Training: Disabilities (SPD) — Serving Seniors and Persons with Disabilities
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This document mandates requirements for contracted mental health and substance use disorder providers serving Holman Group members who are seniors or persons with disabilities, covering access, communication, accommodations, continuity of care, training, and compliance. It applies to all clinical, administrative, and operational interactions with SPD members enrolled in Holman Group health plans.
No material clinical or coverage changes in this revision.
Provider Requirements for Serving Seniors and Persons with Disabilities (SPD)
SPD provider requirements (access, communication, accommodations, continuity, parity, grievance support)
Providers contracted with Holman Group must meet the following requirements when serving seniors and persons with disabilities (SPD).
When to apply SPD requirements
Apply when any of the following are present
- Member self-identifies as having a disability or special need.
- Member requests an accommodation or auxiliary aid.
- A disability or functional limitation is documented in clinical records.
- Communication, cognitive, sensory, or mobility barriers are observed.
- SPD protections apply regardless of diagnosis, level of care, or treatment setting.
Access and clinical decision-making
- Do not deny, delay, or limit mental health or SUD treatment based on a member's disability, age, cognitive status, or functional limitations.
- Make clinical decisions based solely on medical necessity and covered benefits.
- Assist SPD members in understanding treatment options and participating in care planning.
Communication and accommodations
- Ensure effective communication with SPD members, which may include use of qualified interpreters (e.g., ASL), allowing service animals, providing extended appointment times when clinically appropriate, and assisting with forms or administrative requirements.
- Providers may not charge members for accommodations or auxiliary aids.
Compliance and remedies
- Comply with state and federal parity and nondiscrimination requirements applicable to behavioral health services.
- Failure to comply may result in corrective action, contract action, or reporting to regulatory authorities; Holman Group may monitor compliance through accessibility reviews, grievance trend analysis, corrective action plans, and responses to regulatory inquiries.
Authorization, Utilization Management, and Provider Cooperation
Cooperate with authorization/UM and provide accessible support for SPD members
Providers must cooperate with Holman Group authorization and utilization management processes and ensure those processes are accessible for seniors and persons with disabilities. If a member's disability affects participation in standard intake or authorization, providers must offer reasonable assistance or alternative communication methods and promptly respond to requests for clinical information and documentation.
- Cooperate with Holman Group authorization and UM processes while ensuring accessibility for SPD members.
- Offer reasonable assistance or alternative communication methods when a member’s disability affects participation in standard intake or authorization processes.
- Promptly respond to requests for clinical information and documentation.
Key Definitions
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