DEVELOPMENT AND MANAGEMENT. a. CONTRACTOR shall maintain a limited Provider Network, as approved by ADMINISTRATOR and CONTRACTOR, to provide Specialty Mental Health Services at provider’s individual offices or facilities, based upon County assessment needs, including, but not limited to, addressing geographic accessibility and cultural competency, which includes service availability in threshold languages that include English, Spanish, Farsi, Korean, Arabic, Chinese and Vietnamese. Additional languages required may be added should DHCS designate additional languages as meeting the threshold for language requirements. b. CONTRACTOR shall provide a range of Network Providers capable of delivering services as set forth by this Contract which may include but is not limited to: psychiatrists; licensed psychiatric nurse practitioners, Licensed Professional of the Healing Arts (LPHA) as determined by DHCS; and other providers as approved by ADMINISTRATOR. c. CONTRACTOR shall identify and recruit those Network Providers who are serving a specialty population, such as ECT or culturally specific services, or who are in geographic location(s) that would maximize Beneficiary access. Such providers shall be pursued to participate in the Provider Network, and their credentialing process shall be expedited in order to maintain limited Provider Network. d. CONTRACTOR shall work with ADMINISTRATOR on credentialing specified in the Services Paragraph of this Exhibit A to the Contract. Individual, group and organizational providers must meet the following criteria to be a CONTRACTOR Network Provider: 1) Comply with all applicable Federal Medicaid (Medi-Cal) laws, regulations, and guidelines, and all applicable state statutes and regulations; 2) Provide Specialty Mental Health Services, within scope of licensure, to all Beneficiaries who are referred by CONTRACTOR. To assist in referrals, providers shall, as a part of their application, indicate their specialties, which CONTRACTOR shall verify to the extent possible; 3) Appropriately refer Beneficiaries for other services when necessary; 4) Not refuse to provide services solely on the basis of age, sex, race, religion, physical or mental disability, or national origin; 5) Maintain a safe facility; standards; 6) If applicable, store and dispense medications according to state and federal 7) Maintain client records that meet state and federal standards; including but not limited to individualized treatment plans separate case notes. These shall be developed with Client and signed by Client. 8) Provide services at the rates established by CONTRACTOR, as agreed by ADMINISTRATOR; 9) Demonstrate positive outcomes as defined by CONTRACTOR; 10) Address the needs of Beneficiaries based on factors including age, language, culture, physical disability, psychiatric disability, and specified clinical interventions; 11) Meet ▇▇, authorization, clinical, and administrative requirements of COUNTY and CONTRACTOR; 12) Work with Beneficiaries, their families, and other providers in a collaborative and supportive manner; and 13) Provide services in a managed care environment. e. CONTRACTOR shall maintain a complete list of all Network Providers including name, license number, provider number(s), number of open clients, NPI number, specialty or specialties, language capabilities other than English, and geographic location and ethnicity. Any changes to the Network Provider list shall be submitted to ADMINISTRATOR on a monthly basis or as requested.
Appears in 1 contract
DEVELOPMENT AND MANAGEMENT. a. CONTRACTOR shall maintain a limited Provider Network, as approved by ADMINISTRATOR and CONTRACTOR, Network to provide Specialty Mental Health Services at provider’s providers’ individual offices or facilities, based upon existing community County assessment of Orange, Health Care Agency Contract MA-042-18010155 needs, including, but not limited to, addressing geographic accessibility and cultural competency, which includes shall include a multi-lingual/multi-cultural provider or translator supported service availability in threshold languages that to include English, Spanish, Farsi, Korean, Arabic, Chinese Vietnamese and VietnameseMandarin Chinese. Additional languages required may be added should DHCS designate additional languages as meeting the threshold for language requirements.
b. CONTRACTOR shall provide a range of Network Providers capable of delivering services as set forth by this Contract Agreement which may include but is not limited to: psychiatrists; licensed psychologists; licensed psychiatric nurse practitioners, Licensed Professional of the Healing Arts (LPHA) as determined by DHCS; MFTs, and LCSW practitioners and other providers as approved by ADMINISTRATOR.
