Common use of Orlando EMA Service Philosophy: Medical Case Managers/Intensive Case Management Clause in Contracts

Orlando EMA Service Philosophy: Medical Case Managers/Intensive Case Management. People with HIV (“PWH”) may experience challenges associated with their condition. These challenges may include social disenfranchisement, self-imposed isolation, lack of support systems, inadequate financial resources, lack of comprehensive and interdisciplinary services, as well as delays in the development of sufficient resources. To help PWH with these challenges, the Orlando EMA Xxxx Xxxxx Part A Program (hereinafter the “Recipient”) funds certain medical case manager services (hereinafter collectively referred to as “Services”). All such Services provided under this Contract shall be furnished to PWH, who meet the eligibility requirements set forth by the Xxxx Xxxxx Part A Program (hereinafter referred to as “client”) by qualified case managers (“Case Managers”) who support access, utilization, retention, and adherence to healthcare for client. Case Managers shall perform services so as to facilitate optimal health outcomes for client through advocacy, liaison, and collaboration. MCM/ICM Service delivery models (hereinafter “Program”) shall be capable of connecting clients to resources through advocacy and mediation. Case Managers shall strengthen linkages to healthcare, and seek to remove barriers to care such as financial stressors, health insurance, transportation, knowledge, social isolation, and emotional challenges associated with the HIV disease. In addition to linking clients to Services, Case Managers shall assist clients in developing or rebuilding personal support systems. Services are an integral part of ensuring access to medical care and a means of strengthening connections to clinicians by informing clients of the availability of appropriate medical resources, educating them about their benefits, and serving as advocates in coordinating healthcare and accessing resources to cover client costs. Case Managers shall encourage honest, consistent communication between healthcare and support services personnel, the client, and their self-identified support system. Case Managers shall seek to promote adherence to treatment by assisting client in overcoming difficulty in adhering to complicated medication regimens, and providing up-to- date information about medication, treatment, drug trials, and clinical studies. Case Managers shall seek to help clients to overcome fears about medical treatment, to adhere to medication regimens, and to advocate for themselves with clinicians. Case Managers shall help clients to understand and to decrease reported HIV risk behaviors. The Program shall provide client-centered activities, through which an array of Services for People with HIV are coordinated to improve health outcomes and facilitate client self- sufficiency. Case Managers shall create and xxxxxx an environment of acceptance and respect for human dignity. Case Managers shall educate clients about available resources, and act as liaisons between clients and Service organizations in arranging and coordinating those resources. Case Managers shall assess and monitor client’s needs and progress on an ongoing basis by identifying and addressing their evolving bio-psychosocial service needs and facilitating their access to appropriate resources such as healthcare, financial assistance, HIV education, mental health, substance abuse treatment, and other supportive services to promote increased access to and maintenance of medical care. Services appropriate to this activity shall include, but are not limited to, monitoring client’s adherence with their Case Plan, medical treatment and medication regimens, ensuring Providers involved in the client’s care are rendering services as requested and described in the Xxxx Xxxxx Part A Provider Manual or other professional standards, and assessing the effectiveness of services in helping the client to achieve their Case Plan goals. Case Managers shall be responsible for understanding service systems and advocating for their respective client.