CARE PLANNING REQUIREMENTS Clause Samples
The CARE PLANNING REQUIREMENTS clause sets out the obligations and standards for developing, maintaining, and updating care plans for individuals receiving services. Typically, this clause outlines who is responsible for creating the care plan, the necessary components such as assessments, goals, and interventions, and the frequency with which the plan must be reviewed or revised. Its core practical function is to ensure that each individual receives tailored, coordinated care that meets their specific needs, thereby promoting quality and consistency in service delivery.
CARE PLANNING REQUIREMENTS. 3.6.1. Standalone member plans are no longer required for all SMHS services. The intent of this change is to affirm that care planning is an ongoing, interactive component of service delivery rather than a one-time event. Where possible, DHCS has modified, or may modify, state-level requirements for care, member, service, and treatment plans (hereafter referred to as “care plans”) to eliminate additional care planning specifications and align with the Medi-Cal requirements described in BHIN 23-068
3.6.2. There are some programs, services, and facility types for which federal or state law continues to require the use of care plans and/or specific care planning activities (see Enclosure 1a). For services, programs, or facilities for which care plan requirements remain in effect:
3.6.2.1. Providers must adhere to all relevant care planning requirements in state or federal law.
3.6.2.2. The provider shall document the required elements of the care plan within the member record. For example, required care plan elements may be notated within the assessment record, problem list, or progress notes, or the provider may use a dedicated care plan template within an Electronic Health Record.
3.6.2.3. To support delivery of coordinated care, the provider shall be able to produce and communicate the content of the care plan to other providers, the member, and Medi-Cal behavioral health delivery systems, in accordance with applicable state and federal privacy laws.
CARE PLANNING REQUIREMENTS. 20.6.1 As specified in BHIN 23-068, DHCS no longer requires prospectively completed, standalone client plans for Medi-Cal SMHS, or prospectively completed, standalone treatment plans for DMC-ODS services. The intent of this change is to affirm that care planning19 is an ongoing, interactive component of service delivery rather than a one-time event. Where possible, DHCS has modified, or may modify, state- level requirements for care, client, service, and treatment plans (hereafter referred to as “care plans”) to eliminate additional care planning specifications and align with the Medi-Cal requirements described in BHIN 23-068.
20.6.2 There are some programs, services, and facility types for which federal or state law continues to require the use of care plans and/or specific care planning activities (see BHIN 23-068 Enclosure 1a). For DMC-ODS services, programs, or facilities for which care plan requirements remain in effect:
20.6.2.1 Providers must adhere to all relevant care planning requirements in state or federal law.
20.6.2.2 The provider shall document the required elements of the care plan within the member record. For example, required care plan elements may be notated within the assessment record, problem list, or progress notes, or the provider may use a dedicated care plan template within an Electronic Health Record.
20.6.2.3 To support delivery of coordinated care, the provider shall be able to produce and communicate the content of the care plan to other providers, the member, and Medi-Cal behavioral health delivery systems, in accordance with applicable state and federal privacy laws.
CARE PLANNING REQUIREMENTS. 13.5.1. DHCS no longer requires prospectively completed, standalone client plans for DMC- ODS services. The intent of this change is to affirm that care planning is an ongoing, interactive component of service delivery rather than a one-time event. Where possible, DHCS has modified, or may modify, state-level requirements for care, client, service, and treatment plans (hereafter referred to as “care plans”) to eliminate additional care planning specifications and align with the Medi-Cal requirements described in BHIN23-068.
13.5.2. There are some programs, services, and facility types for which federal or state law continues to require the use of care plans and/or specific care planning activities. For DMC-ODS services, programs, or facilities for which care plan requirements remain in effect:
13.5.2.1. Providers must adhere to all relevant care planning requirements in state or federal law.
13.5.2.2. The provider shall document the required elements of the care plan within the member record. For example, required care plan elements may be notated within the assessment record, problem list, or progress notes, or the provider may use a dedicated care plan template within an Electronic Health Record.
13.5.2.3. To support delivery of coordinated care, the provider shall be able to produce and communicate the content of the care plan to other providers, the member, and Medi-Cal behavioral health delivery systems, in accordance with applicable state and federal privacy laws.
13.5.3. CONTRACTOR shall provide a care plan for peer support services.
13.5.4. CONTRACTOR shall provide and for residential treatment services provided in a DHCS LOC designated AOD treatment facility. The Treatment and Recovery Plans and Treatment and Recovery Services Documentation sections have been amended to include exemptions for residents during the detoxification phase of treatment.
13.5.5. NTPs must comply with the NTP treatment plan components set forth in 42 CFR 8.12.