Non-psychiatrist Behavioral Health Providers Sample Clauses

Non-psychiatrist Behavioral Health Providers. In addition to the access requirements for psychiatrists as described in Section 5.2.3, the Contractor shall establish a network of behavioral health providers, addressing both mental health and addiction, as set forth in this Section 5.2.5. The Contractor is encouraged to contract with all Division of Mental Health and Addiction (DMHA) certified Community Mental Health Centers (CMHCs). If all CMHCs are not included in the provider network, the Contractor shall demonstrate that this does not prevent coordination of care with MRO and 1915(i) State Plan services as required in Sections 3.11.1 and 6.11.2. Further, as described in Section 3.7.4, the Contractor shall, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and shall provide physical health and other medical information to the appropriate CMHC for every member. The Division of Mental Health and Addiction (DMHA) conducts regular annual Consumer Service Reviews to evaluate the quality of care provided in CMHCs. In addition to the regular oversight that the Contractor provides for contracted CMHCs, the Contractors shall utilize the results of DMHA’s review to inform contracting decisions, to monitor contracted CMHCs and to develop improvement plans with contracted CMHCs. In urban areas, the Contractor shall provide at least one (1) behavioral health provider within thirty (30) minutes or thirty (30) miles from the member’s home. In rural areas, the Contractor shall provide at least one (1) behavioral health provider within forty-five (45) minutes or forty-five (45) miles from the member’s home. The availability of professionals will vary, but access problems may be especially acute in rural areas. The Contractor must provide assertive outreach to members in rural areas where behavioral health services may be less available than in more urban areas. The Contractor also shall monitor utilization in rural and urban areas to assure equality of service access and availability. The following list represents behavioral health providers that shall be available in the Contractor’s network:  Outpatient mental health and addiction clinics;  Community mental health centers;  Certified psychologists;  Health services providers in psychology (HSPPs);  Certified social workers;  Licensed clinical social workers;  Psychiatric nurses;  Independent practice school psychologists;  Advanced practice nurses under IC 25-23-1-1(b)(3), credentialed in psychiatric or...
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Non-psychiatrist Behavioral Health Providers. In addition to the access requirements for psychiatrists as described in Section 6.2.4, the Contractor shall establish a network of behavioral health providers, addressing both mental health and addiction, including the following:  Outpatient mental health and addiction clinics;  Community mental health centers;  Health service providers in psychology (HSPP);  Licensed clinical social workers;  Psychiatric nurses;  Independent practice school psychologists;  Advanced practice nurses under IC 25-23-1-1(b)(3), credentialed in psychiatric or mental health nursing;  Marital and family therapists; and  Licensed mental health counselors. The Contractor is encouraged to contract with all Division of Mental Health and Addiction (DMHA) certified CMHCs. If all CMHCs are not included in the provider network, the Contractor must demonstrate that this does not prevent coordination of care with MRO and 1915(i) State Plan HCBS services as required in Sections 3.12.1 and 3.12.2. Further, as described in Section 3.10.2, the Contractor must, at a minimum, establish referral agreements and liaisons with both contracted and non-contracted CMHCs, and must provide physical health and other medical information to the appropriate CMHC for every member. The Contractor must provide at least one (1) behavioral health provider within thirty (30) minutes or thirty (30) miles in urban areas, and within forty-five (45) minutes or forty-five
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Non-psychiatrist Behavioral Health Providers. In addition to the access requirements for psychiatrists as described in Section 5.2.3, the Contractor shall establish a network of behavioral health providers, addressing both mental health and addiction, as set forth in this Section 5.2.5. The Contractor is encouraged to contract with all Division of Mental Health and Addiction (DMHA) certified Community Mental Health Centers (CMHCs). If all CMHCs are not included
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Related to Non-psychiatrist Behavioral Health Providers

  • 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.

  • 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.

  • HEALTH PROGRAM 3701 Health examinations required by the Employer shall be provided by the Employer and shall be at the expense of the Employer. 3702 Time off without loss of regular pay shall be allowed at a time determined by the Employer for such medical examinations and laboratory tests, provided that these are performed on the Employer’s premises, or at a facility designated by the Employer. 3703 With the approval of the Employer, a nurse may choose to be examined by a physician of her/his own choice, at her/his own expense, as long as the Employer receives a statement as to the fitness of the nurse from the physician. 3704 Time off for medical and dental examinations and/or treatments may be granted and such time off, including necessary travel time, shall be chargeable against accumulated income protection benefits.

  • Hospital 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.

  • 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.

  • 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.

  • Physician Visits This plan covers the services of a physician or other provider in charge of your medical care while you are inpatient in a general or specialty hospital.

  • Extended Health Plan An employee who makes an election under this provision must enrol in each and every of the benefit plans and shall not be entitled to except any of them.

  • 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.

  • 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.

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