gsa166a

Provision of easily understood information

AZ | AZBH | CA | CO | CT | DE | DC | FL | FLMH | IL | IA | IABH | KS | KY | ME | MD | MA | MI | MN | MO
MT | NE | NEBH | NV | NJ | NM | NY | ND | OK | PA | PABH | RI | SC | TN | TX | UT | UTMH | VA | WV | WI

"8. MEMBER INFORMATION...
The Contractor shall make every effort to ensure that all information prepared for distribution to members is written at a 4th grade level." Arizona Contract, page 21.

AZBH

"5. MEMBER HANDBOOK AND PROVIDER MANUAL
Member Handbook: ...
Every effort shall be made to ensure that all information prepared for distribution to members is written at a 4th grade level." Arizona Behavioral Health Contract, page 12.

"6.7.7.9 Health Education Reading Level
The Contractor will ensure that all plan materials used to communicate covered benefits are written at the appropriate reading level, as determined by the Contractor and approved by DHS." California Contract, page 131.

"6.9.9 Primary Care Physician Selection...
Contractor shall provide the Member sufficient information (verbal and written) in the appropriate language and reading level about the selection process and the available providers in the network, including certified nurse midwives and certified nurse practitioners, to ensure their ability to make an informed decision." California Contract, page 138.

"III. MARKETING…
D. Marketing Activities...
3. All marketing materials and new Member information, including Member Handbooks, shall be written at the sixth grade level, unless otherwise approved by the Department..." Colorado Contract, pages 16, 18.

"XVIII. MEMBER RIGHTS AND RESPONSIBILITIES...
D. Member Information…
2. Written information provided to Members shall be written at the sixth (6th) grade level, unless otherwise directed by the Department, translated into other languages, and provided in alternative formats as required in the Contract…" Colorad Contract, pages 58-60.

"3.28 Services to Members
a… All written materials and correspondence to Members shall be…written at no higher than a seventh grade reading level…" Connecticut Contract, page 38.

"STANDARDS FOR INTERNAL QUALITY ASSURANCE PROGRAMS FOR HEALTH PLANS...
Standard X: Enrollee Rights and Responsibilities...
H. Written information for members
1. Member information is written in prose that is readable and easily understood…" Connecticut Contract, pages 1-11.

"5.10.1 Member Handbook Reading Level
The member handbook and all other materials intended for use by the member, must be written at no higher than a sixth grade reading level. This can be checked using standard software packages which suggest changes to text so that the appropriate reading level is attained." Delaware RFP, page II.20

"4. Evidence of coverage
a. Within ten (10) business days of the date on which the District notifies Provider that an individual has been enrolled with Provider, Provider shall issue to each enrollee the following:...

(2) a Member Handbook written at the 5th grad reading level and containing at a minimum the following information:...

(5) a separate brochure explaining the EPSDT program at a 5th grade reading level which shall be pre-approved by the District and which lists all of the services available to children, clarifies that services are free, and that includes a telephone number which care givers can call to get assistance in scheduling an appointment and getting transportation." District of Columbia Contract, pages 16-18.

"11. Plan Materials. The plan shall ensure that all marketing, pre-enrollment, member, disenrollment, and grievance materials developed for the Medicaid population adhere to the following policies and procedures.
a. All materials developed for the Medicaid population must be at or near the fourth-grade comprehension level so that the materials are understandable (in accordance with Section 1932 (a)(5) of the Social Security Act as enacted by Section 4701 of the 1997 Balanced Budget Act), ..." Florida Contract, page 27.

FLMH

"2.16 Outreach Requirements...
In addition, the outreach plan shall provide for the following: ...
C. Outreach communications that are written at the fourth grade reading level…" Florida Mental Health RFP, page 40.

"(d) Language Requirements...
(2) Written Material
Written materials which are to be provided to Eligible Enrollees, Prospective Beneficiaries or Beneficiaries shall be easily understood by individuals who have a sixth grade reading level..." Illinois HMO Contract, page 8.

"4.12 Enrollee Information
All Enrollee Information shall be prepared in a manner which is clear and understandable to an individual who has completed no more than the sixth school grade…" Iowa Contract, page 30.

IABH

"48.0 OUTREACH TO IOWA PLAN ENROLLEES
Within 10 working days of the date enrollee information is provided to the Contractor, the Contractor shall provide the Medicaid enrollee(s) with information about the Iowa Plan. The information required shall be in a manner and form which may be easily understood by each enrollee and potential enrollee…" Iowa Behavioral Health Contract, page 33.

