REGION SPECIFIC REQUIREMENTS. 2.7.1. Integration
2.7.1.1. In addition to the requirements described in Section 2.4 the Contractor shall:
2.7.1.1.1. Advance the integration of physical and behavioral health care through the Contractor’s centralized innovations program, which includes the Integrated Care Action Team, the Chronic Pain Project, and the BHI Integrated Care Learning Community.
2.7.1.1.2. Implement the BHI Chronic Pain Care Management Program.
2.7.1.1.3. Implement the BHI-Colorado Access Care Coordination System.
2.7.1.1.4. Implement and continually refine the Four Quadrant Clinical Integration Model.
2.7.1.1.5. Implement the following strategies in order to continue integration efforts in their region:
2.7.1.1.5.1. Provide Primary Care Liaison Services
2.7.1.1.5.2. Provide Training for Primary Care Medical Providers and Behavioral Health Network Providers 2.7.1.1.5.3. Evaluate and Plan for Partnership Development 2.7.1.1.5.4. Assign Behavioral Health Specialists to Practices Incrementally 2.7.1.1.5.5. Implementation Planning and Agreements
2.7.2. Members involved with the Correctional System
2.7.2.1. In addition to the requirements described in Section 2.4.2.4.2.5, the Contractor shall:
2.7.2.1.1. Ensure that its Transitions Coordinator shall regularly convene a BHI Corrections Committee with a meeting schedule that reflects needs in this area as they are assessed.
2.7.2.1.1.1. This committee shall monitor compliance with standards for access to behavioral health services for Members being released from correctional facilities and work with those facilities to troubleshoot when problems arise.
2.7.2.1.2. Ensure that its Providers are co-located in county jails and shall provide assistance with discharge and transition planning, including scheduling intakes for inmates not yet connected with services and scheduling appointments for those who have existing service providers.
2.7.2.1.2.1. The Contractor shall ensure that its Providers assist with other post-release needs such as medical and dental services, education resources, and benefits acquisition.
2.7.2.1.3. Implement re-entry case managers to seamlessly transition behavioral health care services from correctional facilities to BHI providers when there is no on- site staff available. The Contractor’s case managers shall also support other needs such as medical and dental services and benefits acquisition.
2.7.2.1.4. Implement In-reach programs.
2.7.3. Female Medicaid Members for a Period of One Year Post-Partum
2.7.3.1. I...
REGION SPECIFIC REQUIREMENTS. 2.7.1. Integration
2.7.1.1. In addition to the requirements described in Section 2.4, the Contractor shall:
2.7.1.1.1. Develop an Integrated Health Care Collaborative that will disseminate the knowledge, resources, and skills required to implement best practices in integrated health care.
2.7.2. Members residing in Long-Term Care/Nursing Facilities
2.7.2.1. In addition to the requirements described in Section 2.4.2.4.2.1, the Contractor shall:
2.7.2.1.1. Hold quarterly meetings with the assisted living residences and nursing facilities in the region to address systems issues and concerns.
2.7.2.1.2. Conduct an annual survey of Members in long-term care and nursing facilities and of the nursing facility and assisted living residence staff, focusing on the degree to which clients and facility staff agree clients receive access to and appropriate behavioral health services.
2.7.3. Members involved with the Correctional System
2.7.3.1. In addition to the requirements described in Section 2.4.2.4.2.5, the Contractor shall:
2.7.3.1.1. Monitor access and care coordination for individuals transitioning from criminal justice facilities to the community.
2.7.3.1.1.1. Quarterly reports shall measure the time from initial contact to actual initial appointment, along with routine measures of access, medical records audits assessing care coordination, and examination of trends in grievances.
2.7.3.1.1.2. The Contractor shall submit this report to the Department every quarter within five (5) Business Days after it has been finalized by the Contractor.
2.7.3.1.1.2.1. DELIVERABLE: Quarterly Access and Care Coordination Report. 2.7.3.
1.1.2.2. DUE: Within five (5) Business Days after it has been finalized by the Contractor.
REGION SPECIFIC REQUIREMENTS. 2.7.1. Integration
2.7.1.1. In addition to the requirements described in Section 2.4, the Contractor shall:
2.7.1.1.1. Implement the six (6) strategies (that align with the Vermont Blueprint for Health) to further integration efforts in its region.
2.7.1.1.2. Establish Members with a Patient-Centered Medical Home (PCMH) or the closest available alternative.
2.7.1.1.2.1. For those PCMHs with established integrated behavioral health capacity, the Contractor shall help with referrals for Members with particularly complex behavioral health care needs and/or those in need of specialty services or in-patient substance use disorder treatment.
2.7.1.1.2.2. For PCMHs with less robust integrated programs the Contractor shall: 2.
