Common use of Care Coordination Clause in Contracts

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the requirements set forth in this MOU. ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. MCP must have policies and procedures in place to maintain cross- system collaboration with DMC-ODS and to identify strategies to monitor and assess the effectiveness of this MOU. iv. The Parties must implement policies and procedures that align for coordinating Members’ care that address: 1. The requirement for DMC-ODS to refer Members to MCP to be assessed for care coordination and other similar programs and other services for which they may qualify provided by MCP including, but not limited to, ECM, CCM, or Community Supports; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/CalAIM/Documents/2023‐PHM‐Policy‐Guide.pdf. 2. The specific point of contact from each Party, if someone other than each Party’s Responsible Person, to act as the liaison between Parties and be responsible for initiating, providing, and maintaining ongoing care coordination for all Members under this MOU; 3. A process for how MCP and DMC-ODS will engage in collaborative treatment planning to ensure care is clinically appropriate and non- duplicative and considers the Member’s established therapeutic relationships; 4. A process for coordinating the delivery of Medically Necessary Covered Services with the Member’s Primary Care Provider, including without limitation transportation services, home health services, and other Medically Necessary Covered Services for eligible Members; 5. A process for how MCP and DMC-ODS will help to ensure the Member is engaged and participates in their care program and a process for ensuring the Members, caregivers, and providers are engaged in the development of the Member’s care; 6. A process for reviewing and updating a Member’s problem list, as clinically indicated. The process must describe circumstances for updating problem lists and coordinating with outpatient SUD providers; 7. A process for how the Parties will engage in collaborative treatment planning and ensure communication among providers, including procedures for exchanges of medical information; and 8. Processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the requirements set forth in this MOU. ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. MCP must have policies and procedures in place to maintain cross- system collaboration with DMC-ODS and to identify strategies to monitor and assess the effectiveness of this MOU. iv. The Parties must implement policies and procedures that align for coordinating Members’ care that address: 1. The requirement for DMC-ODS to refer Members to MCP to be assessed for care coordination and other similar programs and other services for which they may qualify provided by MCP including, but not limited to, ECM, CCM, or Community Supports; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/CalAIM/Documents/2023‐PHM‐Policy‐Guide.pdf.; 2. The specific point of contact from each Party, if someone other than each Party’s Responsible Person, to act as the liaison between Parties and be responsible for initiating, providing, and maintaining ongoing care coordination for all Members under this MOU;; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/CalAIM/Documents/2023‐PHM‐Policy‐Guide.pdf. DocuSign Envelope ID: 06E8AB6B-BDBE-4700-B94F-1CF4AC89D0CC 3. A process for how MCP and DMC-ODS will engage in collaborative treatment planning to ensure care is clinically appropriate and non- duplicative and considers the Member’s established therapeutic relationships; 4. A process for coordinating the delivery of Medically Necessary Covered Services with the Member’s Primary Care Provider, including without limitation transportation services, home health services, and other Medically Necessary Covered Services for eligible Members; 5. A process for how MCP and DMC-ODS will help to ensure the Member is engaged and participates in their care program and a process for ensuring the Members, caregivers, and providers are engaged in the development of the Member’s care; 6. A process for reviewing and updating a Member’s problem list, as clinically indicated. The process must describe circumstances for updating problem lists and coordinating with outpatient SUD providers; 7. A process for how the Parties will engage in collaborative treatment planning and ensure communication among providers, including procedures for exchanges of medical information; and 8. Processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the requirements set forth in this MOU. ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. MCP must have policies and procedures in place to maintain cross- system collaboration with DMC-ODS and to identify strategies to monitor and assess the effectiveness of this MOU. iv. The Parties must implement policies and procedures that align for coordinating Members’ care that address: 1. The requirement for DMC-ODS to refer Members to MCP to be assessed for care coordination and other similar programs and other services for which they may qualify provided by MCP including, but not limited to, ECM, CCM, or Community Supports; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/CalAIM/Documents/2023‐PHM‐Policy‐Guide.pdf.; 2. The specific point of contact from each Party, if someone other than each Party’s Responsible Person, to act as the liaison between Parties and be responsible for initiating, providing, and maintaining ongoing care coordination for all Members under this MOU;; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/CalAIM/Documents/2023‐PHM‐Policy‐Guide.pdf. 3. A process for how MCP and DMC-ODS will engage in collaborative treatment planning to ensure care is clinically appropriate and non- duplicative and considers the Member’s established therapeutic relationships; 4. A process for coordinating the