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SHJ25-009 fully executed document
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2025-06-17 10:00 AM - Commissioners' Agenda
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SHJ25-009 fully executed document
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Last modified
9/17/2025 3:19:55 PM
Creation date
9/17/2025 3:19:18 PM
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Template:
Meeting
Date
6/17/2025
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Fully Executed Version
Supplemental fields
Item
Request to Approve Agreement SHJ25-009 Community Health Plan of Washington - 1115 Medicaid Re-Entry Initiative
Order
16
Placement
Consent Agenda
Row ID
132242
Type
Contract
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Docusign Envelope lD: CEBC6B3C-DFA1-4BOC-AFE8-6A4A63440086 <br />2.3.6.I Facility's inpatient and emergency services shall be available 24-hours-a-day, <br />seven-days-a-week. All other services shall be available during Facility's regular <br />business hours. <br />2.3.6.2If applicable, Facility shall assure that transitional health care by a home care <br />nurse or home care registered counselor occurs within seven (7) calendar days of <br />discharge from inpatient or institutional care for physical or behavioral health disorders <br />or discharge from a substance use disorder treatment program, if ordered by the Primary <br />Care Provider or as part of the discharge plan. <br />2.3.6.3 Facility shall make best efforts to refer Members to other Participating Providers <br />for Covered Services as Medically Necessary and appropriate when such Covered <br />Services are not available from Facility. <br />2.3.6.4 Facility shall provide written notification to CHPW pursuant to Section 7.6.1 at <br />least thirty (30) days prior to any change expected to significantly affect the delivery of <br />Covered Services or performance of duties hereunder. <br />2.3-6.5 CHPW will monitor Member access to and availability of Covered Services and <br />inform Facility of significant concerns or Member complaints about access to or <br />availability of Covered Services. <br />2.3.7 Facility is responsible for its relationship with each Member it treats and shall be solely <br />responsible for the quality of health care services provided to Members. Facility shall <br />maintain a quality improvement system (i) tailored to the nature and types of Covered <br />Services provided hereunder, (ii) which affords quality control for health care provided, <br />including Covered Services, and (iii) provides for free exchange of information between <br />CHPW and Facility. <br />2.3.8 Facility shall require providers to obtain Members' written informed consent prior to <br />treatment. <br />2.3.8.1Without regard to Benefit Plan limitations or cost, Facility and Facility-Based <br />Providers shall communicate freely and openly with Members (i) about their health <br />status, and treatment altematives (including medication treatment options); (ii) about <br />their rights to participate in treatment decisions (including refusing treatment); and (iii) <br />provide them with access to all relevant information to assist them in making informed <br />decisions about their health care. <br />2.3.8.2If applicable, Facility shall assure that all sterilizations and hysterectomies <br />performed for Members are in compliance with 42 CFR 441 Subpart F, and that the <br />Washington State Health Care Authority ("HCA") Sterilization Consent form HCA 13- <br />364 or its equivalent is used. No payment shall be made under state sponsored Benefit <br />Plans for sterilization procedures and hysterectomies that do not comply with the <br />requirements of this paragraph. <br />2020 F acility Agmt - Template Page 5 of51 Contract #5908-662684
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