Transitional Care. CAS agrees to accept the Pet and provide a suitable and comfortable environment at the CAS shelter facility in its sole discretion. For the duration that the Pet is housed in a CAS shelter facility, CAS will provide the Pet with basic routine veterinary care as it deems appropriate in its sole discretion, (including but not limited to: tests, exams, vaccinations, microchipping, spay/neuter surgery, heartworm and flea protection), through CAS shelter clinics. Any Pet with a special health and/or dietary need as determined by the CAS in its sole discretion will receive a medical workup to determine the best care plan for the Pet.
Transitional Care i. The Parties must establish policies and procedures and develop a process describing how MCP and MHP and DMC-ODS will coordinate transitional care services for Members. A “transitional care service” is defined as the transfer of a Member from one setting or level of care to another, including, but not limited to, discharges from hospitals, institutions, and other acute care facilities and skilled nursing facilities to home or community-based settings,2 or transitions from outpatient therapy to intensive outpatient therapy.
ii. For Members who are admitted to an acute psychiatric hospital, psychiatric health facility, adult residential, crisis residential stay or residential SUD treatment, including, but not limited to, Short-Term Residential Therapeutic Programs and Psychiatric Residential Treatment Facilities, where MHP or DMC-ODS is the primary payer, MHPs and DMC-ODS are primarily responsible for coordination of the Member upon discharge. In collaboration with MHP and DMC-ODS, MCP is responsible for ensuring transitional care coordination as required by Population Health Management,3 including, but not limited to:
1. Tracking when Members are admitted, discharged, or transferred from facilities contracted by MHP (e.g., psychiatric inpatient hospitals, psychiatric health facilities, residential mental health facilities) in accordance with Section 11(a)(iii) of this MOU.
2. Approving prior authorizations and coordinating services where MCP is the primary payer (e.g., home services, long-term services and supports for dual-eligible Members);
3. Ensuring the completion of a discharge risk assessment and developing a discharge planning document;
4. Assessing Members for any additional care management programs or services for which they may qualify, such as ECM, CCM, or Community Supports and enrolling the Member in the program as appropriate;
5. Notifying existing CCM Care Managers of any admission if the Member is already enrolled in ECM or CCM; and
6. Assigning or contracting with a care manager to coordinate 2 Expectations for transitional care are defined in the PHM Policy Program Guide: 3 Expectations for transitional care are defined in the PHM Policy Program Guide: xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/2023-PHM-Program-Guide-a11y.pdf; see also PHM Roadmap and Strategy: xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/Final-Population-Health- Management-Strategy-and-Roadmap.pdf with behavioral health or county care coordinators for each eligible Member to...
Transitional Care. 1. The Parties must establish policies and procedures and develop a process describing how MCP and MHP will coordinate transitional care services for Members. A “transitional care service” is defined as the transfer of a Member from one setting or level of care to another, including, but not limited to, discharges from hospitals, institutions, and other acute care facilities and skilled nursing facilities to home or community-based settings,2 or transitions from outpatient therapy to intensive outpatient therapy. For Members who are admitted to an acute psychiatric hospital, psychiatric health facility, adult residential, or crisis residential stay, including, but not limited to, Short- Term Residential Therapeutic Programs and Psychiatric Residential Treatment Facilities, where MHP is the primary payer, MHPs are primarily responsible for coordination of the Member upon discharge. In collaboration with MHP, MCP is responsible for ensuring transitional care coordination as required by Population Health Management,3 including, but not limited to:
a. Tracking when Members are admitted, discharged, or transferred from facilities contracted by MHP (e.g., psychiatric inpatient hospitals, psychiatric health facilities, residential mental health facilities) in accordance with Section 11(a)(iii) of this MOU.
b. Approving prior authorizations and coordinating services where MCP is the primary payer (e.g., home services, long-term services and supports for dual-eligible Members);
c. Ensuring the completion of a discharge risk assessment and developing a discharge planning document;
d. Assessing Members for any additional care management programs or services for which they may qualify, such as ECM, CCM, or Community Supports and enrolling the Member in the program as appropriate;
e. Notifying existing CCM Care Managers of any admission if the Member is already enrolled in ECM or CCM; and
f. Assigning or contracting with a care manager to coordinate with behavioral health or county care coordinators for each eligible Member to ensure physical health follow up needs are met as outlined by the Population Health Management Policy Guide.
