Common use of Clarifying Information Clause in Contracts

Clarifying Information. The PPS is expected to utilize the preventative care screening based on nationally-accepted best practices determined to be age-appropriate. • Any staffer working at a PCMH/APCM Service Site who is qualified to perform a preventive care screening can do so. However, preventive care screenings conducted with a patient via telepsychiatry alone will not count within this active engagement definition. • Appropriate screenings would only count if the PCP or the clinical staff is provided the results of the screen and they are incorporated into the medical record. • The expectation of co-located primary care-behavioral health site is that there is a licensed behavioral health provider on site engaged in the practice. In order to be considered actively engaged by definitions set by CNYCC, Medicaid members must: • Have traditional Medicaid, be dually eligible for Medicaid and Medicare, or be a member of Medicaid Managed Care (e.g. Fidelis, Total Care or United Healthcare) AND • Have received the appropriate preventive care screenings that include mental/substance abuse from the table below AND Screened For: Screen Used: Depression/Suicide PHQ-2/PHQ-9/A (depression, adults/adolescents) Edinburgh scale (postpartum depression) CES-DC (Depression Scale for Children) (ages 6-17 yr) Columbia Rating Scale (suicide, children up to adults) Zung-Self Rated Depression Scale Modified Mini Screen (Depression and Anxiety) Mood and Feelings Questionnaire (ages 8-18) Anxiety GAD-7 (anxiety, children, adults) SCARED (children, parents) Modified Mini Screen (Depression and Anxiety) PSWQ (youth) Bipolar disorder Young Mania Rating Scale (youth) Child Mania Rating Scale-Parent (parent of youth) Substance Use/Abuse Including Tobacco CRAFFT (substance abuse, 12-18 yrs) MSSI (substance abuse, adults) CAGE SSI-AOD Simple Screening Instrument for Alcohol and Other Drugs Audit C – for Alcohol ASSIST DAST-10 Social/Emotional/Psychosocial ASQ-SE (social-emotional, ages at stages, 6 mos to 5 yrs) SDQ-2 (strengths and difficulties, 6-16 yrs) Pediatric Symptom Checklist (Children) Strengths and Difficulties Questionnaires (Children) Modified Overt Aggression Scale (MOAS; clinician rating) MOAS (retrospective; parent) ▇▇▇▇▇▇▇▇ Child Behavior Rating Form (CBRF long; parent) Outburst Monitoring Scale NEW ADHD Edelbrock Rating Scale Vanderbilt Parent Rating ADHD Rating Scale (adults) Autism Modified CHAT (M-CHAT; parent) M-CHAT Follow Up Eating Disorders Eating Attitude Test BULIT-R • Have NOT been submitted to other PPSs for payment. Model 2 Project Title Integration of primary care and behavioral health services Actively Engaged Definition The total number of patients receiving primary care services at a participating mental health or substance abuse site. Counting Criteria A count of patients who meet the criteria over a 1-year measurement period. Duplicate counts of patients are not allowed. The count is not additive across DSRIP years. Data Source EHRs or other IT Platforms (i.e. patient registries).

Clarifying Information.  The PPS is expected to utilize the preventative care screening based on nationally-accepted best practices determined to be age-appropriate. •  Any staffer working at a PCMH/APCM Service Site who is qualified to perform a preventive care screening can do so. However, preventive care screenings conducted with a patient via telepsychiatry alone will not count within this active engagement definition. •  Appropriate screenings would only count if the PCP or the clinical staff is provided the results of the screen and they are incorporated into the medical record. •  The expectation of co-located primary care-behavioral health site is that there is a licensed behavioral health provider on site engaged in the practice. In order to be considered actively engaged by definitions set by CNYCC, Medicaid members must: •  Have traditional Medicaid, be dually eligible for Medicaid and Medicare, or be a member of Medicaid Managed Care (e.g. Fidelis, Total Care or United Healthcare) AND •  Have received the appropriate preventive care screenings that include mental/substance abuse from the table below AND Screened For: Screen Used: Depression/Suicide PHQ-2/PHQ-9/A (depression, adults/adolescents) Edinburgh scale (postpartum depression) CES-DC (Depression Scale for Children) (ages 6-17 yr) Columbia Rating Scale (suicide, children up to adults) Zung-Self Rated Depression Scale Modified Mini Screen (Depression and Anxiety) Mood and Feelings Questionnaire (ages 8-18) Anxiety GAD-7 (anxiety, children, adults) SCARED (children, parents) Modified Mini Screen (Depression and Anxiety) PSWQ (youth) Bipolar disorder Young Mania Rating Scale (youth) Child Mania Rating Scale-Parent (parent of youth) Substance Use/Abuse Including Tobacco CRAFFT (substance abuse, 12-18 yrs) MSSI (substance abuse, adults) CAGE SSI-AOD Simple Screening Instrument for Alcohol and Other Drugs Audit C – for Alcohol ASSIST DAST-10 Social/Emotional/Psychosocial ASQ-SE (social-emotional, ages at stages, 6 mos to 5 yrs) SDQ-2 (strengths and difficulties, 6-16 yrs) Pediatric Symptom Checklist (Children) Strengths and Difficulties Questionnaires (Children) Modified Overt Aggression Scale (MOAS; clinician rating) MOAS (retrospective; parent) ▇▇▇▇▇▇▇▇ Child Behavior Rating Form (CBRF long; parent) Outburst Monitoring Scale NEW ADHD Edelbrock Rating Scale Vanderbilt Parent Rating ADHD Rating Scale (adults) Autism Modified CHAT (M-CHAT; parent) M-CHAT Follow Up Eating Disorders Eating Attitude Test BULIT-R •  Have NOT been submitted to other PPSs for payment. Model 2 Project Title Integration of primary care and behavioral health services Actively Engaged Definition The total number of patients receiving primary care services at a participating mental health or substance abuse site. Counting Criteria A count of patients who meet the criteria over a 1-year measurement period. Duplicate counts of patients are not allowed. The count is not additive across DSRIP years. Data Source EHRs or other IT Platforms (i.e. patient registries).