"O. MEMBER HANDBOOK…
The member handbook must be written at no higher than a sixth grade reading level." Kansas Contract, page 21.

"All written materials, including marketing, new member information, updates, and grievance and appeal information shall be geared toward persons who read at a sixth-grade level (as determined by the Department)…" Kentucky RFA, page 56.

"7.8.5 Member Information Materials
All written materials provided to Members, including marketing materials, new member information, and grievance and appeal information must be geared toward persons who read at a sixth-grade level, be published in at least a 14-point font size…" Kentucky RFA, page 59.

"C. MATERIALS PROVIDED TO MEMBERS
The Contractor shall comply with the following requirements for all written materials that it provides to Enrollees, whether the materials are prepared by the Contractor or by other entities: ...
3. all materials must be written at no higher than a 6th grade reading level..." Maine Contract, page 16.

"10.09.65.02...
H. An MCO:
(3) Shall prepare all publications, including, but not limited to, provider directories, enrollee handbooks, health education materials, and informational brochures: ...
(b) At an appropriate reading comprehension level…" Maryland COMAR 10.09.65.02.

".01 Access Standards: Addressing Enrollees' Individualized Needs.
A. An MCO shall provide access to health care services and information in a manner that addresses the individualized needs of its enrollees, including, but not limited to, the delivery of services and information to enrollees: …
(2) With all written materials produced by the MCO for distribution to its enrollees written at an appropriate reading comprehension level…" Maryland COMAR 10.09.66.01.

".02 Internal Grievance Process for Enrollees...
B. An MCO Shall: ...
(3) Prepare the document describing the MCO's internal grievance process…at a suitable reading comprehension level…" Maryland COMAR 10.09.71.02.

"2.3 Enrollment Activities…
G. Enrollee Outreach, Health Risk Assessment, Orientation, and Education
The Contractor shall: ...
4. Ensure, in accordance with 42 USC 1396u-2(a)(5), that all written information for use by Enrollees and potential Enrollees is prepared in a format and manner that is easily readable, comprehensible to its intended audience…" Massachusetts Contract, pages 25-36.

"II-S MARKETING...
3. Marketing Materials...
Materials must be written at no higher than 6th grade level as determined by any one of the following indices:
*Fry Readability Index
*PROSE The Readability Analyst (software developed by Education Activities, Inc.)
*Gunning FAG Index
*McLaughlin SMOG Index
*Other computer generated readability indices accepted by DCH…" Michigan Contact, pages 46-47.

"II-T MEMBER AND ENROLLEE SERVICES...
3. Member Handbook...
The handbook must be written at no higher than a sixth grade reading level…" Michigan Contract, pages 48-50.

"Section 3.2.3. Enrollment Materials.
F… All marketing materials, new Enrollee information, Complaint and Appeal information and other written information which are disseminated to Enrollees in the English language must be understandable to a person who reads at the seventh grade level, using the Flesch scale analysis readability score as determined under Minnesota Statutes, Section 72C.09…." Minnesota Contract, page 28.

"Section 8.1. Internal Complaint Process...
Section 8.1.4. Notice to Enrollees. Pursuant to Section 3.2.3.A.(6) of this Contract, the HEALTH PLAN shall inform all Enrollees in writing that is understandable to a person who reads at the seventh grade level and when possible, orally, of all Complaint and Appeal procedures available to them…" Minnesota Contract, page 78.

"Section 8.2.2. Form. Notification under Section 8.2.1. must be made by a denial/termination/reduction (DTR) notification form that has been approved in writing by the STATE. The notification form must contain a clear and detailed description in plain language of the basis for the denial, termination, or reduction and of the Enrollee's rights…" Minnesota Contract, page 80.

"n. Member Handbook: ...
o. The member handbook must be written at no higher than a sixth grade level…" Missouri RFP, page 42.

"2.8 ENROLLEE HANDBOOK...
In addition, such handbook shall be prepared shall be prepared in a manner which is clear and understandable to an individual to an individual who has completed no more than the eight school grade." Montana Contract, page 51.

