MHO Members Clause Samples

MHO Members. OHA may assign MHO Members to Contractor as limited benefit Members. Contractor shall provide to MHO Members, the benefits and covered services described in Exhibit M, which by this reference is incorporated herein, in lieu of the benefits and covered services in sections 1 through 6 of this Exhibit B, Part 2, “Benefits and Covered Services for Members.” 1. Member and Member Representative Engagement and Activation a. Uses Community input and the Community Health Assessment (CHA) process to help determine the most culturally and linguistically appropriate and effective methods for patient activation, with the goal of ensuring that Members are partners in maintaining and improving their health; b. Engages Members to participate in the development of holistic approaches to patient engagement and responsibility that account for social determinants of health and health disparities; c. Educates Members on how to navigate the coordinated and integrated health system developed by Contractor by means that may include Peer Wellness Specialists, Personal Health Navigators, and Community Health Workers as part of the Member’s primary care team; d. Encourages Members to make healthy lifestyle choices and to use wellness and prevention resources, including mental health and addictions treatment, culturally-specific resources provided by community based organizations and service providers; e. Provides plain language narrative and alternative (video or audio) formats for individuals with limited literacy to inform Members of rights and responsibilities; f. Meaningfully engages the CAC to monitor patient engagement and activation. 2. Member Rights under Medicaid a. Ensure Members are aware that a second opinion is available from a qualified Health Care Professionals within the Provider Network, or that the Contractor will arrange for the Member to obtain a qualified Health Care Professionals from outside the network, at no cost to the Member. b. Provide equal access for both males and females under 18 years of age to appropriate facilities, services and treatment under this Contract, consistent with OHA obligations under ORS 417.270. c. Make oral interpretation services available free of charge to each Potential Member and Member. This applies to all non-English languages, not just those that OHA identifies as prevalent. Contractor shall notify its Members and Potential Members that oral interpretation is available for any language and that written information is availabl...