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. Residential Treatment Facility 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. Intermediate Care Services 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.
Hospice g. Individuals whose permanent residence and principal work location are outside the State of Minnesota and outside of the service areas of the health plans participating in Advantage. If these individuals use the plan administrator’s national preferred provider organization in their area, services will be covered at Benefit Level Two. If a national preferred provider is not available in their area, services will be covered at Benefit Level Two through any other provider available in their area. If the national preferred provider organization is available but not used, benefits will be paid at the POS level described in paragraph “i” below. All terms and conditions outlined in the Summary of Benefits will apply.
Healthcare Section 1. Bargaining unit employees with one (1) year or more of service will be provided coverage for the duration of this contract through the “Full Coverage” Team Care Plan (“Team Care MM200”), which includes dental, vision, life, short term disability, medical and prescription drug benefits. Prior to January 1, 2020, bargaining unit employees with less than one (1) year of service will be provided coverage through the “Medical Only” plan. On January 1, 2020, all bargaining unit employees enrolled in the Medical Only plan shall be enrolled in the Full Coverage plan, and the Medical Only plan will eliminated. The rates for 2019 and a further description of the plan and rates are referenced
Health Services At the time of employment and subject to (b) above, full credit for registered professional nursing experience in a school program shall be given. Full credit for registered professional nursing experience may be given, subject to approval by the Human Resources Division. Non-degree nurses shall be placed on the BA Track of the Teachers Salary Schedule and shall be ineligible for movement to any other track.
Community Mental Health Center Services Assertive Community Treatment Staffing Full Time Equivalents Community Mental Health Center June 2020 March 2020 Nurse Masters Level Clinician/or Equivalent Functional Support Worker Peer Specialist Total (Excluding Psychiatry) Psychiatrist/Nurse Practitioner Total (Excluding Psychiatry) Psychiatrist/Nurse Practitioner 01 Northern Human Services 1.81 1.80 9.75 0.00 13.36 1.20 16.37 1.20 02 West Central Behavioral Health 0.70 1.20 3.70 0.50 6.10 0.50 6.10 0.50 03 Lakes Region Mental Health Center 1.00 2.00 2.50 1.00 6.50 0.75 7.00 0.75 04 Riverbend Community Mental Health Center 0.50 2.00 8.00 0.00 10.50 0.50 10.50 0.50 05 Monadnock Family Services 2.00 2.25 3.50 1.10 8.85 0.65 8.85 0.65 06 Greater Nashua Mental Health 1 1.00 1.00 5.00 1.00 8.00 0.25 6.50 0.25 06 Greater Nashua Mental Health 2 1.00 1.00 5.00 1.00 8.00 0.25 7.50 0.25 07 Mental Health Center of Greater Manchester-CTT 1.00 11.00 5.25 1.00 18.25 0.91 18.25 0.91 07 Mental Health Center of Greater Manchester-MCST 1.00 8.00 7.25 1.00 17.25 0.91 16.25 0.91 08 Seacoast Mental Health Center 1.00 2.10 5.00 1.00 9.10 0.60 9.10 0.60 09 Community Partners 0.25 2.00 6.95 0.00 9.20 0.70 11.05 0.63 10 Center for Life Management 1.00 2.00 4.30 1.00 8.30 0.40 8.55 0.40 Total 12.26 36.35 66.20 8.60 123.41 7.62 127.02 7.55 2b. Community Mental Health Center Services: Assertive Community Treatment Staffing Competencies Community Mental Health Center Substance Use Disorder Treatment Housing Assistance Supported Employment June 2020 March 2020 June 2020 March 2020 June 2020 March 2020 01 Northern Human Services 3.55 2.55 8.75 10.75 1.00 1.50 02 West Central Behavioral Health 0.20 0.20 4.10 4.10 0.60 0.60 03 Lakes Region Mental Health Center 1.00 1.00 5.50 6.00 2.00 2.00 04 Riverbend Community Mental Health Center 1.50 1.50 9.50 9.50 0.50 0.50 05 Monadnock Family Services 1.40 1.40 2.00 2.00 1.00 1.00 06 Greater Nashua Mental Health 1 4.25 4.25 6.25 6.25 1.00 1.00 06 Greater Nashua Mental Health 2 5.25 5.25 7.00 7.00 0.00 0.00 07 Mental Health Center of Greater Manchester-CCT 10.91 10.91 13.75 13.75 2.00 2.00 07 Mental Health Center of Greater Manchester-MCST 5.91 5.91 12.75 11.75 2.00 2.00 08 Seacoast Mental Health Center 2.00 2.00 5.00 5.00 2.00 2.00 09 Community Partners 2.70 2.63 5.05 5.05 0.38 0.68 10 Center for Life Management 3.00 3.00 7.00 7.00 0.30 0.30 Total 41.67 40.60 86.65 88.15 12.78 14.58 Revisions to Prior Period: None. Data Source: Bureau of Mental Health CMHC ACT Staffing Census Based on CMHC self-report. Notes: Data compiled 07/16/2020; for 2b: the Staff Competency values reflect the sum of FTEs trained to provide each service type. These numbers are not a reflection of the services delivered, but rather the quantity of staff available to provide each service. If staff are trained to provide multiple service types, their entire FTE value is credited to each service type.
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. Inpatient 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. Residential Treatment Facility 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. Intermediate Care Services 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.
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.
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.
