Common use of Gateway to Work (GTW) Program Clause in Contracts

Gateway to Work (GTW) Program. The Contractor shall be responsible for administering the HIP GTW program according to the GTW eligibility and operational requirements outlined in the MCE Policy and Procedure manual. The Contractor shall participate in GTW readiness reviews, conducted by OMPP, which may include documentation provided by the Contractor and on-site walkthroughs. The State will assign a GTW Referral Status for all fully eligible HIP members and provide the Referral Status to the Contractor. For all members who are referred to participate in the GTW program, the Contractor shall monitor each member’s compliance with the required GTW community engagement hours using the data provided by the member in the GTW member portal. The Contractor shall complete all outbound GTW member communications requirements as applicable to each member participating in GTW according to the MCE Policy and Procedure manual. The Contractor shall assist members who contact the Contractor regarding help with GTW requirements and shall conduct assessments and develop Assistance Plans according to the requirements set forth in the MCE Policy and Procedures manual. If during the assessment process, the Contractor identifies an exemption to the member’s participation in GTW or a member reports an exemption, the Contractor shall appropriately record or refer the exemption depending upon the type of exemption identified. The Contractor shall attempt to develop an Assistance Plan for a member if the member meets the criteria set forth in the MCE Policy and Procedure manual, including for failure to comply with GTW reporting requirements, or if the member requests an Assistance Plan. The Contractor shall conduct outreach to GTW members with an Assistance Plan per the requirements set forth in the MCE Policy and Procedure manual. If the member is non-compliant with GTW requirements when the Assistance Plan expires, the Contractor shall assess if a new Assistance Plan is appropriate. In accordance with the MCE Policy and Procedure manual, each calendar year the Contractor shall review Gateway to Work compliance for each member required to participate in the program based upon the referral status provided by the State. Non- compliant members will have the opportunity to complete pre-suspension activities, and the Contractor shall conduct all pre-suspension activity communication requirements. The State shall make all final eligibility decisions related to a member’s compliance with GTW requirements. The Contractor shall complete their assigned number of GTW verifications of member qualifying activities at the frequency required by the State. Verifications shall be completed on a sample of member accounts with a GTW reporting status according to the methodology and requirements set forth in the MCE Policy and Procedure manual. The Contractor shall report the results of each monthly verification to the State, in the format approved by the State, at which time the State may validate the results. The Contractor shall address member grievances related to GTW according to the MCE Policy and Procedure Manual and per the requirements of Section 7.9. The Contractor shall participate in the appeal process, as required by the State, for any GTW appeals as set forth in Section 7.9.

Gateway to Work (GTW) Program. The Contractor shall be responsible for administering the HIP GTW program according to the GTW eligibility and operational requirements outlined in the MCE Policy and Procedure manual. The Contractor shall participate in GTW readiness reviews, conducted by OMPP, which may include documentation provided by the Contractor and on-site walkthroughs. The State will assign a GTW Referral Status for all fully eligible HIP members and provide the Referral Status to the Contractor. For all members who are referred to participate in the GTW program, the Contractor shall monitor each member’s compliance with the required GTW community engagement hours using the data provided by the member in the GTW member portal. The Contractor shall complete all outbound GTW member communications requirements as applicable to each member participating in GTW according to the MCE Policy and Procedure manual. The Contractor shall assist members who contact the Contractor regarding help with GTW requirements and shall conduct assessments and develop Assistance Plans according to the requirements set forth in the MCE Policy and Procedures manual. If during the assessment process, the Contractor identifies an exemption to the member’s participation in GTW or a member reports an exemption, the Contractor shall appropriately record or refer the exemption depending upon the type of exemption identified. The Contractor shall attempt to develop an Assistance Plan for a member if the member meets the criteria set forth in the MCE Policy and Procedure manual, including for failure to comply with GTW reporting requirements, or if the member requests an Assistance Plan. The Contractor shall conduct outreach to GTW members with an Assistance Plan per the requirements set forth in the MCE Policy and Procedure manual. If the member is non-compliant with GTW requirements when the Assistance Plan expires, the Contractor shall assess if a new Assistance Plan is appropriate. In accordance with the MCE Policy and Procedure manual, each calendar year the Contractor shall review Gateway to Work compliance for each member required to participate in the program based upon the referral status provided by the State. Non- Non-compliant members will have the opportunity to complete pre-suspension activities, and the Contractor shall conduct all pre-pre- suspension activity communication requirements. The State shall make all final eligibility decisions related to a member’s compliance with GTW requirements. The Contractor shall complete their assigned number of GTW verifications of member qualifying activities at the frequency required by the State. Verifications shall be completed on a sample of member accounts with a GTW reporting status according to the methodology and requirements set forth in the MCE Policy and Procedure manual. The Contractor shall report the results of each monthly verification to the State, in the format approved by the State, at which time the State may validate the results. The Contractor shall address member grievances related to GTW according to the MCE Policy and Procedure Manual and per the requirements of Section 7.9. The Contractor shall participate in the appeal process, as required by the State, for any GTW appeals as set forth in Section 7.9.