Common use of Non-psychiatrist Behavioral Health Providers Clause in Contracts

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 mental health nursing by the American Nurses Credentialing Center;  Marital and family therapists; and  Licensed mental health counselors. All services covered under the clinic option shall be delivered by licensed psychiatrists and HSPPs, or an advanced practice nurse or person holding a master’s degree in social work, marital and family therapy or mental health counseling.

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-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 mental health nursing by the American Nurses Credentialing Center;  Marital and family therapists; and  Licensed mental health counselors. All services covered under the clinic option shall be delivered by licensed psychiatrists and HSPPs, or an advanced practice nurse or person holding a master’s degree in social work, marital and family therapy or mental health counseling.

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-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;  ▪ Psychologists; ▪ 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 mental health nursing by the American Nurses Credentialing Center;  ▪ Marital and family therapists; and  ▪ Licensed mental health counselors. All services covered under the clinic option shall be delivered by licensed psychiatrists and HSPPs, or an advanced practice nurse or person holding a master’s degree in social work, marital and family therapy or mental health counseling.

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-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. forty- 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;  Psychologists; 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 mental health nursing by the American Nurses Credentialing Center;  Marital and family therapists; and  Licensed mental health counselors. All services covered under the clinic option shall be delivered by licensed psychiatrists and HSPPs, or an advanced practice nurse or person holding a master’s degree in social work, marital and family therapy or mental health counseling.

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;   Psychologists;  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 mental health nursing by the American Nurses Credentialing Center;   Marital and family therapists; and   Licensed mental health counselors. All services covered under the clinic option shall be delivered by licensed psychiatrists and HSPPs, or an advanced practice nurse or person holding a master’s degree in social work, marital and family therapy or mental health counseling.

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;  ▪ Psychologists; ▪ 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 mental health nursing by the American Nurses Credentialing Center;  ▪ Marital and family therapists; and  ▪ Licensed mental health counselors. All services covered under the clinic option shall be delivered by licensed psychiatrists and HSPPs, or an advanced practice nurse or person holding a master’s degree in social work, marital and family therapy or mental health counseling.

Non-psychiatrist Behavioral Health Providers. In addition to the access requirements for psychiatrists as described in Section 5.2.38.2.3, the Contractor shall establish a network of behavioral health providers, addressing both mental health and addiction, as set forth in this Section 5.2.58.2.5. 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 6.11.1 and 6.11.2. Further, as described in Section 3.7.46.7.4, 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 shall 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;   Psychologists;  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 mental health nursing by the American Nurses Credentialing Center;   Marital and family therapists; and   Licensed mental health counselors. All services covered under the clinic option shall be delivered by licensed psychiatrists and HSPPs, or an advanced practice nurse or person holding a master’s degree in social work, marital and family therapy or mental health counseling.