SPECIAL HOSPITALS AND SPECIALTY CARE FACILITIES Sample Clauses

SPECIAL HOSPITALS AND SPECIALTY CARE FACILITIES. 7.11.1 HMO must include all medically necessary specialty services through its network specialists, sub-specialists and specialty care facilities (e.
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SPECIAL HOSPITALS AND SPECIALTY CARE FACILITIES. 7.12.1 HMO must include all medically necessary specialty services through its network specialists, subspecialists and specialty care facilities (e.g., children's hospitals, and tertiary care hospitals). 7.12.2 HMO must include requirements for pre-admission and discharge planning in its contracts with network hospitals. Discharge plans for a Member must be provided by the HMO or the hospital to the Member/family, the PCP and specialty care physicians. 7.12.3 The HMO must have appropriate multidisciplinary teams for people with disabilities or chronic or complex medical conditions. These teams must include the PCP and any individuals or providers involved in the day-to-day or ongoing care of the Member. 7.12.4 The HMO must include in its provider network a TDHS-designated perinatal care facility, as established by Section 32.042, Texas Health and Safety Code, once the designated system is finalized and perinatal care facilities have been approved for the service area. See also Article 6.9.1 of this contract.
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SPECIAL HOSPITALS AND SPECIALTY CARE FACILITIES. 71 7.12 BEHAVIORAL HEALTH - LOCAL MENTAL HEALTH AUTHORITY (LMHA)....................71 7.13 SIGNIFICANT TRADITIONAL PROVIDERS (STPs) ...................................73 7.14 RURAL HEALTH PROVIDERS .....................................................73 7.15 FEDERALLY QUALIFIED HEALTH CENTERS (FQHC) AND RURAL HEALTH CLINICS (RHC) ..............................................................74 7.16 COORDINATION WITH PUBLIC HEALTH ............................................75 7.17 COORDINATION WITH TEXAS DEPARTMENT OF PROTECTIVE AND REGULATORY SERVICES ...................................................................79 1999 Renewal Contract Bexar Service Area August 9, 1999
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SPECIAL HOSPITALS AND SPECIALTY CARE FACILITIES. BEHAVIORAL HEALTH - LOCAL MENTAL HEALTH AUTHORITY (LMHA)...............................................67 7.14 SIGNIFICANT TRADITIONAL PROVIDERS (STPS).............69
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SPECIAL HOSPITALS AND SPECIALTY CARE FACILITIES. 61 7.12 SIGNIFICANT TRADITIONAL PROVIDERS (STPs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 7.13 RURAL HEALTH PROVIDERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
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SPECIAL HOSPITALS AND SPECIALTY CARE FACILITIES. 7.11.1 HMO must include all medically necessary specialty services through its network specialists, subspecialists and specialty care facilities (e.g., children's hospitals, and tertiary care hospitals). 7.11.2 HMO must include requirements for pre-admission and discharge planning in its contracts with network hospitals. Discharge plans for a Member must be provided by HMO or the hospital to the Member/family, the PCP and specialty care physicians. 7.11.3 HMO must have appropriate multidisciplinary teams for people with disabilities or chronic or complex medical conditions. These teams must include the PCP and any individuals or providers involved in the day-to-day or ongoing care of the Member. 7.11.4 HMO must include in its provider network a TDH-designated perinatal care facility, as established by Section 32.042, Texas Health and Safety Code, once the designated system is finalized and perinatal care facilities have been approved for the service area. Also see Article 6.9.1 of this contract. Dallas Service Area Contract 67 7.12 SIGNIFICANT TRADITIONAL PROVIDERS (STPS) 7.12.1 HMO must include significant traditional providers as designated by TDH in its provider network to provide primary care and specialty care services. HMO must include STPs in its provider network for at least three (3) years following the Implementation Date in the service area. 7.12.2 STPs must agree to the contract requirements contained in Article 7.2, unless exempted from a requirement by law or rule. STPs must also agree to the following contract requirements: 7.12.2.1 STP must agree to accept the standard reimbursement rate offered by HMO to other providers for the same or similar services. 