Common use of Target Populations Clause in Contracts

Target Populations. (1) The PSN shall have Case Management services available to Children/Adolescents who have a serious emotional disturbance as defined as: a Child/Adolescent with a defined mental disorder; a level of functioning which requires two or more coordinated mental health services to be able to live in the community; and be at imminent risk of out of home mental health treatment placement. (2) The PSN must have case management services available for adults who: • Have been denied admission to a long-term mental health institution or residential treatment facility; or • Have been discharged from a long-term mental health institution or residential treatment facility. • Require numerous services from different providers and also require advocacy and coordination to implement or access services; • Would be unable to access or maintain consistent care within the service delivery system without case management services; • Do not possess the strengths, skills, or support system to allow them to access or coordinate services; The PSN will not be required to seek approval from the Department of Children and Families, District Substance Abuse and Mental Health (SAMH) Office for individual eligibility or mental health targeted case management agency or individual provider certification. The staffing requirements for case management services are listed below. Refer to section d. Additional Requirement For Case Management. (3) Mental health targeted Case Management services shall be available to all Enrollees within the principles and guidelines described as follows: (a) Enrollees, who require numerous services from different providers and also require advocacy and coordination to implement or access services are appropriate for Case Management services; (b) Enrollees who would be unable to access or maintain consistent care within the service delivery system without Case Management services are appropriate for the service; (c) Enrollees who do not possess the strengths, skills, or support system to allow them to access or coordinate services are appropriate for Case Management services; (d) Enrollees without the skills or knowledge necessary to access services may benefit from Case Management. Case Management provides support in gaining skills and knowledge needed to access services and enhances the Enrollee’s level of independence. (4) The PSN will not be required to seek approval from the DCF, District Substance Abuse and Mental Health Program Office for client eligibility or mental health targeted Case Management agency or individual provider certification. The staffing requirements for Case Management services are found in Section VII.E..7, Provider Network, Behavioral Health Services, in this Contract.

Target Populations. (1) The PSN shall have Case Management services available to Children/Adolescents who have a serious emotional disturbance as defined as: a Child/Adolescent with a defined mental disorder; a level of functioning which requires two or more coordinated mental health services to be able to live in the community; and be at imminent risk of out of home mental health treatment placement. (2) The PSN must have case management services available for adults who: • Have been denied admission to a long-term mental health institution or residential treatment facility; or • Have been discharged from a long-term mental health institution or residential treatment facility. • Require numerous services from different providers and also require advocacy and coordination to implement or access services; • Would be unable to access or maintain consistent care within the service delivery system without case management services; • Do not possess the strengths, skills, or support system to allow them to access or coordinate services; The PSN will not be required to seek approval from the Department of Children and Families, District Substance Abuse and Mental Health (SAMH) Office for individual eligibility or mental health targeted case management agency or individual provider certification. The staffing requirements for case management services are listed below. Refer to section d. Section VI, B.5.d., Additional Requirement For Targeted Case Management. (3) Mental health targeted Case Management services shall be available to all Enrollees within the principles and guidelines described as follows: (a) Enrollees, who require numerous services from different providers and also require advocacy and coordination to implement or access services are appropriate for Case Management services; (b) Enrollees who would be unable to access or maintain consistent care within the service delivery system without Case Management services are appropriate for the service; (c) Enrollees who do not possess the strengths, skills, or support system to allow them to access or coordinate services are appropriate for Case Management services; (d) Enrollees without the skills or knowledge necessary to access services may benefit from Case Management. Case Management provides support in gaining skills and knowledge needed to access services and enhances the Enrollee’s Enrollee‘s level of independence. (4) The PSN will not be required to seek approval from the DCF, District Substance Abuse and Mental Health Program Office for client eligibility or mental health targeted Case Management agency or individual provider certification. The staffing requirements for Case Management services are found in Section VII.E..7, Provider Network, Behavioral Health Services, in this Contract.Case

Target Populations. (1) The PSN Health Plan shall have Case Management services available to Children/Adolescents who have a serious emotional disturbance as defined as: a Child/Adolescent with a defined mental disorder; a level of functioning which requires two or more coordinated mental health services to be able to live in the community; and be at imminent risk of out of home mental health treatment placement. (2) The PSN health plan must have case management services available for adults who: • Have been denied admission to a long-term mental health institution or residential treatment facility; or • Have been discharged from a long-term mental health institution or residential treatment facility. • Require numerous services from different providers and also require advocacy and coordination to implement or access services; • Would be unable to access or maintain consistent care within the service delivery system without case management services; • Do not possess the strengths, skills, or support system to allow them to access or coordinate services; The PSN health plan will not be required to seek approval from the Department of Children and Families, District Substance Abuse and Mental Health (SAMH) Office for individual eligibility or mental health targeted case management agency or individual provider certification. The staffing requirements for case management services are listed below. Refer to section d. Additional Requirement For Case Management. (3) Mental health targeted Case Management services shall be available to all Enrollees within the principles and guidelines described as follows: (a) Enrollees, who require numerous services from different providers and also require advocacy and coordination to implement or access services are appropriate for Case Management services; (b) Enrollees who would be unable to access or maintain consistent care within the service delivery system without Case Management services are appropriate for the service; (c) Enrollees who do not possess the strengths, skills, or support system to allow them to access or coordinate services are appropriate for Case Management services; (d) Enrollees without the skills or knowledge necessary to access services may benefit from Case Management. Case Management provides support in gaining skills and knowledge needed to access services and enhances the Enrollee’s level of independence. (4) The PSN Health Plan will not be required to seek approval from the DCF, District Substance Abuse and Mental Health Program Office for client eligibility or mental health targeted Case Management agency or individual provider certification. The staffing requirements for Case Management services are found in Section VII.E..7, Provider Network, Behavioral Health Services, in this Contract.