Laserfiche WebLink
<br />'. <br /> <br />period of time as determined by RECEIVING AGENCY. <br /> <br />RECEIVING AGENCY'S Health Service Regional Director or designee, as coordinator of <br />regional services, will assist RECEIVING AGENCY staff in providing direction to <br />'PERFORMING AGENCY. RECEIVING AGENCY personnel may, from time to time, provide <br />technical assistance and training to PERFORMING AGENCY. PERFORMING AGENCY shall <br />cooperate with RECEIVING AGENCY staff to attain the goals of unified community health <br />assessment, policy development, coordinated services, and quality assurance and to prevent <br />unnecessary duplication of services. <br /> <br />PERFORMANCE MEASURES: <br /> <br />The following performance measures will be used to assess, in part, PERFORMING AGENCY'S <br />effeétiveness in providing the services described in this contract Attachment, without waiving <br />the enforceability of any of the other terms of the contract. <br /> <br />PERFORMING AGENCY shall report on: <br /> <br />. Screening, referral and PRC eligibility services (PHC-200) (monthly) <br />. Client intake - new and recertified clients (PRC-200) (monthly) <br />. Number ofPRC eligible clients receiving medical services (PRC-200) (monthly) <br />. Clients served by month (PRC-200) (monthly) <br />. Cost and type of services provided (PRC-200) (monthly) <br />. Contract objectives (PHC-301) (quarterly) <br />. Client demographic data (PHC-300) (annually) <br /> <br />ELIGffiILITY: <br /> <br />All individuals considered for PRC eligibility must be screened and detennined eligible using a <br />DSRS or PHC program approved screening tool as updated in the spring of each year when <br />federal poverty levels and eligibility determination forms are revised. <br /> <br />CO-PAY: <br /> <br />PERFORMING AGENCY may assess co-pay from clients provided services by RECEIVING <br />AGENCY under this Attachment. A co-pay assessment may not exceed 25% of the amount <br />RECEIVING AGENCY pays PERFORMING AGENCY for the provision of a given service. A <br />client shall not be denied services due to inability to pay. Local Realth Departments shall <br />comply with RECEIVING AGENCY fee collection policies detailed in 25 TAC § 1.91. <br /> <br />PERFORMING AGENCY shall make reasonable efforts to investigate and apply for all other <br />sources of third party funding available to or identified by the patient before submitting claims <br />for allowable costs to RECEIVING AGENCY Program. <br /> <br />ATTACHMENT - Page 2 <br /> <br />T <br />