Community Living Services (case management & monitoring) Sample Clauses

Community Living Services (case management & monitoring). For Members who transitioned from a SNF or other Long Term Care (LTC) facility will receive Community Living Services for 365 days following the day of discharge. Member lives in the community and receive LTSS as identified in their individual Comprehensive Service Plan (CSP). Once it is determined that the Member would benefit from Community Living Services, the Contractor will develop an Independent Living Plan (ILP), in coordination with Member, and will provide ongoing monitoring and care coordination, as needed. Contractor will submit all relevant information to Company via fax or other process, as agreed upon by the parties. Contractor will contact every Member in case management at least once a month to monitor and identify "red flags," service needs, adjustments in the ILP, as needed. Contractor will also be available to provide additional support to Members to effectively resolve issues for the purpose of resolution and navigation with Company and its providers to ensure that Member receives access to needed care. Contractor will provide linkages and coordination of additional services necessary as specified in the Member’s CSP/ILP, or just the ILP (if applicable), including but not limited to: (see Addendum 2) • Peer Counseling (Stepping Stones 10-week program) • Independent Living Skills TrainingAssistive Technology and Device Lending/Loan Program • Housing/Personal Care Attendant Services • Advocacy Support Services A key component of Community Living Services and the most effective method for measuring the success of the Member receiving HCBS in a community setting is the Quality of Life (QoL) Survey. The QoL is structured to measure the Member’s quality of life, based on multiple areas, and is used to compare the Member’s situation between the institutional setting and the community setting, or between their situation prior to receiving Community Transition Program services and afterward. The goal is to demonstrate that the Member’s quality of life improves once in the community and when receiving Community Transition Program services. QoL Survey administration schedule: • At the start of entering the program, or just prior to transition or within ten days after day of transition • Eleven months after transition • Twenty-four months after transition *NOTE: Members who are receiving Community Transition Program Services, who are residing in a SNF or another LTC facility, who are at risk of institutionalization, or Members living in the comm...
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