7.12.2.2 STP must meet the credentialing requirements of HMO. HMO must not require STPs to meet a different or higher credentialing standard than is required of other providers providing the same or similar services. HMO may not require STPs to contract with a subcontractor which requires a different or higher credentialing standard than HMO, if the application of the higher standard results in a disproportionate number of STPs being excluded from the subcontractor, if the STP would not be excluded using the credentialing standards of HMO. 7.12.2.3 HMO must demonstrate a good faith effort to include STPs in its provider network. HMO's compliance with the TDH's good faith effort requirement for STPs must be reported using report requirements defined by TDH. HMO must submit quarterly reports,...
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SPECIAL HOSPITALS AND SPECIALTY CARE FACILITIES. Section 7.12, Special Hospitals And Specialty Care Facilities, is being replaced with Section 7.12 Behavioral health- Local Mental Health Authority (LMHA,) to be consistent with the STAR contract.
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SPECIAL HOSPITALS AND SPECIALTY CARE FACILITIES. 7.11.1 HMO must include all medically necessary specialty services through its network specialists, subspecialists and specialty care facilities (e.g., children's hospitals, and tertiary care hospitals). 7.11.2 HMO must include requirements for pre-admission and discharge planning in its contracts with network hospitals. Discharge plans for a Member must be provided by HMO or the hospital to the Member/family, the PCP and specialty care physicians. 7.11.3 HMO must have appropriate multidisciplinary teams for people with disabilities or chronic or complex medical conditions. These teams must include the PCP and any individuals or providers involved in the day-to-day or on-going care of the Member. 7.11.4 HMO must include in its provider network a TDH-designated perinatal care facility, as established by Section 32.042, Texas Health and Safety Code, once the designated system is finalized and perinatal care facilities have been approved for the service area (see Article 6.9.1). 1999 Renewal Contract Tarrant Service Area 78 August 9, 1999 79 7.12 BEHAVIORAL HEALTH - LOCAL MENTAL HEALTH AUTHORITY (LMHA) 7.12.1 Assessment to determine eligibility for rehabilitative and targeted MHMR case management services is a function of the LMHA. HMO must provide all covered services described in detail in the Texas Medicaid Provider Procedures Manual (Provider Procedures Manual) and the Texas Medicaid Bulletins which is the bi-monthly update to the Provider Procedures Manual. Clinical information regarding covered services are published by the Texas Medicaid program in the Texas Medicaid Service Delivery Guide. Covered services must be provided to Members with SPMI and SED, when medically necessary, whether or not they are also receiving targeted case management or rehabilitation services through the LMHA. 7.12.2 HMO will coordinate with the LMHA and state psychiatric facility regarding admission and discharge planning, treatment objectives and projected length of stay for Members committed by a court of law to the state psychiatric facility. 7.12.3 HMO must enter into written agreements with all LMHAs in the service area which describes the process(es) which HMO and LMHA will use to coordinate services for STAR Members with SPMI or SED. The agreement will contain the following provisions: 7.12.3.1 Describe the behavioral health covered services indicated in detail in the Provider Procedures Manual and the Texas Medicaid Bulletins which is the bi-monthly update to the Prov...
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SPECIAL HOSPITALS AND SPECIALTY CARE FACILITIES. 68 7.12 SIGNIFICANT TRADITIONAL PROVIDERS (STPs) .............................68 7.13 RURAL HEALTH PROVIDERS ...............................................69
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Related to SPECIAL HOSPITALS AND SPECIALTY CARE FACILITIES

  • Access to Properties Subject to the rights of Tenants, Borrower shall permit agents, representatives and employees of Lender to inspect the Properties or any part thereof at reasonable hours upon reasonable advance notice.

  • Office Facilities During the period of employment, Executive shall have his office where the Corporation’s principal executive offices are located from time to time, which currently are at 3000 Xxxx Xxxxxxxxxx Xxxxxx, Xxxxx Xxxxx, Xxxxx Xxxxxx, and the Corporation shall furnish Executive with office facilities reasonably suitable to his position at such location.

  • Standard Tenant Services Landlord shall provide the following services on all days (unless otherwise stated below) during the Lease Term. 6.1.1 Subject to limitations imposed by all governmental rules, regulations and guidelines applicable thereto, Landlord shall provide heating and air conditioning ("HVAC") when necessary for normal comfort for normal office use in the Premises from 7:00 A.M. to 6:00 P.M. Monday through Friday, and on Saturdays from 9:00 A.M. to 1:00 P.M. (collectively, the "Building Hours"), except for the date of observation of New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Christmas Day and, at Landlord's discretion, other locally or nationally recognized holidays (collectively, the "Holidays"); provided, however, Landlord acknowledges that, pursuant to Tenant's requirements, in no event shall Holidays include Xxxxxx Xxxxxx Xxxx Day, Columbus Day or Veterans Day. The daily time periods identified hereinabove are sometimes referred to as the "Business Hours." 6.1.2 Landlord shall provide adequate electrical wiring and facilities and power for normal general office use as more specifically set forth on Schedule 3 to Exhibit B, attached hereto. Tenant shall pay directly to the utility company pursuant to the utility company's separate meters, the cost of all electricity provided to and/or consumed in the Premises (including normal and excess consumption and including the cost of electricity to operate the HVAC air handlers), which electricity shall be separately metered (as described above). Landlord may designate the electricity utility provider from time to time. 6.1.3 As part of Operating Expenses, Landlord shall replace lamps, starters and ballasts for Building standard lighting fixtures within the Premises. In addition, Tenant shall bear the cost of replacement of lamps, starters and ballasts for non-Building standard lighting fixtures within the Premises. 6.1.4 Landlord shall provide city water from the regular Building outlets for drinking, lavatory and toilet purposes, and for the Building's life safety systems. 6.1.5 Landlord shall provide janitorial services to the Premises five (5) days per week, except the date of observation of the Holidays, in and about the Premises and window washing services in a manner consistent with Comparable Buildings in the vicinity of the Project. 6.1.6 Landlord shall provide nonexclusive, non-attended automatic passenger elevator service during the Building Hours, shall have one elevator available at all other times, except on the Holidays. Tenant shall cooperate fully with Landlord at all times and abide by all regulations and requirements that Landlord may reasonably prescribe for the proper functioning and protection of the HVAC, electrical, mechanical and plumbing systems.

  • Property Management Agreement The Property Management Agreement is in full force and effect and, to Borrower's Knowledge, there are no defaults thereunder by any party thereto and no event has occurred that, with the passage of time and/or the giving of notice would constitute a default thereunder.

  • PROFESSIONAL DEVELOPMENT AND EDUCATIONAL IMPROVEMENT A. The Board of Education agrees to pay the actual tuition costs of courses taken by a teacher at accredited colleges or universities up to three courses per two (2) year fiscal periods from July 1, 2006 to June 30, 2008 and July 1, 2008 to June 30, 2010 respectively, except as follows: 1. No teacher may be reimbursed for courses taken during the first year of teaching in Vineland. 2. Teachers taking courses in the second and third years of employment in Vineland will not receive remuneration until tenure has been secured. The remuneration will then be retroactive and will be paid to the teacher in a lump sum within sixty (60) days after the teacher has secured tenure. 3. All courses must be pre-approved by the Superintendent or his designee subject to the following requirements: (a) A teacher must provide official documentation that he/she has obtained a grade of B or better; (b) Reimbursement shall be paid only for courses directly related to teacher’s teaching field which increase the teacher’s content knowledge and are related to the teacher’s current certification, as determined by the Superintendent or his/her designee in his/her sole discretion; no reimbursement shall be paid for courses leading to a post graduate or professional degree in a field other than education or teaching. Further, effective September 1, 2010, all newly hired teachers shall not be eligible for reimbursement until they are tenured, and they shall not be eligible for retroactive reimbursement upon gaining tenure for courses taken prior to being tenured. (c) The maximum total payments to be made by the Board shall not exceed $130,000.00. Courses shall be applied for no earlier than the following dates: Summer Session - April 1 Fall/Winter Session - June 1 Spring Session - October 1 Courses must, as set forth hereinabove in this sub-article 18.A.3, be pre-approved by the Superintendent or his designee, prior to the teacher commencing the course(s); and (d) Teacher taking courses shall sign a contract requiring them to reimburse the Board for all tuition paid for a course if the teacher shall voluntarily leave the employ of the Board within one (1) full school/academic year of completion of said course, except that reimbursement shall not be required when the teacher shall voluntarily leave the employ of the Board due to a significant, documented life change. 4. Tuition reimbursement costs shall be a sum not to exceed the actual cost of college credits charged in an accredited public State college/University of the State of New Jersey. B. When the Superintendent initiates in-service training courses, workshops, conferences and programs designed to improve the quality of instruction, the cooperation of the Vineland Education Association will be solicited. Notwithstanding the above, the initiation of in-service training courses, workshops, conferences and programs shall be determined solely at the discretion of the Board. C. One professional leave day may be granted to a teacher upon request, according to the following guidelines: 1. The professional day may be for attendance at a workshop, seminar or visit to another school for the expressed purpose of self professional improvement for the job. 2. The request shall arrive in the office of the Superintendent of Schools at least ten (10) working days prior to the date requested and shall be reviewed by the immediate supervisor prior to submission. The Board reserves the right to deny a professional leave day before or immediately following a holiday or on a day which by its nature suggests a hardship for providing a substitute. 3. No more than two teachers from any one elementary school or from any one department in the secondary schools may be granted a professional leave for a given day. 4. The teacher may be required to submit a report to the Superintendent of Schools, Assistant Superintendent, supervisor (s), principal and staff regarding the activity of the professional day. 5. Costs incurred by the teacher for the professional day authorized under this Section shall be the teacher’s responsibility. 6. A maximum of 90 professional leave days may be authorized for the school year which shall be apportioned as follows: elementary, 35; grades seven and eight, 20; and high school, 35. D. If the Board initiates a teacher’s attendance at a professional workshop, seminar or visit, the expenses shall be the responsibility of the Board. Further, this day shall not be subtracted from the 90 professional leave days granted to teachers of the Association. E. The Board agrees to pay the full cost of courses taken by secretaries related to skills and knowledge improvement when such courses are required and approved by the Board. F. The Board and the Association agree that it is important to communicate when developing and implementing current and future learning technologies, including but not limited to distance and on-line learning.

