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Business Psychology Associates. In Partnership With Idaho Department of Health and Welfare Substance Use Disorder (SUD) Bureau Case Management Training Dean Allen, M. Ed. LCPC, LSW, QSUDP Clinical Regional Field Staff. Learning Objectives. Define Case Management (CM)

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business psychology associates

Business Psychology Associates

In Partnership

With

Idaho Department of Health and Welfare

Substance Use Disorder (SUD) Bureau

Case Management

Training

Dean Allen, M. Ed.

LCPC, LSW, QSUDP

Clinical Regional Field Staff

learning objectives

Learning Objectives

Define Case Management (CM)

Understand the Purpose of CM Services

Identify CM Qualifications

Introduce Models of Case Management

Explore the Role of CM

Identify Values and Objectives

Define Components of CM

Review CM Documentation

Introduce CM Code of Ethics

Define Purpose CM Supervision

definition

Definition

Case management is a collaborative process that assesses, plans, links, coordinates, monitors, and advocates for options and services required to meet the client's health and human service needs. Serves as the client’s partner, NOT as the client’s:

Parent

Therapist

Supervisor

purpose

Purpose

Keep the client engaged in treatment

Improve client outcomes

Facilitate access to needed services

Maintain the least restrictive level of care required for successful client outcomes

(must not duplicate any other state funded services, such as Medicaid)

case manager qualifications
Case Manager Qualifications

Basic and Intensive (Recovery Support Services):

  • SUD Case Managers must meet the following criteria:
    • Qualified Professional (QP), per IDAPA 16.07.20 (section 745:04)
      • ISAS or Trainees must have intensive clinical supervision at least one (1) hour per month and a Learning Plan.

-or-

    • Bachelor’s degree in a *human services field from a nationally accredited university or college(with 6 months or 1040 hours of supervised experience working with SUD population)

-and-

    • Case Management Training Certificate-issued by the Department within 6 months of hire.
  • *Related fields:
    • Sociology Social Work
    • Psychology Counseling
    • Health Ed./Promotion  Alcohol and Drug Studies
case manager qualifications1
Case Manager Qualifications

Clinical Case Management (SUD Treatment Services)

  • SUD Clinical Case Managers must meet the following criteria:
    • Master’s Level Licensed Qualified Professional (QP), per IDAPA 16.07.20 (section 455:03)
        • Clinical Case Manager must have at least one (1) hour of clinical supervision per month
        • A Clinical Case Manager may not hold trainee status
    • Case Management Training Certificate-issued by the Department within 6 months of hire.
case management models
Case Management Models

I. Basic (Brokerage/Generalist)

  • Brief (less than 6 mo.)
  • Identify needs
  • Broker supportive services

II. Intensive

  • Long-term
  • Resource acquisition
  • Complex client needs:
    • criminal justice
    • co-occurring disorders
    • pregnant and parenting women

III. Clinical

  • Long-term
  • Comprehensive
  • Resource acquisition
  • Clinical activities:
    • SUD treatment
    • and/or psychotherapy)
case management intensive learning plan components
Case management intensive learning plan components

1) Assessments

2) Planning

3) Monitoring

4) Coordinating

5) Linking

6) Advocating

desired outcomes
Desired Outcomes
  • The intensity level of case management should be matched with the intensity of the patient needs
      • Adequate matching of services and referral
      • Co-Occurring - Quadrant
  • Support for client as he/she moves through the recovery continuum
      • CM not static
      • Right care in the right place for the right length of time
  • Team Approach
  • Early intervention
  • Proactive (Assertive)
  • CM services planning that reinforces treatment goals
  • Motivational enhancement Denial/Resistance
co occurring disorders by severity
Co-occurring Disorders by Severity

IV

More Severe

Mental disorder

More severe

Substance abuse

Disorder

II

More severe

Mental disorder

Less severe

Substance abuse

disorder

III

Less severe

Mental disorder

More severe

Substance abuse

Disorder

I

Less severe

Mental disorder

Less severe

Substance abuse

disorder

case management
Case Management
  • OBJECTIVES
  • Keep the client engaged in treatment
  • Improve client outcomes
  • Facilitate access to needed services
  • Maintain least restrictive level of care
  • VALUES
  • Self-determination maximized
  • Client & family involved in developing plans & outcomes
  • Individualized & client driven
  • Client choice
  • Accessible
  • Settings & Times convenient to client
  • Community-based
  • Holistic
  • Culturally appropriate
  • Efficient, effective, and accountable
non professional resume

Non-Professional Resume

Group Activity

Each group will receive poster paper and markers.

