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Pilot providers. The streamlined communication process minimizes delays and ensures that members receive services efficiently. Member Eligibility Process The member eligibility process begins with a detailed assessment conducted upon referral. Licensed clinical staff evaluate the individual’s medical and social conditions, verifying alignment with the program’s criteria. If deemed eligible, the state designated administrative point of contact ensures that the member’s information is updated and shared with MCOs and care providers. Eligibility is reassessed periodically throughout the member’s stay to ensure that services remain appropriate to their evolving needs. This ongoing evaluation safeguards resources while maintaining high-quality care. Managed Care Organization Requirements MCOs play a pivotal role in the Recuperative Care Pilot by coordinating care and facilitating seamless transitions between medical and social services. They are required to integrate recuperative care into their service offerings, collaborating closely with Kentucky Medicaid and Recuperative Care Pilot providers. MCOs must also track outcomes and report utilization metrics, ensuring accountability and continuous improvement of the program. Information Transparency on Kentucky DMS Website To promote transparency and accessibility, Kentucky DMS provides comprehensive information about the Recuperative Care Pilot on its official website. This includes eligibility criteria, clinical and social risk criteria, program requirements, and details on the administrative processes. By maintaining a centralized repository of information, Kentucky DMS empowers providers, MCOs, and members to understand the program’s scope and navigate its processes effectively. This open communication fosters trust and ensures consistent application of clinical criteria across the state. Through these administrative and clinical processes, the TEAMKY Recuperative Care Pilot ensures that Medicaid members receive appropriate, patient-centered care while maintaining efficiency and accountability in service delivery. This approach reflects Kentucky’s commitment to addressing health-related social needs and improving outcomes for its most vulnerable populations. Member Medical Record Documentation and Secure Data Exchange via KHIE DMS is implementing a robust process for gathering member medical record documentation and ensuring secure data exchange through the KHIE. This process supports the TEAMKY Recuperative Care Pilot by enabling efficient communication among providers, MCOs, and other community partners. These efforts are essential to ensure high-quality, coordinated care for Medicaid members experiencing homelessness or at risk of homelessness.