Clinical Management for Behavioral Health Services (CMBHS) System 1. request access to CMBHS via the CMBHS Helpline at (000) 000-0000. 2. use the CMBHS time frames specified by System Agency. 3. use System Agency-specified functionality of the CMBHS in its entirety. 4. submit all bills and reports to System Agency through the CMBHS, unless otherwise instructed.
Behavioral Health Services Behavioral health services include the evaluation, management, and treatment for a mental health or substance use disorder condition. For the purpose of this plan, substance use disorder does not include addiction to or abuse of tobacco and/or caffeine. Mental health or substance use disorders are those that are listed in the most updated volume of either: • the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association; or • the International Classification of Disease Manual (ICD) published by the World Health Organization. This plan provides parity in benefits for behavioral healthcare services. Please see Section 10 for additional information regarding behavioral healthcare parity. This plan covers behavioral health services if you are inpatient at a general or specialty hospital. See Inpatient Services in Section 3 for additional information. This plan covers services at behavioral health residential treatment facilities, which provide: • clinical treatment; • medication evaluation management; and • 24-hour on site availability of health professional staff, as required by licensing regulations. This plan covers intermediate care services, which are facility-based programs that are: • more intensive than traditional outpatient services; • less intensive than 24-hour inpatient hospital or residential treatment facility services; and • used as a step down from a higher level of care; or • used a step-up from standard care level of care. Intermediate care services include the following: • Partial Hospital Program (PHP) – PHPs are structured and medically supervised day, evening, or nighttime treatment programs providing individualized treatment plans. A PHP typically runs for five hours a day, five days per week. • Intensive Outpatient Program (IOP) – An IOP provides substantial clinical support for patients who are either in transition from a higher level of care or at risk for admission to a higher level of care. An IOP typically runs for three hours per day, three days per week.
Home Health Care This plan covers the following home care services when provided by a certified home healthcare agency: • nursing services; • services of a home health aide; • visits from a social worker; • medical supplies; and • physical, occupational and speech therapy.
Mental Health Services This agreement covers medically necessary services for the treatment of mental health disorders in a general or specialty hospital or outpatient facilities that are: • reviewed and approved by us; and • licensed under the laws of the State of Rhode Island or by the state in which the facility is located as a general or specialty hospital or outpatient facility. We review network and non-network programs, hospitals and inpatient facilities, and the specific services provided to decide whether a preauthorization, hospital or inpatient facility, or specific services rendered meets our program requirements, content and criteria. If our program content and criteria are not met, the services are not covered under this agreement. Our program content and criteria are defined below.
Extended Health Care Plan The Employer shall pay the monthly premium for regular employees entitled to coverage under a mutually acceptable extended health care plan.
STAFF ORIENTATION 4101 The Employer shall provide an appropriate orientation program for nurses newly employed. The orientation program shall include such essential information as policies, nursing procedures, the location of supplies and equipment, fire, safety and disaster plans. Where necessary, orientation shall be provided for nurses moving to a new area of practice. 4102 The Employer shall provide a program of inservice education for nurses pertinent to patient care. 4103 The Employer shall provide, access to reference materials as is required in relation to maintaining current knowledge of general nursing care. Licensed Practical Nurse 2015 Hourly 25.198 26.022 26.836 27.825 28.732 29.745 30.804 31.420 Monthly 4,231.164 4,369.528 4,506.212 4,672.281 4,824.582 4,994.681 5,172.505 5,275.942 Annual 50,773.970 52,434.330 54,074.540 56,067.375 57,894.980 59,936.175 62,070.060 63,311.300 Nurse II 2015 Hourly 32.917 34.066 35.218 36.419 37.593 38.811 39.587 Monthly 5,527.313 5,720.249 5,913.689 6,115.357 6,312.491 6,517.014 6,647.317 Annual 66,327.755 68,642.990 70,964.270 73,384.285 75,749.895 78,204.165 79,767.805 Nurse II (20 Year Scale) 2015 Hourly 33.575 34.747 35.923 37.148 38.345 39.587 Monthly 5,637.802 5,834.600 6,032.070 6,237.768 6,438.765 6,647.317 Annual 67,653.625 70,015.205 72,384.845 74,853.220 77,265.175 79,767.805 Nurse III 2015 Hourly 34.168 35.321 36.523 37.697 38.787 39.975 41.201 42.025 Monthly 5,737.377 5,930.985 6,132.820 6,329.955 6,512.984 6,712.469 6,918.335 7,056.698 Annual 68,848.520 71,171.815 73,593.845 75,959.455 78,155.805 80,549.625 83,020.015 84,680.375 Nurse III (20 Year Scale) 2015 Hourly 34.851 36.027 37.254 38.451 39.563 40.775 42.025 Monthly 