Code part CO: Commendation 630/Contract/ COMMENT KEY: R: Recommendation EVALUATION NOT EVALUATION ITEM C-Stone MET N/A RQ: Required (typed bold) MECHANISM MET Quarterly Reports APORS High Risk Case Management: Includes all service components of case management, emphasizing compliance with the recommendations regarding the high-risk conditions(s), and MUST be performed by the RN case manager. 630.20E monitoring. At least annually, appropriate professional health personnel of the Division and its consultants shall review each project for appropriateness of services and quality of care furnished to recipients in accordance with the project plan Code: Policy & Eligibility 630.220e7 Procedures High Risk Case Management eligibility is determined by: Contract Cornerstone when identified through the Adverse Observation Pregnancy Outcome Reporting System or by agency defined conditions Interview with Meets medical criteria without infant assigned CM discharge referral/record (HRIF) HRIF Manual IDPH Electronic referral system PA15 Screens consistently monitored appropriately. Direct service staff for the APORS Program must be a Registered Nurse; proof of current license
EVALUATION ITEM Code part 630/Contract/ C-Stone Quarterly Reports EVALUATION MECHANISM MET NOT MET N/A CO: Commendation COMMENT KEY: R: Recommendation RQ: Required (typed bold) APORS High Risk Case Management: Includes all service components of case management, emphasizing compliance with the recommendations regarding the high-risk conditions(s), and MUST be performed by the RN case manager. 630.20E monitoring. At least annually, appropriate professional health personnel of the Division and its consultants shall review each project for appropriateness of services and quality of care furnished to recipients in accordance with the project plan Eligibility High Risk Case Management eligibility is determined by: when identified through the Adverse Pregnancy Outcome Reporting System or by agency defined conditions Meets medical criteria without infant discharge referral/record (HRIF) IDPH Electronic referral system consistently monitored appropriately. Code: 630.220e7 Contract Policy & Procedures Cornerstone Observation Interview with assigned CM HRIF Manual PA15 Screens Direct service staff for the APORS Program must be a Registered Nurse; proof of current license
FY18_APOR-HRIF_Clinical_Review_Tool_Final-5-23-2017.docx