Children in Xxxxxx Care. Services for Arizona’s children in xxxxxx care are provided through an MCO contract between AHCCCS and the Arizona DES/CMDP. CMDP operates in the same manner as other AACP Health Plans, but children in xxxxxx care who receive acute care services will be enrolled in CMDP instead of other Health Plans. Children in xxxxxx care who are eligible for or receive ALTCS will be enrolled or remain with the Program Contractor. Case Management services provided and reimbursed through this contractual relationship must be provided consistent with Federal policy, regulations and law. Children in xxxxxx care who are also eligible for CRS receive treatment for their CRS and behavioral health care conditions through the separate MCO contract for the CRS program. CRS eligible xxxxxx children will receive services for all conditions other than behavioral health or CRS related conditions through CMDP.
Children in Xxxxxx Care. No less than quarterly, Contractor’s staff shall meet with DCBS staff to identify, discuss and resolve any health care issues and needs of the Contractor’s Xxxxxx Care membership. Examples of these issues include needed specialized Medicaid Covered Services, community services and whether the child’s current primary and specialty care providers are enrolled in the Contractor’s Network. If the DCBS service plan identifies the need for case management or DCBS staff requests case management for a Member, the Contractor’s staff will work with xxxxxx parent and/or DCBS staff to develop a case management plan. The Contractor’s staff will consult with DCBS staff before the development of a new case management plan (on a newly identified health care issue) or modification of an existing case management plan. The designated Contractor staff will sign each service plan made available by DCBS to indicate their agreement with the plan. If the DCBS and Contractor staff cannot reach agreement on the service plan for a Member, information about that Member’s physical health care needs, unresolved issues in developing the case management plan, and a summary of resolutions discussed by the DCBS and Contractor staff will be forwarded to the designated Department representative. The Contractor shall notify the Department and DCBS no later than three (3) business days prior to the decertification of a xxxxxx child for services at a hospital or other residential facility located in Kentucky and no later than seven (7) business days prior to the decertification of a xxxxxx child for services at a hospital or other residential facility located out of state. Written documentation of an upcoming medical necessity review does not qualify as a decertification notification. The Department shall provide the Contractor with the office or division, the individual(s) and the contact information for such notification and provide updated contact information as necessary. The decertification notification shall include the Member name, Member ID, facility name, level of care, discharge plan and date of next follow-up appointment. If the Contractor fails to notify the Department and DCBS at least three (3) business days or seven (7) business days, as applicable, prior to the decertification and the xxxxxx child remains in the facility because arrangements for placement cannot be made, the Contractor shall be responsible for the time the xxxxxx child remains in the facility prior to notificati...
Children in Xxxxxx Care. Services for Arizona’s children in xxxxxx care are provided through an MCO contract between AHCCCS and the Arizona DES/CMDP. CMDP operates in the same manner as other AACP Health Plans, but children in xxxxxx care who receive acute care services will be enrolled in CMDP instead of other Health Plans. Children in xxxxxx care who are eligible for or receive ALTCS will be enrolled or remain with the Program Contractor. Case Management services provided and reimbursed through this contractual relationship must be provided consistent with Federal policy, regulations and law.
Children in Xxxxxx Care. 9.1. Children in xxxxxx care will be eligible for the additional free hours from the term after they meet the following criteria: • the child has attained the age of 3 and is under compulsory school age • accessing the extended entitlement is consistent with the child’s care plan • in single xxxxxx parent families, the xxxxxx parent holds additional paid employment outside of their role as a xxxxxx carer • in 2 xxxxxx parent families, both partners hold additional paid employment outside of their role as a xxxxxx carer.
Children in Xxxxxx Care. Upon Enrollment with the Contractor, each child in Xxxxxx Care shall have a service plan prepared by DCBS. DCBS shall forward a copy of the service plan to the Contractor on each newly enrolled Xxxxxx Care child. No less than monthly, DCBS staff shall meet with Contractor’s staff to identify, discuss and resolve any health care issues and needs of the child as identified in the service plan. Examples of these issues include needed specialized Medicaid Covered Services, community services and whether the child’s current primary and specialty care providers are enrolled in the Contractor’s Network. If DCBS service plan identifies the need for case management or DCBS staff requests case management for a Member, the xxxxxx parent and/or DCBS staff will work with Contractor’s staff to develop a case management care plan. The Contractor will consult with DCBS staff before the development of a new case management care plan (on a newly identified health care issue) or modification of an existing case management care plan. The DCBS and designated Contractor staff will sign each service plan to indicate their agreement with the plan. If the DCBS and Contractor staff cannot reach agreement on the service plan for a Member, information about that Member’s physical health care needs, unresolved issues in developing the case management plan, and a summary of resolutions discussed by the DCBS and Contractor staff will be forwarded to the designated county DCBS worker. That DCBS staff member shall work with the designated Contractor representative and a designated Department representative, if needed, to agree on a service plan. If agreement is not reached through mediation, the service plan shall be referred to the Department for resolution through the appeals process.
