Cov Lus Nug Txog Kev Daws Teeb Meem
1. Cov kauj ruam thawj zaug uas Managed Care Plan (MCP) thiab Lub Koom Haum Sab Nraud yuav tsum ua yog tias lawv muaj kev tsis sib haum xeeb los ntawm Daim Ntawv Cog Lus Nkag Siab (MOU) yog dab tsi?
Yog tias muaj kev tsis sib haum xeeb ntawm MCP thiab Lub Koom Haum Sab Nraud, txhua tus neeg muaj lub luag haujlwm ua tiav lawv cov luag haujlwm raws li MOU yam tsis muaj kev ncua sijhawm, suav nrog kev muab kev pabcuam rau Cov Tswv Cuab raws li MOU.
Cov MCPs yuav tsum ua haujlwm koom tes nrog Lub Koom Haum Sab Nraud los tsim cov txheej txheem daws teeb meem thiab cov sijhawm uas yuav tsum tau teev tseg hauv MOU. Cov txheej txheem daws teeb meem yuav tsum hais txog seb MCP yuav ua haujlwm nrog Lub Koom Haum Sab Nraud li cas los daws cov teeb meem ntsig txog cov tog neeg lub luag haujlwm rau kev them nqi thiab kev them nqi rau cov kev pabcuam, thiab kev ua haujlwm ntawm kev tswj hwm kev saib xyuas rau cov Tswv Cuab tshwj xeeb, lossis lwm yam kev txhawj xeeb ntsig txog cov kev pabcuam uas tau muab rau cov Tswv Cuab. Saib ntu Qauv Tseem Ceeb "Kev daws teeb meem tsis sib haum xeeb" kom tau ib qho piv txwv ntawm cov lus uas yuav tsum tau muaj.
Cov ntaub ntawv hais txog cov kev cai tshwj xeeb rau kev daws teeb meem kev tsis sib haum xeeb ntawm Bespoke MOU tuaj yeem pom nyob rau hauv ntu Cov Lus Nug Txog Cov Qauv Tshwj Xeeb ntawm Cov Lus Nug Nquag. Cov ntaub ntawv hais txog Kev Daws Teeb Meem tuaj yeem pom hauv
APL 21-013 thiab
BHIN 21-034.
2. Yog tias MCP thiab Lub Koom Haum Sab Nraud tsis daws qhov kev tsis sib haum xeeb sab hauv, yuav ua li cas?
Yog tias ob tog tsis tuaj yeem daws qhov kev tsis sib haum xeeb raws li lawv cov txheej txheem thiab lub sijhawm uas tau pom zoo hauv MOU, ib tog twg tuaj yeem xa ib daim ntawv "Thov Kev daws teeb meem" rau Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS). Lub Koom Haum Sab Nraud tuaj yeem xa cov lus tsis sib haum xeeb mus rau nws lub koom haum saib xyuas (piv txwv li, California Department of Publich Health (CDPH), California Department of Social Services (CDSS), thiab California Department of Developmental Services (CDDS)). Yog tias MCP xa Daim Ntawv Thov Kev Daws Teeb Meem, nws yuav tsum tau kos npe los ntawm Tus Thawj Coj Saib Xyuas Kev Ua Haujlwm (CEO) ntawm MCP lossis tus neeg sawv cev ntawm CEO. Yog tias Daim Ntawv Thov Kev Daws Teeb Meem raug xa los ntawm Lub Koom Haum Sab Nraud, nws yuav tsum tau kos npe los ntawm tus neeg sawv cev raug cai ntawm Lub Koom Haum Sab Nraud. Yog tias Lub Koom Haum Sab Nraud xav tshuaj xyuas thiab kos npe rau txhua qhov Kev Thov Kev Daws Teeb Meem uas MCP xa tuaj, cov tog neeg yuav tsum suav nrog qhov yuav tsum tau ua no hauv lawv daim MOU uas tau ua tiav.
MCP daim ntawv thov kev daws teeb meem rau DHCS yuav tsum muaj xws li:
- Ib daim ntawv qhia txog qhov teeb meem uas muaj kev tsis sib haum xeeb thiab ib daim ntawv qhia txog cov kev kho uas xav tau, suav nrog txhua yam kev pabcuam uas tau muaj lossis xav tias yuav muab rau ib tug Tswv Cuab;
- Keeb kwm ntawm kev sim daws qhov teeb meem nrog Lub Koom Haum Sab Nraud;
- Kev piav qhia txog qhov kev kho mob uas xav tau; thiab
- Cov ntaub ntawv ntxiv uas cuam tshuam txog kev daws qhov teeb meem tsis sib haum xeeb, yog tias siv tau, suav nrog cov ntaub ntawv uas DHCS lossis lub koom haum saib xyuas ntawm Tog Neeg Thib Peb thov.
Ib tog twg los tau xa Daim Ntawv Thov Kev Daws Teeb Meem mus rau DHCS ntawm email ruaj ntseg mus rau
DHCS, koom tes nrog lub chaw haujlwm cuam tshuam nrog kev saib xyuas Lub Koom Haum Sab Nraud raws li qhov tsim nyog, yuav qhia qhov kev txiav txim siab zaum kawg rau MCP thiab Lub Koom Haum Sab Nraud, suav nrog txhua yam kev nqis tes ua uas MCP yuav tsum ua los ua kom tiav qhov kev txiav txim siab.