delivery of Medically Necessary Covered Services with the Member’s Primary Care Provider, including without limitation transportation services, home health services, and other Medically Necessary Covered Services for eligible Members; 5. A process for how MCP and DMC-ODS will help to ensure the Member is engaged and participates in their care program and a process for ensuring the Members, caregivers, and providers are engaged in the development of the Member’s care; 6. A process for reviewing and updating a Member’s problem list, as clinically indicated. The process must describe circumstances for updating problem lists and coordinating with outpatient SUD providers; 7. A process for how the Parties will engage in collaborative treatment planning and ensure communication among providers, including procedures for exchanges of medical information; and 8. Processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access In addition to care and services that incorporate all the requirements set forth outlined in this Section 8 of the MOU. ii. The Parties must discuss and address individual , the following care coordination issues or barriers to care coordination efforts at least quarterly.requirements apply: iii. MCP must have policies and procedures in place to maintain cross- system collaboration with DMC-ODS and to identify strategies to monitor and assess the effectiveness of this MOU. iv. i. The Parties must implement policies and procedures that align for coordinating Members’ care that address: 1. The requirement for DMC-ODS to refer Members to MCP to be assessed for care coordination and other similar programs and other services for which they may qualify provided by MCP including, but not limited to, ECM, CCM, or Community Supports; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/CalAIM/Documents/2023‐PHM‐Policy‐Guide.pdf.; 2. The specific point of contact from each Party, if someone other than each Party’s Responsible Person, to act as the liaison between Parties and be responsible for initiating, providing, and maintaining ongoing care coordination for all Members under this MOUExhibit E; 3. A process for how MCP and DMC-ODS will engage in collaborative treatment planning to ensure care is clinically appropriate and non- duplicative and considers the Member’s established therapeutic relationships; 4. A process for coordinating the delivery of Medically Necessary Covered Services with the Member’s Primary Care Provider, including without limitation transportation services, home health services, and other Medically Necessary Covered Services for eligible Members; 5. A process for how MCP and DMC-ODS will help to ensure the Member is engaged and participates in their care program and a process for ensuring the Members, caregivers, and providers are engaged in the development of the Member’s care; 6. A process for reviewing and updating a Member’s problem list, as clinically indicated. The process must describe circumstances for updating problem lists and coordinating with outpatient SUD providers; 7. A process for how the Parties will engage in collaborative treatment planning and ensure communication among providers, including procedures for exchanges of medical information; and 8. Processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU Exhibit E outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the requirements set forth in this MOU. ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. MCP must have policies and procedures in place to maintain cross- system collaboration with DMC-ODS and to identify strategies to monitor and assess the effectiveness of this MOU. iv. The Parties must implement policies and procedures that align for coordinating Members’ care that address: 1. The requirement for DMC-ODS to refer Members to MCP to be assessed for care coordination and other similar programs and other services for which they may qualify provided by MCP including, but not limited to, ECM, CCM, or Community Supports; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/CalAIM/Documents/2023‐PHM‐Policy‐Guide.pdf.; 2. The specific point of contact from each Party, if someone other than each Party’s Responsible Person, to act as the liaison between Parties and be responsible for initiating, providing, and maintaining ongoing care coordination for all Members under this MOU;; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/CalAIM/Documents/2023-PHM-Policy-Guide.pdf. 3. A process for how MCP and DMC-ODS will engage in collaborative treatment planning to ensure care is clinically appropriate and non- duplicative and considers the Member’s established therapeutic relationships; 4. A process for coordinating the delivery of Medically Necessary Covered Services with the Member’s Primary Care Provider, including without limitation transportation services, home health services, and other Medically Necessary Covered Services for eligible Members; 5. A process for how MCP and DMC-ODS will help to ensure the Member is engaged and participates in their care program and a process for ensuring the Members, caregivers, and providers are engaged in the development of the Member’s care; 6. A process for reviewing and updating a Member’s problem list, as clinically indicated. The process must describe circumstances for updating problem lists and coordinating with outpatient SUD providers; 7. A process for how the Parties will engage in collaborative treatment planning and ensure communication among providers, including procedures for exchanges of medical information; and 8. Processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the requirements set forth in this MOU.. Docusign Envelope ID: F0807EFB-43F7-4245-B7BE-BF3615C8374B ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. MCP must have policies and procedures in place to maintain cross- system collaboration with DMC-ODS and to identify strategies to