Care Coordination Requirements
(2)For the purpose of OARs 410-141-3860 (Integration and Coordination of Care) – 410-141-3870 (Intensive Care Coordination), the following meanings apply:
(a)“Health Risk Screening” means:
(A)A systematic collaborative approach by the CCO and provider to collecting information from a Member about key areas of their health for the purpose of:
(i)Assessing the Member’s health,
(ii)Evaluating the Member’s level of health risk, and
(iii)Providing the Member with individualized feedback about the results of the screening and evaluation with the goal of motivating behavioral changes to reduce health risks, maintain health, and prevent disease.
(B)Results of the Health Risk Screening shall be documented in the member’s care plan.
(C)Health Risk Screenings are usually administered through a survey or questionnaire. Suggested areas of information to collect include questions, depending on the Member’s age, regarding:
(i)Demographics, such as age, gender, relationship status;
(ii)Lifestyle behaviors, such as exercise, eating habits, alcohol and tobacco use, activities of daily living;
(iii)Living Conditions such as access to food, housing and related living conditions;
(iv)Behavioral/emotional health, such as stress, mood, life events, abuse;
(v)Physical health, such as weight, height, blood pressure; and
(vi)Personal and family health history.
(b)“Intensive Care Coordination (ICC) Assessment” means the utilization of standardized tools, instruments, or processes for the purpose of identifying, and creating individual, personalized treatment and service plans to address the specific physical, behavioral, oral, and social needs of Priority Population Members, as well as other Members who have been identified, as a result of their Health Risk Screenings, as potentially in need of ICC Services, or having experienced a triggering event as set forth in OAR 410-141-3870 (Intensive Care Coordination)(9).
Rule 410-141-3865 — Care Coordination Requirements,