c. CONTRACTOR shall identify and recruit those Network Providers who are serving a specialty populationpopulation (i.e., such as ECT age, gender, or culturally specific servicescultural specific), or who are in geographic location(s) that would maximize Beneficiary accessaccess necessary for the success of the program. Such providers shall be actively pursued to participate in the Provider Network, and their credentialing process shall be expedited in order to maintain limited Provider Networkexpedited.
d. CONTRACTOR shall work closely with ADMINISTRATOR on to periodically review LOC appropriateness and reduce the Provider Network to align with fluctuations of ASO level of care referrals.
e. CONTRACTOR shall conduct provider credentialing specified in the Services Paragraph of this Exhibit A to the ContractAgreement. Individual, group and organizational providers must meet the following criteria to be a CONTRACTOR Network Provider:
1) Comply with all applicable Federal Medicaid (Medi-Cal) laws, regulations, and guidelines, and all applicable state statutes and regulations;
2) Provide Specialty Mental Health Services, within scope of licensure, to all Beneficiaries who are referred by CONTRACTOR. To assist in referrals, providers shall, as a part of their application, indicate their specialties, which CONTRACTOR shall verify to the extent possible;
3) Appropriately refer Beneficiaries for other services when necessary;
4) Not refuse to provide services solely on the basis of age, sex, race, religion, physical or mental disability, or national origin;
5) Maintain a safe facility; standards;
6) If applicable, store and dispense medications according to state and federalfederal standards;
7) Maintain client records that meet state and federal standards; including but not limited to individualized treatment plans separate case notes. These shall be developed with Client client and signed by Client.client. County of Orange, Health Care Agency Contract MA-042-18010155
8) Provide services at the rates established by CONTRACTOR, as agreed by ADMINISTRATOR;
9) Demonstrate positive outcomes as defined by CONTRACTOR;
10) Address the needs of Beneficiaries based on factors including age, language, culture, physical disability, psychiatric disability, and specified clinical interventions;
11) Meet ▇▇QI, authorization, clinical, and administrative requirements of COUNTY and CONTRACTOR;
12) Work with Beneficiaries, their families, and other providers in a collaborative and supportive manner; and
13) Provide services in a managed care environment.
e. f. CONTRACTOR shall maintain a complete list of all Network Providers including name, license number, provider number(s), number of open clients, NPI number, specialty or specialties, language capabilities other than English, and geographic location and ethnicity. Any changes to the Network Provider list shall be submitted to ADMINISTRATOR on a monthly basis or as requested.
Appears in 1 contract
Sources: Contract for Administrative Services Organization for Specialty Mental Health Outpatient Services
DEVELOPMENT AND MANAGEMENT. a. CONTRACTOR shall maintain a limited Provider Network, as approved by ADMINISTRATOR and CONTRACTOR, to provide Specialty Mental Health Services at provider’s individual offices or facilities, based upon County COUNTY assessment needs, including, but not limited to, addressing geographic accessibility and cultural competency, which includes service availability in threshold languages that include English, Spanish, Farsi, Korean, Arabic, Chinese Chinese, Russian and Vietnamese. Additional languages required may be added should DHCS designate additional languages as meeting the threshold for language requirements.
b. CONTRACTOR shall provide a range of Network Providers capable of delivering services as set forth by this Contract which may include but is not limited to: psychiatrists; licensed psychiatric nurse practitioners, Licensed Professional of the Healing Arts (LPHA) ), as determined by DHCS; and other providers as approved by ADMINISTRATOR.
c. CONTRACTOR shall identify work with ADMINISTRATOR on identifying and recruit then recruiting only those Network Providers who are serving a specialty population, at acute facility level of care, LPS conserved population living in residential settings at County approved facilities, providers treating eating disorder diagnosed clients and Network Providers who are providing specialty services, such as ECT Electroconvulsive Therapy (ECT), Transcranial Magnetic Stimulation (TMS), or culturally specific services, or who are in geographic location(s) that would maximize Beneficiary Client access. Such providers shall be pursued to participate in the Provider Network, and their credentialing process shall be expedited in order to maintain limited Provider Network.
d. CONTRACTOR shall work with ADMINISTRATOR on credentialing specified in the Services Paragraph of this Exhibit A to the Contract. Individual, group and organizational providers must meet the following criteria to be a CONTRACTOR Network Provider:
1) Comply with all applicable Federal Medicaid (Medi-Cal) laws, regulations, and guidelines, and all applicable state statutes and regulations;
2) Provide Specialty Mental Health Services, within scope of licensure, to all Beneficiaries Clients who are referred by CONTRACTOR. To assist in referrals, providers shall, as a part of their application, indicate their specialties, which CONTRACTOR shall verify to the extent possible;
3) Appropriately refer Beneficiaries Clients for other services when necessary;
4) Not refuse to provide services solely on the basis of age, sex, race, religion, physical or mental disability, or national origin;
5) Maintain a safe facility; standards;
6) If applicable, store and dispense medications according to state and federalfederal standards;
7) Maintain client records that meet state and federal standards; including but not limited to individualized treatment plans separate case notes. These shall be developed with Client and signed by Client.
8) Provide services at the rates established by CONTRACTOR, as agreed by ADMINISTRATOR;
9) Demonstrate positive outcomes as defined by CONTRACTOR;
10) Address the needs of Beneficiaries Clients based on factors including age, language, culture, physical disability, psychiatric disability, and specified clinical interventions;
11) Meet ▇▇, authorization, clinical, and administrative requirements of COUNTY and CONTRACTOR;
12) Work with BeneficiariesClients, their families, and other providers in a collaborative and supportive manner; and
13) Provide services in a managed care environment.
e. CONTRACTOR shall maintain a complete list of all Network Providers including name, license number, provider number(s), number of open clients, NPI number, specialty or specialties, language capabilities other than English, and geographic location and ethnicity. Any changes to the Network Provider list shall be submitted to ADMINISTRATOR on a monthly basis or as requested.
Appears in 1 contract
DEVELOPMENT AND MANAGEMENT. a. CONTRACTOR shall maintain a limited Provider Network, as approved by ADMINISTRATOR and CONTRACTOR, Network to provide Specialty Mental Health Services at provider’s providers’ individual offices or facilities, based upon County assessment existing community needs, including, but not limited to, addressing geographic accessibility and cultural competency, which includes shall include a multi-lingual/multi-cultural provider or translator supported service availability in threshold languages that to include English, Spanish, Farsi, Korean, Arabic, Chinese Vietnamese and VietnameseMandarin Chinese. Additional languages required may be added should DHCS designate additional languages as meeting the threshold for language requirements.
b. CONTRACTOR shall provide a range of Network Providers capable of delivering services as set forth by this Contract Agreement which may include but is not limited to: psychiatrists; licensed psychologists; licensed psychiatric nurse practitioners, Licensed Professional of the Healing Arts (LPHA) as determined by DHCS; MFTs, and LCSW practitioners and other providers as approved by ADMINISTRATOR.
c. CONTRACTOR shall identify and recruit those Network Providers who are serving a specialty populationpopulation (i.e., such as ECT age, gender, or culturally specific servicescultural specific), or who are in geographic location(s) that would maximize Beneficiary accessaccess necessary for the success of the program. Such providers shall be actively pursued to participate in the Provider Network, and their credentialing process shall be expedited in order to maintain limited Provider Networkexpedited.
d. CONTRACTOR shall work closely with ADMINISTRATOR on to periodically review LOC appropriateness and reduce the Provider Network to align with fluctuations of ASO level of care referrals.
e. CONTRACTOR shall conduct provider credentialing specified in the Services Paragraph of this Exhibit A to the ContractAgreement. Individual, group and organizational providers must meet the following criteria to be a CONTRACTOR Network Provider:
1) Comply with all applicable Federal Medicaid (Medi-Cal) laws, regulations, and guidelines, and all applicable state statutes and regulations;
2) Provide Specialty Mental Health Services, within scope of licensure, to all Beneficiaries who are referred by CONTRACTOR. To assist in referrals, providers shall, as a part of their application, indicate their specialties, which CONTRACTOR shall verify to the extent possible;
3) Appropriately refer Beneficiaries for other services when necessary;
4) Not refuse to provide services solely on the basis of age, sex, race, religion, physical or mental disability, or national origin;
5) Maintain a safe facility; standards;
6) If applicable, store and dispense medications according to state and federal
7) Maintain client records that meet state and federal standards; including but not limited to individualized treatment plans separate case notes. These shall be developed with Client client and signed by Clientclient.
