COMMUNITY MEDICAL ALLIANCE CLINICAL PROGRAMS (CY2000-2001)
For the CMA Model: MD/NP primary care teams; different benefits, different
HMO Management system, including specialized member services, primary care team
orders rather than request services, specialized network.
In addition, children/adolescents with severe BH problems are served through
NHP’s MHSPY Program. This model utilizes a SW rather than a NP.
Current (By Population):
Advanced HIV/AIDS = 230 enrolled; adjusted capitation; 14 primary care sites,
and uses the CMA Model.
Adults – Severe Disability = 220 enrolled; adjusted capitation; 3 primary
care sites, and uses the CMA Model.
Adult MR/DD = 40 enrolled; NO adjusted capitation; 2 primary care sites, and
uses the CMA Model.
Medically complex members at primary care sites = 80 enrolled; NO adjusted capitation;
3 primary care sites (Plans underway to expand third site; see Brightwood above.),
and uses the MD/NP Teams Clinical Model.
Severely disabled/ chronically ill children = 21 enrolled; adjusted capitation;
13 primary care sites, and uses the CMA Model (Pediatric).
Planned 2000-2001 (by Population):
Brightwood CHC (1800 TANF, 800 SSI disabled, 330 General Relief) = 2900 enrolled;
NO adjusted capitation; 1 primary care site, and uses the CMA Model with Medical
Outreach/ Health Educator augment.
Behavioral Health Intensive Case Management Program = <blank> enrolled;
NO adjusted capitation; unknown primary care sites, and uses the CMA Model with
Psych RN in lead.
Children with Special Health Care Needs = all information TO BE DETERMINED