Code of Massachusetts Regulations
105 CMR - DEPARTMENT OF PUBLIC HEALTH
Title 105 CMR 173.000 - Mobile Integrated Health Care and Community Ems Programs
Section 173.040 - Minimum Requirements for MIH Program Approval
Universal Citation: 105 MA Code of Regs 105.173
Current through Register 1531, September 27, 2024
(A) A complete application for MIH Program Approval shall, at a minimum:
(1) Identify
and validate one or more gaps in service delivery using data and a
corresponding community health needs assessment;
(2) Describe how the proposed MIH Program
would address identified gaps in service delivery and provide improvements in
quality, access, and cost effectiveness, an increase in patient satisfaction,
improvement in patients' quality of life, and an increase in interventions that
promote health equity, including cultural and linguistic competencies, through
one or more of the following:
(a) A decrease
in avoidable emergency department visits or hospital readmissions;
(b) A decrease in total medical
expenditures;
(c) A decrease in
cost to patient;
(d) A decrease in
time to appropriate patient care in an appropriate health care
setting;
(e) An increase in access
to medical or follow-up care under the direction of the patient's Primary Care
Provider; or
(f) Improvement in
clinical care coordination, including, but not limited to the patient's
adherence to medication and other therapies previously prescribed by the
patient's Primary Care Provider.
(3) Pursuant to M.G.L. c. 111O, §
2(b)(iii), describe any proposed partnerships with existing health care
entities; identify all partnerships, contracts, agreements, and affiliation
agreements between the applicant and other health care entities; and propose a
plan for coordination and use of existing personnel and resources without
duplication of services;
(4) For
proposed programs with a primary focus on MassHealth beneficiaries with
behavioral health needs, identify partnership or coordination with an
ESP;
(5) Demonstrate, through such
information as financial and legal viability, sustainability and compliance
history, sufficient capacity to develop and operate the proposed MIH Program in
accordance with 105 CMR 173.000;
(6) Designate a medical director who shall be
responsible for meeting the requirements of all clinical aspects of the
proposed MIH Program, including, but not limited to, 105 CMR
173.100(A)(9);
(7) Provide a
complete description of the proposed operational plan for medical control and
medical direction including, but not limited to, lines of authority and
responsibility, development and review of clinical protocols, training and
assessment of skills, communication systems, and continuous quality assurance
and improvement; and
(8) Provide a
complete description of the proposed coordination and interaction with
applicable 911 EMS systems in accordance with the provisions of 105 CMR
173.100.
(B) Upon receipt of a complete initial or renewal application for a Certificate of Approval to operate an MIH Program, the Department shall evaluate the application, and any other information requested by the Department, and determine approval based on the applicant's satisfaction of the minimum requirements set forth at 105 CMR 173.040(A).
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