2. The Parties must include a process for updating and overseeing the implementation of the discharge planning documents as required for Members transitioning to or from MCP or MHP services. 2 Expectations for transitional care are defined in the PHM Policy Program Guide: xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/2023-PHM-Program-Guide-a11y...
Transitional Care. Ownership and operation of ----------------- transitional care facilities which provide medically complex treatment to patients with long-term acute and subacute illnesses;
Transitional Care. 1. The Parties must establish policies and procedures and develop a process describing how MCP and MHP will coordinate transitional care services for Members. A “transitional care service” is defined as the transfer of a Member from one setting or level of care to another, including, but not limited to, discharges from hospitals, institutions, and other acute care facilities and skilled nursing facilities to home or community-based settings,2 or transitions from outpatient therapy to intensive outpatient therapy. For Members who are admitted to an acute psychiatric hospital, psychiatric health facility, adult residential, or crisis residential stay, including, but not limited to, Short-Term Residential Therapeutic Programs and Psychiatric Residential Treatment Facilities, where MHP is the primary payer, MHPs are primarily responsible for coordination of the Member upon discharge. In collaboration with MHP, MCP is responsible for ensuring transitional care coordination as required by Population Health Management,3 including, but not limited to:
a. Tracking when Members are admitted, discharged, or transferred from facilities contracted by MHP (e.g., psychiatric inpatient hospitals, psychiatric health facilities, residential mental health facilities) in accordance with Section 11(a)(iii) of this MOU.
b. Approving prior authorizations and coordinating services where MCP is the primary payer (e.g., home services, long-term services and supports for dual-eligible Members);
c. Ensuring the completion of a discharge risk assessment and developing a discharge planning document; Docusign Envelope ID: F0807EFB-43F7-4245-B7BE-BF3615C8374B 2 Expectations for transitional care are defined in the PHM Policy Program Guide: xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/PHM-Policy-Guide.pdf 3 Expectations for transitional care are defined in the PHM Policy Program Guide: see also PHM Roadmap and Strategy: xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/Final- Population-Health-Management-Strategy-and-Roadmap.pdf Docusign Envelope ID: F0807EFB-43F7-4245-B7BE-BF3615C8374B
d. Assessing Members for any additional care management programs or services for which they may qualify, such as ECM, CCM, or Community Supports and enrolling the Member in the program as appropriate;
e. Notifying existing CCM Care Managers of any admission if the Member is already enrolled in ECM or CCM; and
f. Assigning or contracting with a care manager to coordinate with behavioral health or county care coordinator...
Transitional Care. (a) “Transitional care” is specialized care provided for up to 90 days or through the postpartum period, whichever is later, to an enrollee who is undergoing treatment for a chronic or disabling condition or who is in the second or third trimester of pregnancy when the Contractor terminates the provider contract for reasons other than cause. The 90-day period begins the earlier of the date the enrollee receives the notice required under Section 1.022.25, or the date the Contractor’s or the provider’s contract ends.
(b) The Contractor must ensure the following: If it terminates a specialty provider contract or a PPO or POS network contract other than for cause, it allows enrollees who are undergoing treatment for a chronic or disabling condition or who are in the second or third trimester of pregnancy to continue treatment under the specialty provider for up to 90 days, or through their postpartum period, whichever is later, under the same terms and conditions that existed at the beginning of the transitional care period; and
(c) In addition, the Contractor must:
(1) Pay for or provide the transitional care required under this clause at no additional cost to enrollees;
(2) Require the specialty provider or network to promptly transfer all medical records to the designated new provider during or upon completion of the transition period, as authorized by the patient; and,
(3) Require the specialty provider or network to give all necessary information to the Contractor for quality assurance purposes.