5,852.064 6,049.534 6,255.568 6,456.564 6,643.287 6,846.802 7,056.698 Annual 70,224.765 72,594.405 75,066.810 77,478.765 79,719.445 82,161.625 84,680.375 Nurse IV 2015 Hourly 35.340 36.649 37.959 39.387 41.024 42.612 44.273 45.158 Monthly 5,934.175 6,153.978 6,373.949 6,613.734 6,888.613 7,155.265 7,434.175 7,582.781 Annual 71,210.100 73,847.735 76,487.385 79,364.805 82,663.360 85,863.180 89,210.095 90,993.370 Nurse IV (20 Year Scale) 2015 Hourly 36.047 37.382 38.718 40.175 41.844 43.464 45.158 Monthly 6,052.892 6,277.061 6,501.398 6,746.052 7,026.305 7,298.330 7,582.781 Annual 72,634.705 75,324.730 78,016.770 80,952.625 84,315.660 87,579.960 90,993.370 Nurse V 2015 Hourly 37.305 38.733 40.369 41.957 43.690 45.388 47.157 48.100 Monthly 6,264.131 6,503.916 6,778.628 7,045.280 7,336.279 7,621.402 7,918.446 8,076.792 Annual 75,169.575 78,046.995 81,343.535 84,543.355 88,035.350 91,456.820 95,021.355 96,921.500 Nurse V (20 Year Scale) 2015 Hourly 38.051 39.508 41.177 42.797 44.564 46.296 48.100 Monthly 6,389.397 6,634.052 6,914.305 7,186.330 7,483.038 7,773.870 8,076.792 Annual 76,672.765 79,608.620 82,971.655 86,235.955 89,796.460 93,286.440 96,921.500 Nurse Practitioner 2015 Hourly 42.515 45.635 47.511 49.385 51.408 52.437 Monthly 7,138.977 7,662.877 7,977.889 8,292.565 8,632.260 8,805.046 Annual 85,667.725 91,954.525 95,734.665 99,510.775 103,587.120 105,660.555 Nurse Practitioner (20 Year Scale) 2015 Hourly 43.365 46.548 48.461 50.373 52.437 Monthly 7,281.706 7,816.185 8,137.410 8,458.466 8,805.046 Annual 87,380.475 93,794.220 97,648.915 101,501.595 105,660.555 Weekend Worker - Licensed Practical Nurse 2015 Hourly 28.977 29.925 30.861 31.999 33.042 34.206 35.425 36.133 Monthly 4,865.721 5,024.906 5,182.076 5,373.165 5,548.303 5,743.758 5,948.448 6,067.333 Annual 58,388.655 60,298.875 62,184.915 64,477.985 66,579.630 68,925.090 71,381.375 72,807.995 Weekend Worker - Nurse II 2015 Hourly 37.855 39.176 40.501 41.882 43.232 44.633 45.526 Monthly 6,356.485 6,578.303 6,800.793 7,032.686 7,259.373 7,494.625 7,644.574 Annual 76,277.825 78,939.640 81,609.515 84,392.230 87,112.480 89,935.495 91,734.890 Weekend Worker - Nurse II (20 Year Scale) 2015 Hourly 38.612 39.959 41.311 42.720 44.097 45.526 Monthly 6,483.598 6,709.782 6,936.805 7,173.400 7,404.621 7,644.574 Annual 77,803.180 80,517.385 83,241.665 86,080.800 88,855.455 91,734.890 Weekend Worker - Nurse III 2015 Hourly 39.293 40.619 42.002 43.352 44.605 45.971 47.381 48.329 Monthly 6,597.950 6,820.607 7,052.836 7,279.523 7,489.923 7,719.297 7,956.060 8,115.245 Annual 79,175.395 81,847.285 84,634.030 87,354.280 89,879.075 92,631.565 95,472.715 97,382.935 Weekend Worker - Nurse III (20 Year Scale) 2015 Hourly 40.079 41.431 42.842 44.219 45.497 46.891 48.329 Monthly 6,729.932 6,956.955 7,193.886 7,425.107 7,639.705 7,873.780 8,115.245 Annual 80,759.185 83,483.465 86,326.630 89,101.285 91,676.455 94,485.365 97,382.935 Weekend Worker - Nurse IV 2015 Hourly 40.641 42.146 43.653 45.295 47.177 49.003 50.914 51.932 Monthly 6,824.301 7,077.016 7,330.066 7,605.785 7,921.805 8,228.420 8,549.309 8,720.248 Annual 81,891.615 84,924.190 87,960.795 91,269.425 95,061.655 98,741.045 102,591.710 104,642.980 Weekend Worker - Nurse IV (20 Year Scale) 2015 Hourly 41.454 42.989 44.526 46.201 48.121 49.983 51.932 Monthly 6,960.818 7,218.570 7,476.658 7,757.918 8,080.318 8,392.979 8,720.248 Annual 83,529.810 86,622.835 89,719.890 93,095.015 96,963.815 100,715.745 104,642.980 Weekend Worker - Nurse V 2015 Hourly 42.900 44.543 46.425 48.251 50.244 52.196 54.230 55.315 Monthly 7,203.625 7,479.512 7,795.531 8,102.147 8,436.805 8,764.578 9,106.121 9,288.310 Annual 86,443.500 89,754.145 93,546.375 97,225.765 101,241.660 105,174.940 109,273.450 111,459.725 Weekend Worker - Nurse V (20 Year Scale) 2015 Hourly 43.758 45.434 47.353 49.216 51.249 53.240 55.315 Monthly 7,347.698 7,629.126 7,951.358 8,264.187 8,605.561 8,939.883 9,288.310 Annual 88,172.370 91,549.510 95,416.295 99,170.240 103,266.735 107,278.600 111,459.725 1 Eligibility for the 20 Year increment is determined in accordance w ith Article 2105.
Medical Verification The Town may require medical verification of an employee’s absence if the Town perceives the employee is abusing sick leave or has used an excessive amount of sick leave. The Town may require medical verification of an employee’s absence to verify that the employee is able to return to work with or without restrictions.
Health Care The Company will reimburse the Executive for the cost of maintaining continuing health coverage under COBRA for a period of no more than 12 months following the date of termination, less the amount the Executive is expected to pay as a regular employee premium for such coverage. Such reimbursements will cease if the Executive becomes eligible for similar coverage under another benefit plan.
Medical Care The Parents must comply with the School Welfare Officer's recommendations which may include a reasonable decision to release the Pupil home or to his / her education guardian when s/he is unwell.
Urgent Care This plan covers services received at an urgent care center. For other services, such as surgery or diagnostic tests, the amount that you pay is based on the type of service being provided. See Summary of Medical Benefits for details. Follow-up care (such as suture removal or wound care) should be obtained from your