in partnership with idaho department of health and welfare substance use disorder (sud) bureau case...

In Partnership With

Idaho Department of Health and WelfareSubstance Use Disorder (SUD) Bureau

Case Management Training

Dean Allen, M. Ed.LCPC, LSW, QSUDP

Clinical Regional Field Staff

1.Define Case Management (CM)2.Understand the Purpose of CM Services3.Identify CM Qualifications4.Introduce Models of Case Management5.Explore the Role of CM6.Identify Values and Objectives7.Define Components of CM8.Review CM Documentation9.Introduce CM Code of Ethics10.Define Purpose CM Supervision

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

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)

Basic and Intensive (Recovery Support Services):

SUD Case Managers must meet the following criteria:o 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-o 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-o Case Management Training Certificate-issued by the

Department within 6 months of hire.*Related fields:Sociology Social WorkPsychology CounselingHealth Ed./Promotion Alcohol and Drug Studies

Clinical Case Management (SUD Treatment Services)

SUD Clinical Case Managers must meet the following criteria:oMaster’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 monthA Clinical Case Manager may not hold trainee status

o Case Management Training Certificate-issued by the Department within 6 months of hire.

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)

1) Assessments

2) Planning

3) Monitoring

4) Coordinating

5) Linking

6) Advocating

Team Approach

Early intervention

Proactive (Assertive)

CM services planning that reinforces treatment goals

Motivational enhancement Denial/Resistance

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

IIILess severe

Mental disorderMore severe

Substance abuseDisorder

ILess severe

Mental disorderLess severe

Substance abusedisorder

IVMore Severe

Mental disorderMore severe

Substance abuseDisorder

IIMore severe

Mental disorderLess severe

Substance abusedisorder

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

OBJECTIVES

Keep the client engaged in treatment

Improve client outcomes Facilitate access to needed

services Maintain least restrictive

level of care

Group ActivityEach group will receive poster paper and markers. Brainstorm all of the talents each of you possess

Non-work related skills, experience, gifts or assetsThink 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 houseNot 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.

1. Assessment2. Planning3. Monitoring4. Coordinating5. Linking6. Advocating

Objectives:

Assess Client Engagement and Motivation Identify Strengths and Supports Assess Needs Promote a Shared Understanding of Needs

Document:

Medical Psychosocial Legal Educational Financial

Needs of the client

Rapport create an environment of trust and mutual

respectTechniques

open-ended questionsReflective listening (paraphrasing)Clarifying questions

Case managers personal views and “isms”Assess

Document;Times and date of serviceService needs identified in the current

assessment, including the GAINAssessment 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

1. Verify services are being received2. Assure client adherence to the Plan3. Assess client’s satisfaction4. Document progress

Celebrate completed goalsRecognize client effort/growth

5. Reassess appropriateness of services6. Update and Revise Service Plan (at least

every 90 days)

Serve as a Single Point of Contact

Develop Collaborative Networks Clinical Courts Faith-based Educational Medical• Probation/Parole Vocational Human Services

Develop interagency agreements

Establish and maintain credibility

Communicate changes in plan, client statusand needs to all team members

Facilitate effective management of client 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 servicesAll services and support systemsProvide 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.

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

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 completedCM Plan is in direct correlation with the

treatment recommendations

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 contactsand additional contacts made for clients well being

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)

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

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.

Client Name: Client IDOC ID: Client BPA ID: Case Manager: Supervising Officer: Facility Name : Address: Phone Number: Email :

Client report checklist must be completed every week for six (6) months and monthly thereafter for re-entry clients.

Date: Client Encounter Types (date): Face to Face Phone

Appointments Attended: Yes No Relevant Information (client progress, status, issues, problems, etc.

Treatment

Case Management

Other:

Referrals: Yes No 1) Medical Care 2) Mental Health Evaluation 3) Referred for Medicaid 4) Referred for Dental Services 5) Marriage/Family/Life Skills 6) Vocational/Educational Training 7) Child Care 8) Transportation 9) Safe Housing 10) Legal Services 11) Social Support:

12 Step Meetings (AA/NA) YMCA Faith Based Group Other:__________________

12) Financial Services 13) Other:

Other Items Yes No Family Significant Other/Family involvement

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

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)

Principle 1:  Non-Discriminationo 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 Welfareo 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 Relationshipo 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)

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.

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.

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 (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

◦ Staff name and credentials

◦ Date of supervision

◦ Mode of supervision Observation One-on-one Group

◦ Duration

◦ Issues addressed

◦ Progress of supervisee

◦ Signature and credentials of Supervisor

◦ Signature and credentials of Supervisee (CM)

Questions/Comments

Evaluation

Adjournment

Thank you for your participation in today's training!