Brainstorm all of the talents each of you possess

Non-work related skills, experience, gifts or assets

Think creatively and collaboratively

Examples: collectively we speak three languages , can make a great seven course meal

You can list individual’s skills or what you could accomplish using all of your skills together (i.e. renovate and redecorate a house

Not everyone in the group has to have the skill in order for it to go on the resume.

Please document your group’s resume on poster paper;

Be prepared to share your resume with the whole group.

case management components

Case Management Components

Assessment

Planning

Monitoring

Coordinating

Linking

Advocating

assessment
Assessment

Objectives:

  • Assess Client Engagement and Motivation
  • Identify Strengths and Supports
  • Assess Needs
  • Promote a Shared Understanding of Needs
assessment1
Assessment
  • Document:
  • Medical
  • Psychosocial
  • Legal
  • Educational
  • Financial
          • Needs of the client
elements of an interview

Elements of an Interview

Rapport

create an environment of trust and mutual

respect

Techniques

open-ended questions

Reflective listening (paraphrasing)

Clarifying questions

Case managers personal views and “isms”

Assess

comprehensive service plan

Comprehensive Service Plan

Document;

Times and date of service

Service needs identified in the current

assessment, including the GAIN

Assessment of the client and client’s family strengths and needs

The plan was developed, to the extent possible, collaboratively with client, family members, and other support and service systems

case management monitoring

Case Management Monitoring

Verify services are being received

Assure client adherence to the Plan

Assess client’s satisfaction

Document progress

Celebrate completed goals

Recognize client effort/growth

Reassess appropriateness of services

Update and Revise Service Plan (at least every 90 days)

coordination of community partnerships
Coordination of Community Partnerships
  • Serve as a Single Point of Contact
  • Develop Collaborative Networks
      • Clinical
      • Courts
      • Faith-based
      • Educational
      • Medical
      • Probation/Parole
      • Vocational
      • Human Services
coordination cont
Coordination cont….
  • Develop interagency agreements
  • Establish and maintain credibility
  • Communicate changes in plan, client status

and needs to all team members

  • Facilitate effective management of client

services

linking services
Linking Services
  • Link client services to address specific needs and achieve stated goals
      • Clients are often overwhelmed by the magnitude and complexity of their issues
  • Link throughout the continuum services
      • All services and support systems
      • Provide for needed and timely transitions between levels of care, services and service providers
  • Link with internal and external systems to provide resources, services and opportunities.
advocating
Advocating
  • Advocate for services and actions to meet the clients needs, desires and rights.
    • Advocate to expand and improve access
    • Work with community partners to develop new and better resources
    • Make better use of available community and governmental resources
  • Assist clients in evidencing need
  • Empower clients to advocate for themselves
case management documentation
Case ManagementDocumentation
  • Client record is a legal document
  • All entries should be legible, clear, concise and legibly signed by Case Manager
  • The record should evidence:
      • An assessment has been completed
      • CM Plan is in direct correlation with the treatment recommendations
case management progress notes documentation elements
Case Management Progress Notes Documentation Elements
  • Client name
  • Record number (State Identification Number)
  • Agency name/Name of case manager
  • Date/Time/Service location
  • Documentation of progress, Linkages, client advocacy, and monitoring
  • Documentation of required face to face contacts

and additional contacts made for clients well being

case management documentation elements cont
Case Management DocumentationElements cont…
  • CM Authorization voucher
  • Dated and signed Service Plan
  • Release of Information (ROI) signed and dated (updated every 90 days)
  • Informed consent
  • Documentation of the client’s, family or guardians satisfaction with service (quality measures)
case management forms
Case Management Forms

Required Forms:

  • Supervision Form
  • Progress Note
  • PO(Probation Officer) Report(submit weekly for first 6 months, then monthly)
  • Comprehensive Service Plan
  • Informed consent
  • State Substance Abuse Treatment and Recovery Support Services form
case management forms continued
Case Management Forms, continued

RSS evaluation form/voucher request form

Forms can be found at: http://www.healthandwelfare.idaho.gov/Medical/SubstanceUseDisorders/RecoverySupportServices/tabid/381/Default.aspx

Other forms can be accessed via BPA website or given to you.