"10.5 Goal: Marketing and educational materials that are developed in appropriate formats that meet the needs of the client, and that are available in a timely manner, and in adequate supply…

The workplan shall identify key enrollment information such as member and provider handbooks, description of the benefit package, member services, provider directories, specialty/ancillary services, etc. The workplan shall describe how the plan will determine the needs of the client, e.g., reading level...and that the materials are meeting the needs on an ongoing basis…" Nebraska Contract, page 51.

"11.2 Distribution of Informational and Marketing Materials: The EBS shall be responsible for the distribution of informational and marketing materials to the NHC client, as it relates to enrollment activities. The EBS shall ensure that any informational and marketing materials is completed in coordination with the plan and the Department and meet the following guidelines:
(b) All printed materials must be in an easily understandable format at a fourth grade reading level…" Nebraska Contract, page 60.

"11.3 Enrollment Activities: The EBS shall complete the following enrollment activities for mandatory clients (and also for potential mandatory clients, if requested), in coordination with the plan and the Department: ...
(b) Provide the client with brochures, written materials, etc., explaining the NHC that are easily understood by the client, and developed in ways appropriate to meet the needs of the client…" Nebraska Contract, pages 61-62.

"13.18.1 Client Information: The plan shall provide the following to each client enrolled with its plan:
(a) A client handbook that is easy to understand and includes policies and procedures to access care;
(b) Other Information about the NHC benefits that is easy to understand…" Nebraska Contract, page 84.

NEBH

"Goal: Marketing and educational materials that are developed in appropriate formats that meet the needs of the client, and that are available in a timely manner, and in an adequate supply.

10.5.1 Initial Measure: ...
The workplan shall describe how the PHP shall determine the needs of the client, e.g., reading level…" Nebraska Behavioral Health Contract, page 43.

"D. Participant Handbook…
The participant handbook must be written at no higher than a sixth grade reading level and approved by DHCFP. If more than ten percent (10%) of a Contractor's Medicaid participants in each geographic service area speak a language other than English as their first language, the Contractor must make available to the participant comparable written materials in that language. The Contractor will be responsible for effectively informing participants under EPSDT, regardless of any thresholds…" Nevada Contract, page 33.

"ARTICLE 12
ENROLLEE NOTIFICATION
12.1 Prior to the effective date of enrollment, the contractor shall provide each enrolled case or, where applicable, an authorized person, with a... member handbook, the content and format of which shall have the prior written approval of DMAHS, in writing…at the fifth grade reading level describing all services covered by the contractor, exclusions or limitations on coverage, the correct use of the contract's plan, and other relevant information…" New Jersey Contract, page 68.

"ARTICLE 15
QUALITY MANAGEMENT AND UTLIZATION REVIEW...
15.4 The contractor shall establish, implement, and adhere to a written Quality Management Program (QMP)...

15.6 The contractor's QMP shall include the following standards: ...
J. Enrollee Rights and Responsibilities, including: ...
8. Written information for enrollees must be readable and easily understood…" New Jersey Contract pages 76-79.

"Standards for Internal Quality Assurance Programs of HMOs, HIOs, and PHPs Contracting with Medicaid...
STANDARD X: ENROLLEE RIGHTS AND RESPONSIBILITIES - The organization demonstrates a commitment to treating members in a manner that acknowledges their rights and responsibilities...
H. Written information for members...
1. Member information (for example, subscriber brochures, announcements, handbooks) is written in prose that is readable and easily understood…" New Jersey Contract, pages 203-216.

"2.A.6.e Member Handbook...
Member handbooks shall be made available in formats other than written English… In addition, such language used shall be prepared in a manner which is clear and understandable to an individual who has completed no more than the sixth school grade." New Mexico Contract, page 21.

"2.A.1.g Member's Bill of Rights
The CONTRACTOR shall have a written policy which is approved by HSD and complies with any applicable ADA requirements…The policy will also set forth members' responsibilities and will be written at a language level understandable to the Medicaid population (sixth grade level)…" New Mexico Contract, page 6.

"Appendix D...
B. Marketing Materials...
2. Marketing Material Requirements
a) Marketing materials must be written in prose that is understood at a fourth-to sixth-grade reading level and must be printed in at least ten (10) point type." New York Contract, Appendix D, pages D-1-D-5.

