Common use of Service Coordination Clause in Contracts

Service Coordination. Service Coordinators must assist Participants in obtaining the services that they need. Service Coordinators lead the Person-Centered Service Planning process and oversee the implementation of PCSPs. The CHC-MCO must annually submit and obtain Department approval of its Service Coordination staffing plan including after-hours and emergency staffing, Service Coordinator to Participant communications and contact plans including the required frequency of in-person Service Coordinator contact, Service Coordinator caseloads, and how Service Coordinators share and receive real-time information about Participants and Participant encounters. Service Coordinators identify, coordinate and assist Participants gain access to needed LTSS services and State Plan services, as well as non-Medicaid funded medical, social, housing, educational, and other services and supports. Service Coordination includes the primary functions of providing information to Participants and facilitating access, locating, coordinating and monitoring needed services and supports for LTSS Participants. Service Coordinators are responsible to: inform Participants about available LTSS, required needs assessments, the Participant-centered service planning process, service alternatives, service delivery options including opportunities for Participant- direction, roles, rights including DHS Fair Hearing rights, risks and responsibilities, and to assist with fair hearing requests when needed and requested, and to protect a Participant’s health, welfare and safety on on-going basis. Service Coordinators must also: collect additional necessary information, including, at a minimum, Participant preferences, strengths and goals to inform the development of the PCSP; conduct reevaluation of level of care annually or more frequently as needed in accordance with Department requirements; assist the Participant and his or her PCPT in identifying and choosing willing and qualified Providers; coordinate efforts and prompt the Participant to complete activities necessary to maintain LTSS eligibility; explore coverage of services to address Participant identified needs through other sources, including services provided under the State Plan, Medicare or private insurance and other community resources; and actively coordinate with other individuals and entities essential in the physical and behavioral care delivery for the Participant to provide for seamless coordination between physical, behavioral and support services. CHC-MCOs must develop, submit for DHS approval, and implement a plan to monitor the performance of Service Coordinators. The CHC-MCO must assign to every Participant with a PCSP or care plan a Service Coordinator to implement and coordinate the services called for in the PCSP or care plan. The CHC-MCO provides Service Coordination as an administrative function through staff or contracts with Service Coordination Entities. While Participants who are transitioning into CHC at the Start Date for the CHC zone will have a continuity of care period for their Service Coordinator, Participants who transition between CHC-MCOs after the Start Date will not have a continuity of care period for their Service Coordinator. The CHC-MCO must provide Service Coordination through appropriately qualified Service Coordinators employed by or under contract with the CHC-MCO.

Service Coordination. Service Coordinators must assist Participants who need LTSS in obtaining the services that they need. Service Coordinators lead the Person-Centered Service Planning PCSP process and oversee the implementation of PCSPs. The CHC-MCO must annually submit and obtain Department approval of its Service Coordination staffing plan plan, including a staff-to-Participant ratio that is consistent with the ratio in its proposal, after-hours and emergency staffing, Service Coordinator to Participant communications and contact plans plans, including the required frequency of in-in- person Service Coordinator contact, Service Coordinator caseloads, and how Service Coordinators share and receive real-time information about Participants and Participant encounters. The CHC-MCO must provide each Participant with a choice of at least two Service Coordinators. Service Coordinators must identify, coordinate coordinate, and assist Participants gain in gaining access to needed LTSS services and State Plan servicesother Covered Services, as well as non-Medicaid funded noncovered medical, social, housing, educational, and other services and supports. Service Coordination includes the primary functions of providing information to Participants and facilitating accessaccess to, locating, coordinating coordinating, and monitoring needed services and supports for LTSS Participants. Service Coordinators are also responsible tofor: inform informing Participants about available LTSS, required needs assessments, the Participant-centered service planning PCSP process, service alternatives, service delivery options (including opportunities for Participant- directionParticipant-Direction), roles, rights (including complaint, grievance, and DHS Fair Hearing rights), Participant’s risks and responsibilities, and to assist ; assisting with fair hearing requests when needed and requested, ; and to protect protecting a Participant’s health, welfare welfare, and safety on on-going an ongoing basis. Service Coordinators must also: also collect additional necessary information, including, at a minimum, Participant preferences, strengths strengths, and goals to inform the development of the PCSP; conduct reevaluation of level of care annually or more frequently as needed in accordance with Department requirements; assist the Participant and his or her PCPT in identifying and choosing willing and qualified Providers; coordinate efforts and prompt the Participant to complete activities necessary to maintain LTSS eligibility; explore coverage of services to address Participant Participant-identified needs through other sources, including services provided under the State Plan, Medicare or private insurance and other andother community resources; and actively coordinate with other individuals and entities essential in the physical and behavioral care delivery for the Participant to provide for seamless coordination between physical, behavioral behavioral, and support services. The CHC-MCOs MCO must oversee pre-tenancy and transition services for housing, which prepare and support the Participant’s move to housing in an integrated setting. These services include assistance to obtain and retain housing, activities to xxxxxx independence, and assistance in developing community resources to support successful tenancy and maintain residency in the community. The CHC-MCO must develop, submit for DHS approval, and implement a plan to monitor the performance of Service Coordinators. The CHC-MCO must assign to every Participant with a PCSP or care plan a Service Coordinator to implement and coordinate the services called for in the PCSP or care plan. The CHC-MCO provides provide Service Coordination as an administrative function through appropriately qualified staff or contracts with Service Coordination Entitiesentities. While Participants who are transitioning into CHC at the Start Implementation Date for the CHC zone will have a continuity of care period for their Service Coordinator, Participants who transition between CHC-MCOs after the Start Implementation Date will not have a continuity of care period for their Service CoordinatorCoordinators. The CHC-MCO must provide Service Coordination through appropriately qualified Service Coordinators employed by or under contract cooperate with the CHCDepartment’s Disability Advocacy Program, which provides assistance to Participants in applying for SSI or Social Security Disability benefits by sharing Participant-MCOspecific information and performing coordination activities as requested by the Department, on a case-by- case basis.

