FL
"Q. Reporting
Critical Incident
The plan must
report critical incidents as required in section W.7., of this attachment.
This requirement is in addition to critical incident reporting required
by state statutes…" Florida Contract, page 181.
"7. Critical
Incident Reporting
a. The
plan must report immediately, upon learning of such events, in addition
to the requirements under state law for incident reporting to appropriate
state authority, to the agency and the appropriate district ADM office,
the following events if such occur:
(1)
Client violent death.
(2)
Client death that appears to have resulted from suicide.
(3)
Client escape (from protective custody).
(4)
Client death as a result of a confirmed and locked report of abuse, neglect
or exploitation.
(5)
Client death, as a result of a suicide or homicide as determined by final
findings of the appropriate medical examiner's office.
(6)
Client death, as a result of drug overdose or an automobile accident in
which legally defined intoxication is found to be a causative factor as
determined by formal, findings of the appropriated medical examiner's office.
(7)
Client abuse, neglect, or exploitation, where an DCF client is the subject
of a confirmed and locked abuse, neglect, or exploitation report…if the
case involves confirmed/locked abuse, neglect or exploitation finding against
a staff person, the matter is to be reported...
(8)
Client-to-client sexual assault, where it is determined to be a reportable
event by the district as evidenced by criminal charges being filed against
an alleged perpetrator or other clear and convincing evidence that leads
the district to conclude that an assault took place...
b. The
plan must report ... to the agency...
(1)
Client suicide attempt.
(2)
Client altercations requiring medical intervention (residential only).
(3)
Client escape (residential only)
(4)
Client elopement (residential only)..." Florida Contract, pages 184-185.
IA
"4.16
Medical Records...
The HMO shall
file a letter with the Commissioner of Insurance as described in Iowa Code
section 228.7 regarding disclosure of mental health information."
Iowa Contract, pages 33-34.
MA
"APPENDIX A:
REPORTING REQUIREMENTS...
SECTION 2:
REPORTING SPECIFICATIONS...
E. Behavioral
Health (BH) Program...
1. BH
Category One Incidents
Daily, the
Contractor shall provide a written report of BH Category One Incidents
for hospitalized Enrollees on the same day of such BH Category One Incident...
2. BH
Category Two Incidents
The day following
the BH Category Two Incident, the Contractor shall provide a written report
of the BH Category two Incident for Enrollees within 24 hours of such BH
Category two Incident...
3. Administrative
Operations/BH Clinical Referral Line Statistics
The Contractor
shall quarterly report on Behavioral Health calls received on the Behavioral
Health Programs clinical referral line relative to MassHealth Members or
services and for each separate telephone line monthly, quarterly and annually:
...
11. Behavioral Health Intensive Clinical Management (ICM)
Semi-annually,
the Contractor shall report for the ICM program:
1. The
average administrative and Behavioral Health Service cost stratified by
Enrollee age and sex;
2. Average
duration of participation in the ICM by calendar weeks…" Massachusetts
Contract, Appendix A, pages 1-8.
MABH
"Section 5 of
Appendix A of the Contract is amended by inserting the following new Section
5.1.3.G...
Section 5.1.3.G.:
Performance Incentives, Penalties, and Initiatives: Provisions and Standards...
SERVICES/SYSTEM
INTERACTION
5. Medication
Monitoring - The Contractor shall measure the percentage of adult mental
health inpatient discharge events followed by a medication appointment
within 14 business days of discharge…" Massachusetts MH/SAP Contract,
Amendment 6, page 4.
MO
"2.19.3
Quality Assessment and Improvement Report: ...
a. The
health plan must agree to make available on a periodic basis clinical outcome
data in areas of concern to the State, such as asthma rates, immunization
rates, EPSDT/HCY rates, pre-natal care rates, lead screening rates and
behavioral health status. In order to provide this information for
behavioral health status, required assessment protocols and outcome standards
will be provided at a later date. These tools will focus on measuring
symptom reduction and level of functioning." Missouri RFP, page 86.
ORMH
"CLIENT PROCESS
MONITORING SYSTEM
The Process
Monitoring System(CPMS) tracks community-based treatment services for persons
with mental illness, persons with developmental disabilities, and persons
with substance abuse problems…This information allows the Division to manage
publicly funded mental health services, respond to legislative inquiries,
and demonstrate cost effectiveness under the federal requirement for the
OHP Medicaid Demonstration Project and Children's Health Program.
1. General
Provisions:
a. Contractor
shall submit CPMS data for OMAP Members receiving Covered Services who
meet one or more of the following conditions:
(1)
The OMAP Member is functionally impaired, as defined below, or would be
at such risk for such impairment without Medication or support services.
(a) Functional impairment shall be determined by the DSM-IV, Axis
5 Global Level of Level of Functioning (GAF) for adults and CGAS.
(b) A GAF score of 1-60 shall result in an OMAP Member who is an
adult or adolescent 18 or more years of age being registered in the
CPMS.
(c) A CGAS score of 1-50 shall result in an OMAP Member who is a
child or adolescent under 18 years of age being registered in the CPMS.
(2)
The OMAP Member has had nine or more mental health Encounters within 60
calendar days.
(3)
The OMAP Member is civilly committed to the custody of the Division under
ORS 426.130." Oregon Mental Health Contract, Exhibit E, page E1.