"Appendix E
New York State Department of Health
Member Handbook Guidelines

Introduction...
General Format
Member handbooks must be written in a style and reading level that will accommodate the reading skills of many Medicaid recipients. In general the writing should be at no higher than a sixth-grade level, taking into consideration the need to incorporate and explain certain technical or unfamiliar terms to assure accuracy... The SDOH reserves the right to require evidence that a handbook has been tested against the sixth-grade reading-level standard…" New York Contract, Appendix E, pages E-1-E-2.

"2.15 Enrollee Handbook and Membership Card...
Enrollee handbooks shall be made available in languages...
In addition, such handbook shall be prepared in a manner which is clear and understandable to an individual who has completed no more the eighth grade." North Dakota Contract, Attachment C, pages 16-17.

"2.5.3 EPSDT Services...
Health Plans are required to perform the following services:
• Provide EPSDT materials in an easily understood format…" Oklahoma RFP, page 26.

"Marketing Communications...
• Marketing material should be written in a prose that is readable and easily understood. Every effort must be made to get the reading level at or below the 6th grade (Flesch-Kincaid Grade level of 6.0 or less)…" Oklahoma RFP, page 156.

"Provider Directories...
Provider Directories must be written in the 6th grade reading level…" Oklahoma RFP, page 166.

"D. MEMBER ENROLLMENT AND DISENROLLMENT...
12. Member Handbook...
a. Required Information
The Member handbook should be written at no higher than a fourth grade level…" Pennsylvania RFP, pages 20-29.

"E. MEMBER SERVICES...
3. Education and Outreach...
Consideration must be given to the educational needs of …functionally illiterate members…" Pennsylvania RFP, pages 35-36.

PABH

"3) The MCO must publish and distribute a member handbook to all members and make it available to other interested parties upon request. The handbook must be printed at no higher than a fourth grade reading level, delineating a member's rights and responsibilities, as well as covering: …" Pennsylvania Behavioral Health RFP, page 166a.

"2.05.14.01 Required Information
The member handbook must be written at no higher than a sixth-grade level …" Rhode Island RFP, page 17.

"7.1 Information Provided for Enrollment Process...
The Contractor shall be responsible for developing and distributing its own member specific marketing, educational and enrollment materials...All written material must be written at a grade level no higher than the fourth (4th) grade, or as determined appropriate by SCDHHS…" South Carolina Contract, pages 41-42.

"8.3.1 Enrollment Materials...
The enrollment materials must be approved by SCDHHS or its designee prior to distribution or use by the Contractor. The member handbook shall be written at a grade level no higher than fourth grade, 'or as determined appropriate by SCDHHS'...

8.3.2 Member Handbook
The Contractor shall provide each member with a member handbook and other written materials information. The member handbook shall be written at a reading comprehension level no higher than fourth (4th) grade...

8.4 Member's Rights and Responsibilities
The Contractor shall furnish Medicaid HMO Program members with both verbal and written information about the nature and extent of their rights and responsibilities as a member of the Contractor's plan. The written information shall be written at a reading comprehension level no higher than fourth (4th) grade, 'or as determined appropriate by SCDHHS.'…" South Carolina Contract, pages 45-46.

"MARKETING AND EDUCATIONAL MATERIALS AND ACTIVITIES...
SCDHHS has established the following minimum requirements for the Contractor's Medicaid managed care marketing/educational materials: ...
* All materials shall be reviewed and approved for readability, content, reading level and clarity by SCDHHS or its designee.
* The Contractor shall ensure that all written material will be written at a grade level no higher than the fourth (4) grade or as determined appropriate by DHHS." South Carolina Contract, Appendix J, pages 6-7.

"Guidelines for Internal Quality Monitoring Programs of Managed Care Organizations Contracting with TennCare…

STANDARD IX: ENROLLEE RIGHTS AND RESPONSIBILITIES -
The organization demonstrates a commitment to treating members in a manner that acknowledges their rights and responsibilities...

H. Written Information for Members -
1. Member information (for example, subscriber brochures, announcements, handbooks) is written in prose that is readable and easily understood…" Tennessee Contract, pages QCM 2-11.

"3.4 PLAN MATERIALS AND DISTRIBUTION OF PLAN MATERIALS...
3.4.2 Member materials must meet cultural and linguistic requirements as stated in Article VIII. Unless otherwise required, Member materials must be written at a 4th - 6th grade reading comprehension level…" Texas Contract, page 17.