8) Provide services at the rates established by CONTRACTOR, as agreed by ADMINISTRATOR;
9) Demonstrate positive outcomes as defined by CONTRACTOR;
10) Address the needs of Beneficiaries based on factors including age, language, culture, physical disability, psychiatric disability, and specified clinical interventions;
11) Meet ▇▇QI, authorization, clinical, and administrative requirements of COUNTY and CONTRACTOR;
12) Work with Beneficiaries, their families, and other providers in a collaborative and supportive manner; and
13) Provide services in a managed care environment.
e. CONTRACTOR shall maintain a complete list of all Network Providers including name, license number, provider number(s), number of open clients, NPI number, specialty or specialties, language capabilities other than English, and geographic location and ethnicity. Any changes to the Network Provider list shall be submitted to ADMINISTRATOR on a monthly basis or as requested.
Appears in 1 contract
Sources: Contract for Administrative Services Organization for Specialty Mental Health Outpatient Services
DEVELOPMENT AND MANAGEMENT. a. CONTRACTOR shall maintain a limited Provider Network, as approved by ADMINISTRATOR and CONTRACTOR, to provide Specialty Mental Health Services at provider’s individual offices or facilities, based upon County assessment needs, including, but not limited to, addressing geographic accessibility and cultural competency, which includes service availability in threshold languages that include English, Spanish, Farsi, Korean, Arabic, Chinese and Vietnamese. Additional languages required may be added should DHCS designate additional languages as meeting the threshold for language requirements.
b. CONTRACTOR shall provide a range of Network Providers capable of delivering services as set forth by this Contract which may include but is not limited to: psychiatrists; licensed psychiatric nurse practitioners, Licensed Professional of the Healing Arts (LPHA) as determined by DHCS; and other providers as approved by ADMINISTRATOR.
c. CONTRACTOR shall identify and recruit those Network Providers who are serving a specialty population, such as ECT or culturally specific services, or who are in geographic location(s) that would maximize Beneficiary access. Such providers shall be pursued to participate in the Provider Network, and their credentialing process shall be expedited in order to maintain limited Provider Network.
d. CONTRACTOR shall work with ADMINISTRATOR on credentialing specified in the Services Paragraph of this Exhibit A to the Contract. Individual, group and organizational providers must meet the following criteria to be a CONTRACTOR Network Provider:
1) Comply with all applicable Federal Medicaid (Medi-Cal) laws, regulations, and guidelines, and all applicable state statutes and regulations;
2) Provide Specialty Mental Health Services, within scope of licensure, to all Beneficiaries who are referred by CONTRACTOR. To assist in referrals, providers shall, as a part of their application, indicate their specialties, which CONTRACTOR shall verify to the extent possible;
3) Appropriately refer Beneficiaries for other services when necessary;
4) Not refuse to provide services solely on the basis of age, sex, race, religion, physical or mental disability, or national origin;
5) Maintain a safe facility; standards;
6) If applicable, store and dispense medications according to state and federalfederal standards;
7) Maintain client records that meet state and federal standards; including but not limited to individualized treatment plans separate case notes. These shall be developed with Client and signed by Client.
8) Provide services at the rates established by CONTRACTOR, as agreed by ADMINISTRATOR;
9) Demonstrate positive outcomes as defined by CONTRACTOR;
10) Address the needs of Beneficiaries based on factors including age, language, culture, physical disability, psychiatric disability, and specified clinical interventions;
11) Meet ▇▇, authorization, clinical, and administrative requirements of COUNTY and CONTRACTOR;
12) Work with Beneficiaries, their families, and other providers in a collaborative and supportive manner; and
13) Provide services in a managed care environment.
e. CONTRACTOR shall maintain a complete list of all Network Providers including name, license number, provider number(s), number of open clients, NPI number, specialty or specialties, language capabilities other than English, and geographic location and ethnicity. Any changes to the Network Provider list shall be submitted to ADMINISTRATOR on a monthly basis or as requested.
Appears in 1 contract