| I. PURPOSE
| | To establish and coordinate transitional care service for Members between the Los Angeles County Department of Mental Health, the local Mental Health Plan (MHP), and Los Angeles County Managed Care Plans (MCPs).
Contracted agencies shall develop an internal policy and associated procedures that are consistent with their organizational practices and meet the requirements set forth in this policy. | | II. DEFINITIONS
| | Member: An eligible Medi-Cal beneficiary who is enrolled in a Medi-Cal Managed Care Plan (MCP).
Enhanced Care Management (ECM): A Medi-Cal managed care benefit that addresses clinical and non-clinical needs of high-need individuals through the coordination of services and comprehensive care management.
Managed Care Plan (MCP): State contracted health plan that delivers Medi-Cal benefits to enrollees under a managed care network of providers.
Mental Health Plan (MHP): A County Mental Health Plan that is responsible for providing specialty mental health services.
Managed Care Plan Providers: Entities that deliver services to the beneficiary under their assigned MCP.
Transitional Care Service: The transfer of a Member from one setting or level of care to another, including, but not limited to, discharges from hospitals, institutions, and other acute care facilities and skilled nursing facilities to home or community-based settings, or transitions from outpatient therapy to intensive outpatient therapy.
| | III. POLICY
| | Collaboration and Consultation: - MHP and MHP Contracted Providers will work with MCP to provide clinical consultations regarding a Member’s mental illness, including consultation on diagnosis, treatment, and medications.
- MHP and MHP Contracted Providers will work with MCP when MHP is the primary payer and responsible for service coordination for the Member upon discharge for Members who are admitted to an acute psychiatric hospital, psychiatric health facility, adult residential, or crisis residential stay, including, but not limited to, Short-Term Residential Therapeutic Programs and Psychiatric Residential Treatment Facilities.
![]() MHP and MHP Contracted Providers will coordinate with MCP to update and oversee the implementation of the discharge planning documents as required for Members transitioning to or from MCP or DMH/MHP services including notifications to one another within 24 hours of admission and discharge.
| | IV. PROCEDURES
| | There are no procedures.
Please see DMH Procedures-302.15 which are associated with this policy.
| | V. AUTHORITIES
| | | | VI. ATTACHMENTS
| | There are no attachments associated with this policy. | |
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