Transitional Care. 1. The Parties must establish policies and procedures and develop a process describing how MCP and DMC State Plan County will coordinate transitional care services for Members. A “transitional care service” is defined as the transfer of a Member from one setting or level of care to another, including, but not limited to, discharges from hospitals, institutions, and other acute care facilities and skilled nursing facilities to home- or community-based settings,1 level of care transitions that occur within the facility, or transitions from outpatient therapy to intensive outpatient therapy and vice versa.
2. Members who are admitted for residential SUD treatment, including Perinatal Residential Substance Use Disorder Treatment and residential SUD treatment provided to Members under the age of 21 pursuant to the EPSDT benefit mandate where DMC State Plan County is the primary payer, DMC State Plan County is primarily responsible for coordination of the Member upon discharge. In collaboration with DMC State Plan County, MCP is responsible for ensuring transitional care coordination as required by Population Health Management,2 including, but not limited to:
a. Tracking when Members are admitted, discharged, or transferred from facilities contracted by DMC State Plan County in accordance with Section 11(a)(iii) of this MOU;
b. Approving prior authorizations and coordinating services where MCP is the primary payer (e.g., home services, long-term services, and supports for dual-eligible Members);
c. Ensuring the completion of a discharge risk assessment and developing a discharge planning document;
d. Assessing Members for any additional care management programs or services for which they may qualify, such as ECM, CCM, or Community Supports, and enrolling the Member in the program as appropriate;
e. Notifying existing CCM Care Managers of any admission if the Member is already enrolled in ECM or CCM; and
f. Assigning or contracting with a care manager to coordinate with county care coordinators to ensure physical health follow-up needs are met for each eligible Member as outlined by the Population Health Management Policy Guide.3 1 Expectations for transitional care are defined in the Population Health Management Policy Program Guide: xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/PHM-Policy-Guide.pdf 2 The Population Health Management Policy Program Guide can be found here: xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/PHM-Policy-Guide.pdf; see also PHM Roadmap and Strate...
Transitional Care. 1. The Parties must establish policies and procedures and develop a process describing how MCP and DMC-ODS will coordinate transitional care services for Members. A “transitional care service” is defined as the transfer of a Member from one setting or level of care to another, including, but not limited to, discharges from hospitals, institutions, and other acute care facilities and skilled nursing facilities to home- or community-based settings,2 level of care transitions that occur within the facility, or transitions from outpatient therapy to intensive outpatient therapy and vice versa.
2. For Members who are admitted for residential SUD treatment, including, but not limited to, Short-Term Residential Therapeutic Programs and Psychiatric Residential Treatment Facilities where DMC-ODS is the primary payer, DMC-ODS is primarily responsible for coordination of the Member upon discharge. In collaboration with DMC-ODS, MCP is responsible for ensuring transitional care coordination as required by Population Health Management,3 including, but not limited to:
a. Tracking when Members are admitted, discharged, or transferred from facilities contracted by DMC-ODS in accordance with Section 11(a)(iii) of this MOU;
b. Approving prior authorizations and coordinating services where MCP is the primary payer (e.g., home services, long-term services, and supports for dual-eligible Members);
c. Ensuring the completion of a discharge risk assessment and developing a discharge planning document;
d. Assessing Members for any additional care management programs or services for which they may qualify, such as ECM, CCM, or Community Supports, and enrolling the Member in the program as appropriate;
Transitional Care. 1. The Parties must establish policies and procedures and develop a process describing how MCP and DMC-ODS will coordinate transitional care services for Members. A “transitional care service” is defined as the transfer of a Member from one setting or level of care to another, including, but not limited to, discharges from hospitals, institutions, and other acute care facilities and skilled nursing facilities to home- or community-based settings,2 level of care transitions that occur within the facility, or transitions from outpatient therapy to intensive outpatient therapy and vice versa.
