Common use of Intensive Case Management Clause in Contracts

Intensive Case Management. a. Intensive Case Management is intended to provide intensive team Case Management to highly recidivistic adults who have a severe and persistent mental illness. The service is intended to help Enrollees remain in the community and avoid institutional care. Clinical care criteria for this level of Case Management shall address the same elements required above, as well as expanded elements related to access and twenty-four (24) hour coverage as described below. Additionally, the intensive Case Management team composition shall be expanded to include members of the team selected specifically to assist with the special needs of this population. The Health Plan shall include the team composition and how it will assist with special needs in the description of how this service will be provided. b. The Health Plan shall provide this service for all Enrollees for whom the service is determined to be Medically Necessary, to include Enrollees who meet the following criteria:

Intensive Case Management. a. Intensive Case Management is intended to provide intensive team Case Management to highly recidivistic adults who have a severe and persistent mental illness. The service is intended to help Enrollees remain in the community and avoid institutional care. Clinical care criteria for this level of Case Management shall address the same elements required above, as well as expanded elements related to access and twenty-four (24) hour coverage as described below. Additionally, the intensive Case Management team composition shall be expanded to include members of the team selected specifically to assist with the special needs of this population. The Health Plan PSN shall include the team composition and how it will assist with special needs in the description of how this service will be provided. b. The Health Plan PSN shall provide this service for all Enrollees for whom the service is determined to be Medically Necessary, to include Enrollees enrollees who meet the following criteria:

Intensive Case Management. a. Intensive Case Management is intended to provide intensive team Case Management to highly recidivistic adults who have a severe and persistent mental illness. The service is intended to help Enrollees remain in the community and avoid institutional care. Clinical care criteria for this level of Case Management shall address the same elements required above, as well as expanded elements related to access and twenty-four (24) hour coverage as described below. Additionally, the intensive Case Management team composition shall be expanded to include members of the team selected specifically to assist with the special needs of this population. The Health Plan shall include the team composition and how it will assist with special needs in the description of how this service will be provided. b. The Health Plan shall provide this service for all Enrollees for whom the service is determined to be Medically Necessary, to include Enrollees who meet the following criteria: