MENTAL HEALTH AND SUBSTANCE ABUSE ACCESS Sample Clauses

MENTAL HEALTH AND SUBSTANCE ABUSE ACCESS a. The MCO shall provide, to its Members, all behavioral health care services (mental health and substance abuse) covered by the HUSKY B program that are medically necessary and medically appropriate. These services may be provided by the MCO through contracts with providers of services or through subcontracted relationships with specialized behavioral health management entities. A Member will not need a PCP referral to obtain services; self-referral will be sufficient to obtain an initial service visit. The MCO may require authorization for an ongoing course of treatment. b. Notwithstanding any contractual arrangement with a specialized management agency, the MCO is wholly responsible to ensure that medically necessary and medically appropriate services are provided to its HUSKY B Members. c. The MCO shall contract with a consultant or employ a doctoral level mental health professional staff person within the plan with appropriate qualifications, credentials and decision making authority who will have specific responsibilities for exercising oversight of the delivery of behavioral health services by the plan or its subcontractors. Such person shall be responsible for promoting efforts to better integrate and coordinate the provision of behavioral health care with other services. The individual shall be available by phone for consultation on an as needed basis, dedicated to the Connecticut Members, as well as have an extensive understanding of the provisions of this contract. d. In reference to services for children with psychiatric/mental health and substance abuse needs, the MCO and any subcontracted entity is required to contract with and refer to qualified HUSKY B providers. e. The MCO and any subcontractor entity will cooperate in the identification and improvement of processes working toward the development and standardization of administrative procedures. The MCO and any subcontracted entity shall take steps to promote successful provider-Member relationships and will monitor the effectiveness of these relationships. f. The MCO is responsible for monitoring the performance of its network providers and for monitoring and ensuring contract compliance and HUSKY B policy/compliance with any subcontracted entity. Such monitoring will ensure that providers and subcontractors observe all contractual and policy requirements as well as measuring performance relating to such areas as access to care and ensuring quality of care. The MCO and any subcontracted e...
Sample 1
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MENTAL HEALTH AND SUBSTANCE ABUSE ACCESS a. Except as otherwise identified in this section and this Contract, mental health and substance abuse services for HUSKY A Members will be managed by the CT-BHP and paid for by the DEPARTMENT. The MCO shall coordinate services covered under this contract with the behavioral health services managed by the CT BMP as outlined in Appendix N. b. The MCO may track utilization, including, but not limited to, primary care behavioral health, laboratory, behavioral health pharmacy, emergency department, and transportation. The MCO shall bring any increases in the utilization trend for any of these services to the attention of the DEPARTMENT. c. If there is a conflict between the MCO and the BMP as to whether a Member's medical or behavioral health condition is primary, the MCO's medical director shall work with the BHP's medical director to reach a timely and mutually agreeable resolution. If the MCO and BMP are not able to reach a resolution, the DEPARTMENT will make a determination and the DEPARTMENT'S determination shall be binding. Issues related to whether a Member's medical or behavioral health condition is primary must not delay timely medical necessity determinations. In these circumstances, the MCO must render a determination within the standard timeframe required under this contract. d. Ancillary Services 1. The MCO shall retain responsibility for all ancillary services such as laboratory, radiology, and medical equipment, devices and supplies regardless of diagnosis. 2. The MCO is not responsible for ancillary services that are part of the DEPARTMENT'S all-inclusive rate for inpatient behavioral health services. e. Co-Occurring Medical and Behavioral Health Conditions The MCO shall continue programs and procedures designed to support the identification of untreated behavioral health disorders in medical patients at risk for such disorders. The MCO shall: 1. Contact the BMP ASO when co-management of a Member's care by the MCO and the BMP ASO is indicated, such as for persons with special physical health and behavioral health needs; 2. Respond to inquiries by the BMP ASO regarding the presence of medical co- morbidities; 3. Coordinate with the BMP ASO, upon request; 4. Assign a key contact person in order to facilitate timely coordination with the ASO; and 5. Participate in medical/behavioral co-management meetings at least once a month, with the specific frequency to be determined by agreement between the MCO and the ASO. f. Freestanding Primary Care Clin...
Sample 1

Related to MENTAL HEALTH AND SUBSTANCE ABUSE ACCESS

  • Substance Abuse The dangers and costs that alcohol and other chemical abuses can create in the electrical contracting industry in terms of safety and productivity are significant. The parties to this Agreement resolve to combat chemical abuse in any form and agree that, to be effective, programs to eliminate substance abuse and impairment should contain a strong rehabilitation component. The local parties recognize that the implementation of a drug and alcohol policy and program must be subject to all applicable federal, state, and local laws and regulations. Such policies and programs must also be administered in accordance with accepted scientific principles, and must incorporate procedural safeguards to ensure fairness in application and protection of legitimate interests of privacy and confidentiality. To provide a drug-free workforce for the Electrical Construction Industry, each IBEW local union and NECA chapter shall implement an area-wide Substance Abuse Testing Policy. The policy shall include minimum standards as required by the IBEW and NECA. Should any of the required minimum standards fail to comply with federal, state, and/or local laws and regulations, they shall be modified by the local union and chapter to meet the requirements of those laws and regulations.

  • Substance Abuse Program The SFMTA General Manager or designee will manage all aspects of the FTA-mandated Substance Abuse Program. He/she shall have appointing and removal authority over all personnel working for the Substance Abuse Program personnel, and shall be responsible for the supervision of the SAP.

  • Substance Abuse Testing The Parties agree that it is in the best interest of all concerned to promote a safe working environment. The Union has no objection to pre-employment substance abuse testing when required by the Employer and further, the Union has no objection to voluntary substance abuse testing to qualify for employment on projects when required by a project owner. The cost and scheduling of such testing shall be paid for and arranged by the Employer. The Union agrees to reimburse the Employer for any failed pre-access Alcohol and Drug test costs.

  • SUBSTANCE ABUSE POLICY See applicable administrative policy.

  • Substance Abuse Treatment Information Substance abuse treatment information shall be maintained in compliance with 42 C.F.R. Part 2 if the Party or subcontractor(s) are Part 2 covered programs, or if substance abuse treatment information is received from a Part 2 covered program by the Party or subcontractor(s).

  • 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.

  • Accident Prevention Health and Safety Committee (a) The Employer and the Union agree that they mutually desire to maintain standards of safety and health in the workplace in order to prevent accidents, injury and illness. (b) Recognizing its responsibilities under the applicable legislation, the Employer agrees to accept as a member of its Accident Prevention – Health & Safety Committee at least three (3) representatives, one from each base, selected or appointed by the Union from amongst bargaining unit employees. At any time where a vote is required, an equal number of representatives from each side shall be entitled to vote. (c) Such Committee shall identify potential dangers and hazards, institute means of improving health and safety programs and recommend actions to be taken to improve conditions related to safety and health. (d) The Employee agrees to co-operate reasonably in providing necessary information to enable the Committee to fulfill its functions. (e) Meetings shall be held quarterly or more frequently at the call of the Chair if required. The Committee shall maintain minutes of all meetings and make the same available for review. (f) Any representative appointed or select in accordance with (b) hereof shall serve a term of one (1) calendar year from the date of appointment which may be renewed for further periods of one (1) year. The Union will encourage its representative(s) to serve at least one (1) year. Time off for such representative(s) to attend meetings of the Accident Prevention – Health & Safety Committee in accordance with the foregoing shall be granted and time so spent attending such meetings shall be deemed to be work time for which the representative(s) shall be paid by the Employer at his regular or premium rate as may be applicable. (g) The Union agrees to endeavour to obtain the full co-operation of its membership in the observation of all safety rules and practices. (h) Pregnant employees may request to be transferred from their current duties if, in the professional opinion of the employee’s physician, the pregnancy may be at risk. If such a transfer is not feasible, the pregnant employee, if she so requests, will be granted an unpaid leave of absence before commencement of the maternity leave referred to in Article 16.04

  • Mental Health The parties recognize the importance of supporting and promoting a psychologically healthy workplace and as such will adhere to all applicable statutes, policy, guidelines and regulations pertaining to the promotion of mental health.

  • Data Access Control Persons entitled to use data processing systems gain access only to the Personal Data that they have a right to access, and Personal Data must not be read, copied, modified or removed without authorization in the course of processing, use and storage.

  • Workplace Violence Prevention and Crisis Response (applicable to any Party and any subcontractors and sub-grantees whose employees or other service providers deliver social or mental health services directly to individual recipients of such services): Party shall establish a written workplace violence prevention and crisis response policy meeting the requirements of Act 109 (2016), 33 VSA §8201(b), for the benefit of employees delivering direct social or mental health services. Party shall, in preparing its policy, consult with the guidelines promulgated by the U.S. Occupational Safety and Health Administration for Preventing Workplace Violence for Healthcare and Social Services Workers, as those guidelines may from time to time be amended. Party, through its violence protection and crisis response committee, shall evaluate the efficacy of its policy, and update the policy as appropriate, at least annually. The policy and any written evaluations thereof shall be provided to employees delivering direct social or mental health services. Party will ensure that any subcontractor and sub-grantee who hires employees (or contracts with service providers) who deliver social or mental health services directly to individual recipients of such services, complies with all requirements of this Section.

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