billing
Billing
  • Reimbursable services:
    • Face-to-face contact
    • Telephone contact
    • Paperwork completed to obtain service

(Client or representative must be present)

  • Non-Reimbursed Services:
    • Missed appointments
    • Attempted contacts
    • Travel to provide service
    • Leaving a message
    • Transporting clients
    • Documenting services
    • Group case management
    • Mental Health services provided by clinical CM
billing cont
Billing cont…
  • Reimbursement Rates:
    • Basic/Intensive Case Management- $11.25 pr 15minute unit ($45.00/hr)
    • Clinical Case Management (Master’s level)- $12.25pr 15 minute unit ($49/hr)
case management code of ethics
Case Management Code of Ethics
  • Principle 1:  Non-Discrimination
    • I shall affirm diversity among colleagues or clients regardless of age, gender, sexual orientation, ethnic/racial background, religious/spiritual beliefs, marital status, political beliefs, or mental/physical disability and veteran status.
  • Principle 2:  Client Welfare
    • I understand that the ability to do good is based on an underlying concern for the well being of others.  I shall act for the good of others and exercise respect, sensitivity, and insight. I understand that my primary professional responsibility and loyalty is to the welfare of my clients, and I shall work for the client irrespective of who actually pays his/her fees. 
  • Principle 3:  Client Relationship
    • I understand and respect the fundamental human right of all individuals to self-determination and to make decisions that they consider in their own best interest.  I shall be open and clear about the nature, extent, probable effectiveness, and cost of those services to allow each individual to make an informed decision of their care.  

NAADAC - The Association for Addiction Professionals, Code of Ethics (August 18, 2008)

case management code of ethics cont
Case Management Code of Ethics Cont…
  • Principle 4:  Trustworthiness
    • I understand that effectiveness in my profession is largely based on the ability to be worthy of trust, and I shall work to the best of my ability to act consistently within the bounds of a known moral universe, to faithfully fulfill the terms of both personal and professional commitments, to safeguard fiduciary relationships consistently, and to speak the truth as it is known to me. 
  • Principle 5: Compliance with Law
    • I understand that laws and regulations exist for the good ordering of society and for the restraint of harm and evil, and I am aware of those laws and regulations that are relevant both personally and professionally and follow them, while reserving the right to commit civil disobedience.
  • Principle 6:  Rights and Duties
    • I understand that personal and professional commitments and relationships create a network of rights and corresponding duties.  I shall work to the best of my ability to safeguard the natural and consensual rights of each individual and fulfill those duties required of me.
case management code of ethics cont1
Case Management Code of Ethics Cont…
  • Principle 7: Dual Relationships
    • I understand that I must seek to nurture and support the development of a relationship of equals rather than to take unfair advantage of individuals who are vulnerable and exploitable. 
  • Principle 8:  Preventing Harm
    • I understand that every decision and action has ethical implication leading either to benefit or harm, and I shall carefully consider whether any of my decisions or actions has the potential to produce harm of a physical, psychological, financial, legal, or spiritual nature before implementing them.
  • Principle 9:  Duty of Care
    • I shall operate under the principle of Duty of Care and shall maintain a working/therapeutic environment in which clients, colleagues, and employees can be safe from the threat of physical, emotional or intellectual harm.
case management supervision
Case Management Supervision
  • Supervision provides a means to:
    • Protect clients/monitor care
    • Enhance professional performance
    • Monitor the readiness of trainees for professional practice
    • Foster professional development
    • Impart necessary skills
  • The ultimate objective of supervision is to deliver to clients the best possible service, in accordance with agency policies and procedures.
documentation of supervision
Documentation of Supervision
  • Documentation (minimum)
    • Date and time of supervision
    • Mode of supervision
      • Observation
      • One-on-one
      • Group
    • Topics Discussed
    • Signature and credentials of Supervisor
    • Signature and credentials of Supervisee (CM)
    • A minimum of one hour of clinical supervision per month is required
documentation of supervision documentation minimum
Documentation of SupervisionDocumentation (Minimum)
  • Issues addressed
  • Progress of supervisee
  • Signature and credentials of Supervisor
  • Signature and credentials of Supervisee (CM)
  • Staff name and credentials
  • Date of supervision
  • Mode of supervision
    • Observation
    • One-on-one
    • Group
  • Duration
the end
The End
  • Questions/Comments
  • Evaluation
  • Adjournment

Thank you for your participation in today's training!

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