Children of Migrant Farm Workers

CHAPTER PAGE HHSCHHSC UNIFORM Uniform MANAGED Managed Care CARE MANUAL MANUAL 12.2 1 of 3

EFFECTIVE DATE CHILDREN OF MIGRANT FARMWORKERS June 1, 2016 PLAN TEMPLATE Version 2.1

DOCUMENT HISTORY LOG DOCUMENT EFFECTIVE STATUS1 DESCRIPTION3 REVISION2 DATE

Initial version Uniform Managed Care Manual Chapter Baseline 1.0 September 1, 2007 12.2 Farmworker Children Plan Template

Chapter 12.2 is modified to add questions 3 and 5 and Revision 1.1 September 1, 2010 to renumber the remaining questions.

Revision 2.0 applies to contracts issued as a result of Revision 2.0 November 15, 2015 HHSC RFP numbers 529-10-0020, 529-12-0002, 529- 13-0042, and 529-13-0071.

Revision 2.1 applies to contracts issued as a result of HHSC RFP numbers 529-10-0020, 529-12-0002, 529- Revision 2.1 June 1, 2016 12-0003, 529-13-0042, and 529-13-0071. Template is modified to add Dental Plans.

1 Status should be represented as “Baseline” for initial issuances, “Revision” for changes to the Baseline version, and “Cancellation” for withdrawn versions 2 Revisions should be numbered according to the version of the issuance and sequential numbering of the revision—e.g., “1.2” refers to the first version of the document and the second revision. 3 Brief description of the changes to the document made in the revision. CHAPTER PAGE HHSC UNIFORM MANAGED CARE MANUAL 12.2 2 of 3

HHSC Medicaid Managed Care Organizations/Dental Plans

PLAN TO IDENTIFY AND PROVIDE SERVICES TO CHILDREN OF MIGRANT FARMWORKERS

MCO/Dental Plan:

Program(s) covered by the Plan:

Date the Plan was developed:

Date the Plan last revised (if applicable):

1. Describe the methods that will be used to identify the community and statewide groups that work with Farmworker Children in your area:

2. Describe the methods that will be used to identify Farmworker Children enrolled in your health/dental plan whose primary residence is located in your area:

3. Describe the methods that will be used in validating the Farmworker Children identified through the Texas Education Agency migrant match process: Question 3 Added by Version 1.1

4. Describe the methods that will be used to assess healthcare service needs of Farmworker Children, including need for and provision of accelerated services based on the migration patterns of the family:

5. Describe the methods that will be used in identifying the actual number of Farmworker Children who have received accelerated medical or dental services and those who have not Question 5 and the reasons they have not received accelerated medical or dental services: Added by Version 1.1 CHAPTER PAGE HHSC UNIFORM MANAGED CARE MANUAL 12.2 3 of 3

6. Describe the methods that will be used to ensure service or care coordination during transitions for the family:

7. Describe the methods that will be used to provide outreach and information about Medicaid services to the Migrant Farmworkers with children enrolled in your health/dental plan:

8. Described the methods that will be used to provide timely THSteps check ups and follow-up care to Farmworker Children enrolled in your health/dental plan:

9. Describe the methods that will be used to arrange for accelerated services to Farmworker Children enrolled in your health/dental plan:

10. Describe the methods that will be used to arrange for continuity of care for Farmworker Children enrolled in your health/dental plan as they prepare to migrate:

11. Describe the method(s) that will be used to maintain accurate lists of the Farmworker Children enrolled in your health/dental plan:

12. Describe the method(s) that will be used to maintain confidentiality of the information obtained about Farmworker Children enrolled in your health/dental plan: