Special Health Care Needs definition

Special Health Care Needs means individuals who have high health care needs, multiple chronic conditions, mental illness or Substance Use Disorders and either:

Special Health Care Needs means Member with an increased prevalence of risk of disability, including but not limited to: chronic physical or developmental condition; severe and persistent mental illness; behavioral or emotional condition that accompanies the Member's physical or developmental condition.

Special Health Care Needs means Enrollees who have or are at increased risk for chronic physical, developmental, behavioral, or emotional conditions and who also require health and related services of a type or amount beyond that required by adults and children generally. Enrollment Area or Service Area means the counties enumerated in Article 1.4 of this Contract.

Examples of Special Health Care Needs in a sentence

• The care management strategy and plan for members with significant health and social needs that are at high risk of poor health outcomes, including, but not limited to, adults with complex health needs, Children with Special Health Care Needs, other children with potentially care management service’s needs, individuals receiving home and community-based services or children with high need, HIV/AIDS, mental illness, addiction issues or those recently discharged from correctional facilities.

• These services include but are not limited to the Office of Special Health Care Needs, the Chronic Conditions Workforce Initiative, and the Chronic Disease Self- Management Programs.

• The coordination of care is of the utmost importance for Children with Special Health Care Needs.

• The Contractor will treat Children with Special Health Care Needs as a high-risk population.

• Members with Special Health Care Needs – Individuals, as identified in the MCO's Quality Assurance Performance Improvement (QAPI) program, who have or are at increased risk for chronic, physical, developmental, behavioral, or emotional conditions and who require health and related services of a type or amount beyond that required by individuals generally.

More Definitions of Special Health Care Needs

Special Health Care Needs means individuals who have high health care needs, multiple chronic conditions, mental illness or Substance Use Disorders and either 1) have functional disabilities, 2) live with health or social conditions that place them at risk of developing functional disabilities (for example, serious chronic illnesses, or certain environmental risk factors such as homelessness or Family problems that lead to the need for placement in foster care), or 3) are a Member of the Prioritized Populations listed in the Contract.

Special Health Care Needs means members with special health care needs are those members who have serious and chronic physical, developmental or behavioral conditions, and who also require medically necessary health and related services of a type or amount beyond that required by members generally.

Special Health Care Needs means the consumer has health conditions that are predictable and stable, as determined by the individual health care plan team, and for which the individual requires nursing supports for any of the following types of care:

Special Health Care Needs means Enrollees who have or are at increased risk for chronic physical, developmental, behavioral, or emotional conditions and who also require health and related services of a type or amount beyond that required by adults and children generally. Enrollment Area or Service Area means the counties enumerated in Article 1.4 of this Contract.Excluded Parties List System or EPLS means the electronic version of the Lists of Parties Excluded from Federal Procurement and Non-procurement Programs (List) that identifies those individual and firms excluded from receiving Federal contracts or Federally-approved subcontracts and from certain types of Federal financial and non-financial assistance and benefits. The EPLS website is located at xxxx://xxxx.xxx. Exclusion or Excluded means the temporary or permanent barring of a person or other entity from participation in the Medicare or Medicaid program and that services furnished or ordered by that person are not paid for under either program. External Quality Review or EQR means the analysis and evaluation of information on quality, timeliness, and access to the health care services that a Health Plan, or its Providers, furnished to its Enrollees.

Special Health Care Needs means persons as defined in 10 C.C.R. 2505-10, Section 8.205.9.

Special Health Care Needs means individuals who have high health care needs, multiple chronic conditions, mental illness or substance use disorder either 1) have functional disabilities, or 2) live with health or social conditions that place them at risk of developing functional disabilities (for example, serious chronic illnesses, or certain environmental risk factors such as homelessness or family problems that lead to the need for placement in xxxxxx care.

Special Health Care Needs has the meaning provided for in OAR 410-141-3500.