2. For Members who are admitted for residential SUD treatment, including, but not limited to, Short-Term Residential Therapeutic Programs and Psychiatric Residential Treatment Facilities where DMC-ODS is the primary payer, DMC-ODS is primarily responsible for coordination of the Member upon discharge. In collaboration with DMC-ODS, MCP is responsible for ensuring transitional care coordination as required by Population Health Management,3 including, but not limited to:
a. Tracking when Members are admitted, discharged, or transferred from facilities contracted by DMC-ODS in accordance with Section 11(a)(iii) of this MOU; 2 Expectations for transitional care are defined in the PHM Policy Program Guide: 3 xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/PHM-Policy-Guide.pdf 3 Expectations for transitional care are defined in the PHM Policy Program Guide: xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/PHM-Policy-Guide.pdf see also PHM Roadmap and Strategy: xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/Final-Population-Health-Management-Strategy-and- Roadmap.pdf Docusign Envelope ID: F0807EFB-43F7-4245-B7BE-BF3615C8374B
b. Approving prior authorizations and coordinating services where MCP is the primary payer (e.g., home services, long-term services, and supports for dual-eligible Members);
c. Ensuring the completion of a discharge risk assessment and developing a discharge planning document;
d. Assessing Members for any additional care management programs or services for which they may qualify, such as ECM, CCM, or Community Supports, and enrolling the Member in the program as appropriate;
e. Notifying existing CCM Care Managers of any admission if the Member is already enrolled in ECM or CCM; and
f. Assigning or contracting with a care manager to coordinate with county care coordinators to ensure physical health follow-up needs are met for each eligible Member as outlined by the Population H...
Transitional Care. 1. The Parties must establish policies and procedures and develop a process describing how MCP and MHP/DMC-ODS will coordinate transitional care services for Members. A “transitional care service” is defined as the transfer of a Member from one setting or level of care to another, including, but not limited to, discharges from hospitals, institutions, and other acute care facilities and skilled nursing facilities to home or community- based settings;1 for DMC-ODS, level of care transitions that occur within the facility; or transitions from outpatient therapy to intensive outpatient therapy and vice versa.
2. For MHP Members who are admitted to an acute psychiatric hospital, psychiatric health facility, adult residential, or crisis residential stay, or DMC-ODS Members who are admitted for residential SUD treatment, including, but not limited to, Short- Term Residential Therapeutic Programs and Psychiatric Residential Treatment Facilities, where MHP/DMC-ODS is the primary payer, MHP/DMC-ODS are primarily responsible for coordination of the Member upon discharge. In collaboration with MHP/DMC-ODS, MCP is responsible for ensuring transitional care coordination as required by Population Health Management,2 including, but not limited to:
a. Tracking when Members are admitted, discharged, or transferred from facilities contracted by MHP/DMC-ODS (e.g., psychiatric inpatient hospitals, psychiatric health facilities, residential mental health facilities) in accordance with Section 11(a)(iii) of this MOU;
b. Approving prior authorizations and coordinating services where MCP is the primary payer (e.g., home services, long-term services and supports for dual-eligible Members);
c. Ensuring the completion of a discharge risk assessment and developing a discharge planning document;
d. Assessing Members for any additional care management programs or services for which they may qualify, such as ECM, CCM, or Community Supports and enrolling the Member in the program as appropriate;
e. Notifying existing CCM Care Managers of any admission if the Member is already enrolled in ECM or CCM; and
f. Assigning or contracting with a care manager to coordinate with behavioral health or county care coordinators for each eligible Member to ensure physical health follow up needs are met as outlined by the Population Health 1 Expectations for transitional care are defined in the PHM Policy Program Guide: xxxxx://xxx.xxxx.xx.xxx/CalAIM/Documents/2023-PHM-Program-Guide-a11y.pdf 2 Expectati...