"8.2 MEMBER HANDBOOK...
8.2.1 HMO must mail each newly enrolled Member a Member Handbook no later than five (5) days after HMO receives the Enrollment File. If the 5th day falls on a weekend or state holiday, the Member Handbook must be mailed by the following working day. The Member Handbook must be written at a 4th - 6th grade reading comprehension level…" Texas Contract, page 78.

"8.3 ADVANCE DIRECTIVES...
8.3.6 All materials provided to Members regarding advance directives must be written at a 7th - 8th grade reading comprehension level, except where a provision is required by state or federal law and the provision cannot be reduced or modified to a 7th- 8th grade reading level because it is a reference to the law or is required to be included “as written” in the state or federal law…" Texas Contract, pages 79-80.

"C. Marketing and Member Education...
2. Enrollee Materials Must be Comprehensible
The CONTRACTOR will attempt to write all Enrollee and potential enrollee information, instructional and educational materials, including member handbooks, at no greater than a sixth grade reading level…" Utah Contract, Attachment B, page 7.

UTMH

"5. Medicaid Enrollee Information...
b. Before implementation of the Contract, the CONTRACTOR will produce an informational brochure...
1) The CONTRACTOR will attempt to write all Enrollee information, instructional and educational materials, including the brochure at no greater than a sixth grade reading level…" Utah Mental Health Contract, page 10.

"C. MARKETING MATERIALS AND SERVICES...
1. Marketing Services
The Contractor shall...
g. All marketing materials shall set forth the Flesch readability scores and certify compliance therewith." Virginia Contract, pages 18-19.

"F. COMMUNICATION STANDARDS...
The Contractor shall ensure that documents for its membership, such as the enrollee handbook, are comprehensive, yet written to comply with readability requirements. For the purposes of this Contract, no program information document shall be used unless it achieves a Flesch total readability score of (40) or better. (These requirements shall not apply to language that is mandated by Federal or State laws, regulations or agencies)...

All marketing, enrollment and educational documents and materials made available to Medallion II enrollees by the Contractor must set forth the Flesch readability scores and certify compliance with the readability scores. This requirement shall not apply to language that is mandated by Federal or State laws, regulations, or agencies." Virginia Contract, pages 35-36.

"I. ENROLLEE EDUCATION PROGRAM
The Contractor must develop, administer, implement, monitor, and evaluate a program to promote health education services for its new and continuing Medallion II enrollees, as indicated below. For the purposes of this Contract, no program information document shall be used unless it achieves a Flesch total readability score of (40) or better. (These requirements shall not apply to language that is mandated by Federal or State laws, regulations, or agencies)…" Virginia Contract, page 62.

"3.15 Enrollee Handbook and Member Information...
Enrollee handbooks, (or substitute enrollee information approved by the Department which explains the Managed Care Plan's services and how to use the Managed Care Plan) shall be made available in formats other than written English...

In addition, such language used shall be prepared in a manner which is clear and understandable to an individual who has completed no more that the sixth school grade." West Virginia Contract, page 16

"II-4 ENROLLEE INFORMATION
Enrollee information provided by the MCO must be readable at the 6th grade level and easily understood…" West Virginia Contract, Exhibit F, page 8.

"4.1.2 Marketing Materials...
All marketing materials must be prepared at a reading level no higher that the sixth grade, and the MCP must certify to DHHR that its materials satisfy this requirement.16" West Virginia RFA, page 26.

"4.4.2 Member Handbooks
4.4.2.1 General Requirements...
The MCP must certify that the member handbook is written at no higher that a sixth grade level…" West Virginia RFA, page 32.

"2.1.2 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services...
2.1.2.1 Required Activities...
The MCP must inform all EPSDT eligible individuals (or their families) about the EPSDT program using clear and non-technical language…" West Virginia RFA, pages 7- 8.

"H. Written information for members
1. Member information is written in prose that is readable and easily understood…" West Virginia RFA, Appendix E, page E11.

"S. HEALTH EDUCATION AND PREVENTION...
Health related educational materials produced by the HMO must be at a 'sixth grade comprehension level' and reflect sensitivity to the diverse cultures served...

T. ENROLLE HANDBOOK and EDUCATION and OUTREACH FOR NEWLY ENROLLED RECIPIENTS-Within one week of initial enrollment notification to the HMO, mail to caseheads an enrollee handbook which is at the 'sixth grade comprehension level'…" Wisconsin Contract, pages 17-19.