Service Coordination. ‌ Service Coordinators must assist Participants who need LTSS in obtaining the services that they need. Service Coordinators lead the Person-Centered Service Planning PCSP process and oversee the implementation of PCSPs. The CHC-MCO must annually submit and obtain Department approval of its Service Coordination staffing plan plan, including a staff-to-Participant ratio that is consistent with the ratio in its proposal, after-hours and emergency staffing, Service Coordinator to Participant communications and contact plans plans, including the required frequency of in-in- person Service Coordinator contact, Service Coordinator caseloads, and how Service Coordinators share and receive real-time information about Participants and Participant encounters. The CHC-MCO must provide each Participant with a choice of at least two Service Coordinators. Service Coordinators must identify, coordinate coordinate, and assist Participants gain in gaining access to needed LTSS services and State Plan servicesother Covered Services, as well as non-Medicaid funded noncovered medical, social, housing, educational, and other services and supports. Service Coordination includes the primary functions of providing information to Participants and facilitating accessaccess to, locating, coordinating coordinating, and monitoring needed services and supports for LTSS Participants. Service Coordinators are also responsible tofor: inform informing Participants about available LTSS, required needs assessments, the Participant-centered service planning PCSP process, service alternatives, service delivery options (including opportunities for Participant- directionParticipant-Direction), roles, rights (including complaint, grievance, and DHS Fair Hearing rights), Participant’s risks and responsibilities, and to assist ; assisting with fair hearing requests when needed and requested, ; and to protect protecting a Participant’s health, welfare welfare, and safety on on-going an ongoing basis. Service Coordinators must also: also collect additional necessary information, including, at a minimum, Participant preferences, strengths strengths, and goals to inform the development of the PCSP; conduct reevaluation of level of care annually or more frequently as needed in accordance with Department requirements; assist the Participant and his or her PCPT in identifying and choosing willing and qualified Providers; coordinate efforts and prompt the Participant to complete activities necessary to maintain LTSS eligibility; explore coverage of services to address Participant Participant-identified needs through other sources, including services provided under the State Plan, Medicare or private insurance and other andother community resources; and actively coordinate with other individuals and entities essential in the physical and behavioral care delivery for the Participant to provide for seamless coordination between physical, behavioral behavioral, and support services. The CHC-MCOs MCO must oversee pre-tenancy and transition services for housing, which prepare and support the Participant’s move to housing in an integrated setting. These services include assistance to obtain and retain housing, activities to xxxxxx independence, and assistance in developing community resources to support successful tenancy and maintain residency in the community. The CHC-MCO must develop, submit for DHS approval, and implement a plan to monitor the performance of Service Coordinators. The CHC-MCO must assign to every Participant with a PCSP or care plan a Service Coordinator to implement and coordinate the services called for in the PCSP or care plan. The CHC-MCO provides provide Service Coordination as an administrative function through appropriately qualified staff or contracts with Service Coordination Entitiesentities. While Participants who are transitioning into CHC at the Start Implementation Date for the CHC zone will have a continuity of care period for their Service Coordinator, Participants who transition between CHC-MCOs after the Start Implementation Date will not have a continuity of care period for their Service CoordinatorCoordinators. The CHC-MCO must provide Service Coordination through appropriately qualified Service Coordinators employed by or under contract cooperate with the CHCDepartment’s Disability Advocacy Program, which provides assistance to Participants in applying for SSI or Social Security Disability benefits by sharing Participant-MCOspecific information and performing coordination activities as requested by the Department, on a case-by- case basis.