BANNER ATTACHMENT A (FINAL).DOCX.PDF

DocuSign Envelope ID: 4AD76A36-779C-4877-9EFA-83B23A9E26E5
Attachment A
MARICOPA COUNTY CORRECTIONAL HEALTH SERVICES
AND BANNER UNIVERSITY HEALTH PLANS
I. Background
The Maricopa County Correctional Health Services (CHS) enhances community safety
by working in a collaborative partnership with AHCCCS, Banner University Health Plans
(BUHP) and its contracted providers to provide research-based prevention and
intervention services. BUHP’s contracted providers deliver a range of health care services
and treatment programs for adults and youth with physical health needs, serious mental
illness and other mental health and/or substance use disorders.
To facilitate the transition of members transitioning out of jails and back into our
community, collaboration between CHS and BUHP is critical to reentry activities.
Specifically, BUHP will collaborate with CHS to accomplish “reach-in” care
coordination for members who have been incarcerated in the Maricopa County Jail for 30
days or longer and have an anticipated release date. “Reach-in” care coordination
activities shall begin upon knowledge of a member’s anticipated release date. Care1st will
collaborate with CHS to identify justice-involved members with physical and/or
behavioral health chronic and/or complex care needs prior to member’s release.
II. Data Sharing and Coordination
BUHP and CHS will partner to:
a) Communicate timely data necessary for coordination of care in conformance with all
applicable administrative orders, state laws and regulations, 42 CFR Part 2, and
Health Insurance Portability and Accountability Act (HIPAA) requirements that
permit the sharing of written, verbal and electronic information, and
b) Utilize data sharing agreements and administrative orders that permit the sharing of
written, verbal and electronic information at the time of admission into the facility
and at the time of discharge.
III. Collaborative Protocols
When BUHP becomes aware that a member is incarcerated, and is subject to the “Reach-
In” requirements, described above:
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DocuSign Envelope ID: 4AD76A36-779C-4877-9EFA-83B23A9E26E5
1. The BUHP Point of Contact or designee will complete a Justice Transition Form (JTF)
for members with designated chronic conditions and send the JTF to CHS:
a. CHS will confirm diagnosis/chronic condition in TechCare.
b. CHS will complete the CHS section of the JTF and return it to BUHP – scan it
into TechCare.
2. If CHS identifies newly diagnosed chronic care conditions, CHS will complete a JTF
and send it to the BUHP Point of Contact or designee.
3. If member has a diagnosis of HIV+, Medication Assisted Treatment (MAT), or
Substance Use/Misuse, the member’s written consent to release and share information
must be completed and uploaded into TechCare prior to disclosure of the member’s
identifying information.
4. If member is in jail 30 days or more, the BUHP Point of Contact or designee will
initiate a video or in person visit with the member.
5. An Appointment will be made with member’s Primary Care Physician (PCP) to occur
within 7 days of release.
6. The BUHP Point of Contact or designee will forward to CHS an “Introduction Letter,”
via secure email, with the following information:
a. Appointment day/time
b. Clinic name and location
c. Health Plan Point of Contact (or designee) contact information
7. CHS will place this introduction letter into the member’s property which will be
provided upon jail release.
8. CHS and the BUHP Point of Contact or other health staff may coordinate special
needs prior to jail release (such as courtesy release, medical equipment, or specific
medications).
IV. Provide mechanisms for communication and resolving problems
CHS and BUHP will have quarterly steering committee meetings to build and
strengthen relationships and address any problems or conflicts. Additionally, BUHP
will identify and extend invitations to CHS, to provider level meetings appropriate
for CHS participation.
Meetings shall include opportunities for agency cross-training and for identifying,
communicating and resolving problems to increase understanding and knowledge of
each other's mission, goals and how, through agency collaboration, members are
provided identified services to improve their health and well-being and reduce
recidivism.
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BUHP and CHS will work together to ensure processes from both agencies are being
practiced. On-going improvement efforts will focus on reducing redundancies and
providing timely, accurate and relevant information to coordinate services and
evaluate outcomes of those services.
BUHP and CHS will identify key staff who have the authority to assist with disputes
and find resolutions based on the agreements and best interest of the populations
jointly served. If necessary, this may include the BUHP Chief Medical Officer (or
designee) and the CHS Mental Health Director. Meetings shall include opportunities
to report identified gaps and discuss and act on resolutions.
V. Identify and address joint training needs
BUHP and its contracted providers and CHS will provide cross training opportunities as
mutually agreeable needs are identified.
____________________________________ ____________
CHS Authorized Signature Date
___________________________________
Title
5/15/2019 ____________
Banner University Health Plans Signature Date
____________________________________ VP and CEO
Title
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