monitor and assess the effectiveness of this MOU. iv. The Parties must implement policies and procedures that align for coordinating Members’ care that address: 1. The requirement for DMC-ODS to refer Members to MCP to be assessed for care coordination and other similar programs and other services for which they may qualify provided by MCP including, but not limited to, ECM, CCM, or Community Supports; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/CalAIM/Documents/2023‐PHM‐Policy‐Guide.pdf.; 2. The specific point of contact from each Party, if someone other than each Party’s Responsible Person, to act as the liaison between Parties and be responsible for initiating, providing, and maintaining ongoing care coordination for all Members under this MOU;; 1 CalAIM Population Health Management Policy Guide, available at Docusign Envelope ID: F0807EFB-43F7-4245-B7BE-BF3615C8374B 3. A process for how MCP and DMC-ODS will engage in collaborative treatment planning to ensure care is clinically appropriate and non- duplicative and considers the Member’s established therapeutic relationships; 4. A process for coordinating the delivery of Medically Necessary Covered Services with the Member’s Primary Care Provider, including without limitation transportation services, home health services, and other Medically Necessary Covered Services for eligible Members; 5. A process for how MCP and DMC-ODS will help to ensure the Member is engaged and participates in their care program and a process for ensuring the Members, caregivers, and providers are engaged in the development of the Member’s care; 6. A process for reviewing and updating a Member’s problem list, as clinically indicated. The process must describe circumstances for updating problem lists and coordinating with outpatient SUD providers; 7. A process for how the Parties will engage in collaborative treatment planning and ensure communication among providers, including procedures for exchanges of medical information; and 8. Processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the requirements set forth in this MOU. ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. MCP must have policies and procedures in place to maintain cross- system collaboration with DMC-ODS DMC State Plan County and to identify strategies to monitor and assess the effectiveness of this MOU. iv. The Parties must implement policies and procedures that align for coordinating Members’ care that address: 1. The requirement for DMC-ODS DMC State Plan County to refer Members to MCP to be assessed for care coordination and other similar programs and other services for which they may qualify provided by MCP including, but not limited to, ECM, CCM, or Community Supports; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/CalAIM/Documents/2023‐PHM‐Policy‐Guide.pdf.; 2. The specific point of contact from each Party, if someone other than each Party’s Responsible Person, to act as the liaison between Parties and be responsible for initiating, providing, and maintaining ongoing care coordination for all Members under this MOU; 3. A process for how MCP and DMC-ODS DMC State Plan County will engage in collaborative treatment planning to ensure care is clinically appropriate and non- non-duplicative and considers the Member’s established therapeutic relationships; 4. A process for coordinating the MCP’s delivery of Medically Necessary Covered Services with the Member’s Primary Care Provider, including without limitation transportation services, home health services, and other Medically Necessary Covered Services for eligible Members; 5. A process for how MCP and DMC-ODS DMC State Plan County will help to ensure the Member is engaged and participates in their care program and a process for ensuring the Members, caregivers, and providers are engaged in the development of the Member’s care; 6. A process for reviewing and updating a Member’s problem list, as clinically indicated. The process must describe circumstances for updating problem lists and coordinating with outpatient SUD providers; 7. A process for how the Parties will engage in collaborative treatment planning and ensure communication among providers, including procedures for exchanges of medical information; and 8. Processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ ' access to care and services that incorporate all the requirements set forth in this MOU. ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. MCP must have policies and procedures in place to maintain cross- system collaboration with DMC-ODS DMC State Plan County and to identify strategies to monitor and assess the effectiveness of this MOU. iv. The Parties must implement policies and procedures that align for coordinating Members’ ' care that address: 1. The requirement for DMC-ODS DMC State Plan County to refer Members to MCP to be assessed for care coordination and other similar programs and other services for which they may qualify provided by MCP including, but not limited to, ECM, CCM, or Community Supports; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/CalAIM/Documents/2023‐PHM‐Policy‐Guide.pdf.; 2. The specific point of contact from each Party, if someone other than each Party’s 's Responsible Person, to act as the liaison between Parties and be responsible for initiating, providing, and maintaining ongoing care coordination for all forall Members under this MOU; 3. A process for how MCP and DMC-ODS DMC State Plan County will engage in collaborative treatment planning to ensure care is clinically appropriate and non- non-duplicative and considers the Member’s 's established therapeutic relationshipstherapeuticrelationships; 4. A process for coordinating the MCP's delivery of Medically Necessary Covered Services with the Member’s 's Primary Care Provider, including without limitation transportation services, home health services, and other Medically Necessary