Intensive Case Management a. Intensive Case Management is intended to provide intensive team Case Management to highly recidivistic adults who have a severe and persistent mental illness. The service is intended to help Enrollees remain in the community and avoid institutional care. Clinical care criteria for this level of Case Management shall address the same elements required above, as well as expanded elements related to access and twenty-four (24) hour coverage as described below. Additionally, the intensive Case Management team composition shall be expanded to include members of the team selected specifically to assist with the special needs of this population. The Health Plan shall include the team composition and how it will assist with special needs in the description of how this service will be provided.
b. The Health Plan shall provide this service for all Enrollees for whom the service is determined to be Medically Necessary, to include Enrollees who meet the following criteria:
Intensive Case Management. MANDATORY This service is intended to provide intensive team case management to highly recidivistic adults who have a severe and persistent mental illness. The service is intended to help recipients remain in the community and avoid institutional care. Clinical care criteria for this level of case management shall address the same elements required above, as well as expanded elements related to access and 24-hour coverage as described below. Additionally, the intensive case management team composition shall be expanded to include members of the team especially selected to assist with the special needs of this population. The provider shall include this in the description of how this service will be provided. The provider shall provide this service for all prepaid mental health plan enrollees for whom the service is determined to be medically necessary. Intensive case management provides services through the use of a team of case managers. The team can be expanded to include other specialists that are qualified to address identified needs of the recipients receiving the service. This level of care for case management is the most intensive and serves individuals with the most severe and disabling mental conditions. Services are frequent and intense with a focus on assisting the individual with attaining the skills and supports needed to gain independent living skills. Intensive case management services are provided primarily in the recipient’s residence and include community-based interventions. The provider shall provide this service in the least restrictive setting with the goal of improving the client’s level of functioning, and providing ample opportunities for rehabilitation, recovery, and self-sufficiency. Intensive targeted case management services shall be accessible 24 hours per day, 7 days per week. The provider shall demonstrate adequate capacity to provide this service for the targeted population within the guidelines outlined. Intensive case management teams shall provide the same coordination and case management services for recipients admitted to inpatient facilities, state mental hospitals, and forensic or corrections facilities as those listed above for mental health targeted case management services. The following performance measures shall be addressed in the provision of intensive case management: • Average number of days spent in the community by all prepaid mental health plan recipients receiving intensive case management services. • Nu...
Intensive Case Management a. Intensive case management is intended for highly recidivistic adults who have a severe and persistent mental illness. The service is intended to help enrollees remain in the community and avoid institutional care. Care criteria for this level of case management shall address the same elements required above, as well as expanded elements related to access and twenty-four (24) hour coverage as described below. Additionally, the intensive case management team composition shall be expanded to include members selected specifically to assist with the special needs of this population.
b. The Health Plan shall provide this service for all enrollees for whom it is determined to be medically necessary, to include any enrollee who meets the following criteria:
(1) Has resided in a state mental health treatment facility for at least six (6) of the past thirty-six (36) months;
(2) Resides in the community and has had two (2) or more admissions to a state mental health treatment facility in the past thirty-six (36) months;
(3) Resides in the community and has had three (3) or more admissions to a crisis stabilization unit, short-term residential facility, inpatient psychiatric unit, or any combination of these facilities within the past twelve (12) months; or
(4) Resides in the community and, due to a mental illness, exhibits behavior or symptoms that could result in long-term hospitalization if frequent interventions for an extended period of time were not provided. HealthEase of Florida, Inc. Medicaid HMO Non-Reform Contract
c. Intensive case management services are frequent and intense and focus on helping the enrollee attain skills and supports needed for independent living. Case management services are provided primarily in the enrollee’s residence and include community-based interventions.
d. The Health Plan shall provide this service in the least restrictive setting with the goal of improving the enrollee’s level of functioning, and providing ample opportunities for rehabilitation, recovery, and self-sufficiency. Intensive case management services shall be accessible twenty-four (24) hours per day, seven (7) days per week. The Health Plan shall demonstrate adequate capacity to provide this service for the targeted population within the guidelines outlined.
Intensive Case Management. Intensive Case Management Services offers flexible, individualized, ongoing support that varies in intensity, which is based on consumer choice, and focuses on an individual's strengths, talents, and abilities. We encourage people to become involved in activities that develop supportive relationships, which establish valued roles through participation in our community. The priority population for intensive case management services is people aged 18 and over, who have a serious mental illness. Participation is voluntary. Once a person has been accepted into the program, the individual meets with a Community Consultant to jointly develop a support plan that assists persons to realize his or her personal recovery goals. Support services are flexible, based in the community, and tailored to the expressed needs of the individuals we serve. Levels of support vary greatly from person to person. Our services are available 7 days a week. Daily hours can vary based on individual needs, crisis, or emergent situations. Intensive Case Management Services offers a wide range of support options to people, in an effort to assist people in any foreseeable way. We assist people in finding and maintaining affordable housing. Community Consultants assist people to manage their finances, which includes budgeting and personal banking strategies, in addition to accessing available funding. We offer assistance in time management skills to support people with making and keeping appointments, being on time for work or for social obligations, and with providing reminders for maintaining a medication schedule, as prescribed by a physician. We assist people in managing their illnesses, learning about their medications, eating nutritiously, and using public transportation to explore available opportunities within the community. We assist people in finding and securing competitive and/or meaningful employment, which may include skill-building, resumé development, and interview strategies. We encourage people to pursue their interests and to engage in recreational activities. And we strongly advocate on behalf of the people we support. Funding for Intensive Case Management Services has been provided by the North West Local Health Integration Network (LHIN). Responsible Personnel: Director of Adult Services
Intensive Case Management. 1. By July 1, 2012 the State will develop and begin to utilize 3 ICM teams.
2. By January 1, 2013 the State will develop and begin to utilize 1 additional ICM team.
Intensive Case Management. Provide intensive case management services that are individualized, survivor focused, trauma-informed, and linguistically and culturally appropriate. Services shall consist of, but not limited to:
a. Peer mentorship; empowerment through self-transformation;
b. Community Building Activities; health coaching;
c. Chronic disease self-management support;
d. Assisting with securing and tracking eligible benefits;
e. Supporting medication adherence;
f. housing navigation;
g. Financial education; education and employment supportive services and referrals;
h. Linkage to mental health and substance use treatment;
i. Criminal justice system navigation;
j. Accompaniment to medical appointments;
k. Assistance in Family Reunification/Preservation by healing and bridging relationships with kinship networks;
l. Probation appearances, when appropriate; and m. Linkage to community-based reentry services and supports.
