MassHealth or its agent determines that you do not meet the Massachusetts MassHealth criteria for nursing home level of care. Should you be denied enrollment, we will notify you in writing and provide you with recommendations for alternative sources of care.
Intake Assessment. Within three weeks, we will have evaluated your health and safety status. We will meet to share our findings and ideas for your care. At this meeting, we will decide whether you meet the criteria for admission into the program, that is, whether your health needs appear to meet the MassHealth criteria for nursing facility level-of-care and whether you are living safely in your home or in the community. This includes assessing whether ESP can meet your medical, nursing, psychological and social needs in conjunction with your family or support network, if any, and whether remaining in your home or in the community jeopardizes your health and safety. You may be denied enrollment if remaining in your home and or the community would jeopardize your health and safety. In such cases, ESP staff will provide written notification explaining the reason for the denial and refer you to appropriate alternative services. Executive Office of Health & Human Services Board of Hearings 000 Xxxxxxx Xx. Quincy, MA 02171 Phone : 000-000-0000 Or 0-000-000-0000 TTY: 711 or 000-000-0000 Fax: (000) 000-0000 If we assess that you are eligible for ESP, you and your care giver/family will be invited to meet with our staff. At that time, we will review and come to an agreement about your participation in ESP before you sign the Enrollment Agreement. At this meeting you and your care giver/family will have an opportunity to: Discuss the plan of care recommended by enrollment staff and your suggestions and preferences Ask questions about your monthly payment, if any Ask questions about losing Medicare and MassHealth benefits that you may currently have (except for emergency or urgent care), as you will only be eligible for services provided and/or authorized by ESP after enrollment. Discuss the partnership between you, and/or your caregiver/family and ESP What to do if you are dissatisfied with the care you receive from ESP (see the Grievances and Appeals section of this agreement) If you decide to join ESP, you will be given the opportunity to agree to and accept the conditions of enrollment by signing the Enrollment Agreement.
Intake Assessment. 28 CONTRACTOR shall conduct an Intake Assessment, in a collaborative manner with CLIENTS, which includes clinical evaluation and assessment of social family history, mental status exam, substance abuse, domestic violence, Danger Statements, defined in Subparagraph 2.7, Harm Statements, defined in Subparagraph 2.8, Safety Goal defined in Subparagraph 2.12, and Network of Support/Family Connections defined in Subparagraph 2.9. If domestic violence, danger, harm, safety concerns, suicidal ideation, or substance abuse are identified, CONTRACTOR shall develop a safety plan with CLIENT to address any immediate and/or ongoing safety concerns. CONTRACTOR shall also identify behaviors and problems classifieddefined in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5, which could endanger or place child(ren) at risk of abuse and/or neglect. CDA1018CCD1621-00 Page 5 of 26 March 24 April 20, 2018, 2021 1 CONTRACTOR shall determine appropriate treatment plan 2 for identified DSM-5 behaviors. 4 CONTRACTOR shall develop a treatment plan from the Intake 5 Assessment, as described in Subparagraphs 4.5 through 4.5.1.1, and ensure 7 the plan includes and is aligned with CLIENT treatment goals in the 8 resulting Assessment and Treatment Plan (ATP) described in Subparagraph 11 CONTRACTOR may use a maximum of up to three (3), fifty (50) 13 minute sessions per CLIENT to complete the Intake Assessment.
Intake Assessment. Alliance shall require the Eligible Member’s Medical Home to provide an intake assessment of each new Eligible Member’s general health status.
Intake Assessment. The Contractor shall conduct an intake assessment (the “Intake Assessment”) of each Injured Worker, which must include:
