Referral to Community Supports. The Health Home provider identifies available community-based resources and actively manages appropriate referrals, access, engagement, follow-up and coordination of services. • xxxx://xxx.xxxxxx.xx.xxx/health_care/medicaid/program/medicaid_health_homes/provider_qualification_standards.htm Outreach and Engagement • The outreach fee is a flat fee of $135 PMPM (outreach may be billed within the month the member is referred if the member does not enroll in that month) • The outreach and engagement per member per month (PMPM) payment will be available for three (3) months. If outreach and engagement is unsuccessful (defined as neither locating nor engaging the child or family to enroll), the provider may continue outreach, but is not eligible to bill again for these activities until an interval of at least three months has elapsed since billing for outreach and engagement. • Active and meaningful outreach would include direct communications (face-to-face, electronic or by telephone), with the member (if appropriate, with appropriate consent) or their parent/guardian/legally authorized representative (with appropriate provisions to assure patient privacy is protected). There should be evidence that outreach efforts are progressive and are escalated as appropriate with the expected outcome of enrollment. • All outreach efforts MUST be documented in the members record
