Orange County NC Website
Section 3 -Definitions <br />The following terms have the meaning stated for the purposes of this contract: <br />3.1 Clinical Directors -The CCNC leadership body in which each Network is represented by its Clinical <br />Director. This body establishes the CCNC clinical policy and provides oversight for CCNC decisions <br />and activities. <br />3.2 Clinical Pharmacist - Care delivery role working either directly with patients or in concert with a <br />multi-disciplinary care team. <br />3.3 Commtt~tity Care of North Carolina (CCNC A program established within the Department of Health <br />and Human Services Office of Rural Health and Community Care with the goal of improving health care <br />access, quality, and cost-effectiveness. CCNC has administrative oversight responsibility for the <br />operational aspects of this contract in collaboration with the Division of Medical Assistance (DMA). <br />3.4 Community Care Network (Network] -Anon-profit community organization where private and public <br />providers collaborate to serve a target population in a defined service area. <br />3.5 Covered Services -Services covered by Medicaid for Eligible Recipients or the Health Choice <br />population which the Contractor agrees to coordinate pursuant to the terms of this contract and payment. <br />3.6 Eligible Recipients -Persons eligible in the following Medicaid categories: <br />• Work First for Family Assistance (fornieriy AFDC) <br />• Family and Children's Medicaid (MAF) <br />• Infant and Children (MIC) <br />^ Medicaid for the Bind and Disabled (MAB, MAD. MSB) <br />• Residents of Adult Care Homes (SAD) <br />Enrollment of Eligible recipients in the following categories is voluntary: <br />• Medicare /Medicaid Dual Eligibles (Non-QMB); <br />• Medicaid Pregnant Women (MPW); <br />• Title IV-E Adoption Subsidy (iAS); and <br />• Foster Care-Non Title IV-E (HSF) <br />• Indians who are Members of Federally Recognized Tribes <br />• Children under the age of 19 years, who are eligible for Supplemental Security Income under Title <br />XVI <br />• Children under the age of 19 years who are receiving services through afamily-centered, community <br />based, coordinated care system that receives grant funds under section 501(axl)(D) of Title V, and is <br />defined by the state in terms of either program participation or special health care needs. <br />• Community Alternative Progrant (CAP) Enrollees <br />8 <br />