Covered Services for eligible Members; 5. A process for how MCP and DMC-ODS DMC State Plan County will help to ensure the Member is engaged and participates in their care program and a process for ensuring the Members, caregivers, and providers are engaged in the development of the Member’s 's care; 6. A process for reviewing and updating a Member’s 's problem list, as clinically indicated. The process must describe circumstances for updating problem lists and coordinating with outpatient SUD providers;; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/Ca1AIM/Documents/2023-PHM-Policy-Guide.pdf 7. A process for how the Parties will engage in collaborative treatment planning and ensure communication among providers, including procedures for exchanges of medical information; and 8. Processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the requirements set forth in this MOU. ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. MCP MCPs must have policies and procedures in place to maintain cross- cross-system collaboration with DMC-ODS DMC State Plan County and to identify strategies to monitor and assess the effectiveness of this MOU. iv. The Parties must implement policies and procedures that align for coordinating Members’ care that address: 1. The requirement for DMC-ODS DMC State Plan County to refer Members to MCP MCPs to be assessed for care coordination and other similar programs and other services for which they may qualify provided by MCP MCPs including, but not limited to, ECM, CCM, or Community Supports; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/CalAIM/Documents/2023‐PHM‐Policy‐Guide.pdf.; 2. The specific point of contact from each Party, if someone other than each Party’s Responsible Person, to act as the liaison between Parties and be responsible for initiating, providing, and maintaining ongoing care coordination for all Members under this MOU; 3. A process for how MCP MCPs and DMC-ODS DMC State Plan County will engage in collaborative treatment planning to ensure care is clinically appropriate and non- non-duplicative and considers the Member’s established therapeutic relationships; 4. A process for coordinating the MCPs’ delivery of Medically Necessary Covered Services with the Member’s Primary Care Provider, including without limitation transportation services, home health services, and other Medically Necessary Covered Services for eligible Members; 5. A process for how MCP MCPs and DMC-ODS DMC State Plan County will help to ensure the Member is engaged and participates in their care program and a process for ensuring the Members, caregivers, and providers are engaged in the development of the Member’s care; 6. A process for reviewing and updating a Member’s problem list, as clinically indicated. The process must describe circumstances for updating problem lists and coordinating with outpatient SUD providers; 7. A process for how the Parties will engage in collaborative treatment planning and ensure communication among providers, including procedures for exchanges of medical information; and 8. Processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.

Care Coordination. i. The Parties must adopt policies and procedures for coordinating Members’ access to care and services that incorporate all the requirements set forth in this MOU. ii. The Parties must discuss and address individual care coordination issues or barriers to care coordination efforts at least quarterly. iii. MCP must have policies and procedures in place to maintain cross- system collaboration with DMC-ODS and to identify strategies to monitor and assess the effectiveness of this MOU. iv. The Parties must implement policies and procedures that align for coordinating Members’ care that address: 1. The requirement for DMC-ODS to refer Members to MCP to be assessed for care coordination and other similar programs and other services for which they may qualify provided by MCP including, but not limited to, ECM, CCM, or Community Supports; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/CalAIM/Documents/2023‐PHM‐Policy‐Guide.pdf.; 2. The specific point of contact from each Party, if someone other than each Party’s Responsible Person, to act as the liaison between Parties and be responsible for initiating, providing, and maintaining ongoing care coordination for all Members under this MOU; 3. A process for how MCP and DMC-ODS will engage in collaborative treatment planning to ensure care is clinically appropriate and non- duplicative and considers the Member’s established therapeutic relationships;; 1 CalAIM Population Health Management Policy Guide, available at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇.▇▇▇/CalAIM/Documents/2023-PHM-Policy-Guide.pdf. 4. A process for coordinating the delivery of Medically Necessary Covered Services with the Member’s Primary Care Provider, including without limitation transportation services, home health services, and other Medically Necessary Covered Services for eligible Members; 5. A process for how MCP and DMC-ODS will help to ensure the Member is engaged and participates in their care program and a process for ensuring the Members, caregivers, and providers are engaged in the development of the Member’s care; 6. A process for reviewing and updating a Member’s problem list, as clinically indicated. The process must describe circumstances for updating problem lists and coordinating with outpatient SUD providers; 7. A process for how the Parties will engage in collaborative treatment planning and ensure communication among providers, including procedures for exchanges of medical information; and 8. Processes to ensure that Members and providers can coordinate coverage of Covered Services and carved-out services outlined by this MOU outside of normal business hours, as well as providing or arranging for 24/7 emergency access to Covered Services and carved-out services.