Common use of Comprehensive Assessments Clause in Contracts

Comprehensive Assessments. ‌ Each Enrollee shall receive, and be an active participant in, a timely Comprehensive Assessment of medical, behavioral health, community- based or facility-based LTSS, and social needs completed by the Care Management team. The CICO must use Phoenix, SCDHHS’s automated Case Management system, to record the Comprehensive Assessments and to track the Long Term Care Assessments (as described in Section 2.6.4 Long Term Care Assessments). The Comprehensive Assessment will be performed using the state’s uniform assessment tools. Assessment domains will include, but not be limited to, social, functional, medical, behavioral, wellness and prevention domains, caregiver status and capabilities, as well as the Enrollee’s preferences, strengths, and goals. The CICO will complete the Comprehensive Assessment using information from the initial health screen (described in Section 2.6.2 Initial Health Screen), comprehensive data sources, and input from the Enrollee, Providers, and family/caregivers. Assessments will be completed by qualified, trained health professionals who possess a professional scope of practice, licensure, and/or credentials appropriate for responding to or managing the Enrollee’s needs. Examples of health professionals who may complete portions or all of the assessment include, but are not limited to: Registered nurses, Licensed practical nurses (under the supervision of registered nurses), Social workers, Medicaid case managers, Certified geriatric care managers, Certified community health workers The CICO will use the results of the Comprehensive Assessment to confirm the appropriate acuity or risk stratification level for the Enrollee and as the basis for developing the integrated ICP. The Enrollee will continue to receive any community-based or facility- based LTSS (i.e., respite care) in any existing waiver service plan(s) prior to the Comprehensive Assessment or reassessment. The CICO will adhere to all transition requirements for services, as outlined in Section 2.6.9.

Comprehensive Assessments. ‌ Each Enrollee Enrollee shall receive, and be an active participant in, a timely Comprehensive Assessment of medical, behavioral health, community- community-based or facility-based LTSS, and social needs completed by the Care Management team. The For Enrollees identified as high-risk, the CICO must use Phoenix, SCDHHS’s automated Case Management system, to record the Comprehensive Assessments and to track the Long Term Care Assessments (as described in Section 2.6.4 Long Term Care Assessments2.6.4). The For Enrollees identified as high-risk, the Comprehensive Assessment will be performed using the state’s uniform assessment tools. For all other Enrollees, the CICO may utilize internal Comprehensive Assessment tools. Assessment domains will include, but not be limited to, social, functional, medical, behavioral, wellness and prevention domains, caregiver status and capabilities, as well as the Enrollee’s preferences, strengths, and goals. The CICO will complete the Comprehensive Assessment by using information from the initial health screen (described in Section 2.6.2 Initial Health Screen), comprehensive data sources, and input from the Enrollee, Providers, and family/caregivers. Assessments will be completed by qualified, trained health professionals who possess a professional scope of practice, licensure, and/or credentials appropriate for responding to or managing the EnrolleeEnrollee’s needs. Examples of health professionals who may complete portions or all of the assessment include, but are not limited to: Registered nurses, Licensed practical nurses (under the supervision of registered nurses), Social workers, Medicaid case managers, Certified geriatric care managers, Certified community health workers The CICO CICO will use the results of the Comprehensive Assessment to confirm the appropriate acuity or risk stratification level for the Enrollee Enrollee and as the basis for developing the integrated ICP. The Enrollee Enrollee will continue to receive any community-based or facility- facility-based LTSS (i.e., respite care) in any existing waiver service plan(sWaiver Service Plan(s) prior to the Comprehensive Assessment or reassessment. The CICO CICO will adhere to all transition requirements for services, as outlined in Section 2.6.9.2.6.8..