  • Rent Rolls; Operating Histories The Seller has obtained a rent roll (the “Certified Rent Roll(s)”) other than with respect to hospitality properties certified by the related Mortgagor or the related guarantor(s) as accurate and complete in all material respects as of a date within 180 days of the date of origination of the related Mortgage Loan. The Seller has obtained operating histories (the “Certified Operating Histories”) with respect to each Mortgaged Property certified by the related Mortgagor or the related guarantor(s) as accurate and complete in all material respects as of a date within 180 days of the date of origination of the related Mortgage Loan. The Certified Operating Histories collectively report on operations for a period equal to (a) at least a continuous three-year period or (b) in the event the Mortgaged Property was owned, operated or constructed by the Mortgagor or an affiliate for less than three years then for such shorter period of time, it being understood that for mortgaged properties acquired with the proceeds of a Mortgage Loan, Certified Operating Histories may not have been available.

  • Access to Project Site Redeveloper shall permit the representatives of the City to enter Project Site at any and all reasonable times, as the City may deem necessary for the purposes of this Redevelopment Agreement, including but not limited to work and inspection of all work being performed in connection with the construction of the Redeveloper Improvements. Similarly, the City shall permit Redeveloper such entry upon the public rights of way for such purposes. No compensation shall be payable nor shall any charges be made in any form by any party for the access or inspection provided for in this Section. The City’s right of access granted under this Section shall terminate upon issuance by the City of the Redeveloper’s Certificate of Completion of Redeveloper Improvements. Notwithstanding the above, Redeveloper shall not be relieved of the provisions contained in Chapter 14.29 of the Lincoln Municipal Code regarding the use of streets for private construction purposes.

  • Project 3.01. The Recipient declares its commitment to the objectives of the Project. To this end, the Recipient shall carry out the Project in accordance with the provisions of Article IV of the General Conditions.

  • ARTISTES AND SPORTSMEN 1. Notwithstanding the provisions of Articles 14 and 15, income derived by a resident of a Contracting State as an entertainer, such as a theatre, motion picture, radio or television artiste, or a musician, or as a sportsman, from his personal activities as such exercised in the other Contracting State, may be taxed in that other State. 2. Where income in respect of personal activities exercised by an entertainer or a sportsman in his capacity as such accrues not to the entertainer or sportsman himself but to another person, that income may, notwithstanding the provisions of Articles 7, 14 and 15, be taxed in the Contracting State in which the activities of the entertainer or sportsman are exercised.

  • 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. 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. 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.

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