Business Psychology Associates

1
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

2
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

3
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 clients partner, NOT as the
  clients
• Parent
• Therapist
• Supervisor

4
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)

5
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 74504)
• ISAS or Trainees must have intensive clinical
  supervision at least one (1) hour per month and a
  Learning Plan.
• -or-
• Bachelors 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

6
Case Manager Qualifications

• Clinical Case Management (SUD Treatment Services)
• SUD Clinical Case Managers must meet the
  following criteria
• Masters Level Licensed Qualified Professional
  (QP), per IDAPA 16.07.20 (section 45503)
• 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.

7
Case Management Models

• III. Clinical
• Long-term
• Comprehensive
• Resource acquisition
• Clinical activities
• SUD treatment
• and/or psychotherapy)

• 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

8
Case management intensive learning plan components

• 1) Assessments
• 2) Planning
• 3) Monitoring

• 4) Coordinating
• 5) Linking
• 6) Advocating

9
Desired Outcomes

• 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

10
Co-occurring Disorders by Severity

• III
• Less severe
• Mental disorder
• More severe
• Substance abuse
• Disorder
• I
• Less severe
• Mental disorder
• Less severe
• Substance abuse
• disorder

• IV
• More Severe
• Mental disorder
• More severe
• Substance abuse
• Disorder
• II
• More severe
• Mental disorder
• Less severe
• Substance abuse
• disorder

11
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

12
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 individuals 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 groups resume on poster
  paper
• Be prepared to share your resume with the
  whole group.

13
Case Management Components

• Assessment
• Planning
• Monitoring
• Coordinating
• Linking
• Advocating

14
Assessment

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

15
Assessment

• Document
• Medical
• Psychosocial
• Legal
• Educational
• Financial
• Needs of the client

16
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

17
Comprehensive Service Plan

• Document
• Times and date of service
• Service needs identified in the current
• assessment, including the GAIN
• Assessment of the client and clients family
  strengths and needs
• The plan was developed, to the extent
  possible, collaboratively with client, family
  members, and other support and service
  systems

18
Case Management Monitoring

• Verify services are being received
• Assure client adherence to the Plan
• Assess clients satisfaction
• Document progress
• Celebrate completed goals
• Recognize client effort/growth
• Reassess appropriateness of services
• Update and Revise Service Plan (at least every 90
  days)

19
Coordinating, Linking Advocating
20
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

21
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

22
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.

23
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

24
CM Lifecycle
25
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

26
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

27
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 clients, family or
  guardians satisfaction with service (quality
  measures)

28
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

29
Case Management Forms, continued

• RSS evaluation form/voucher request form
• Forms can be found at http//www.healthandwelfare
  .idaho.gov/Medical/SubstanceUseDisorders/RecoveryS
  upportServices/tabid/381/Default.aspx
• Other forms can be accessed via BPA website or
  given to you.

30
(No Transcript)
31
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

32
Billing cont

• Reimbursement Rates
• Basic/Intensive Case Management- 11.25 pr
  15minute unit (45.00/hr)
• Clinical Case Management (Masters level)-
  12.25pr 15 minute unit (49/hr)

33
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)

34
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.

35
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.

36
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.

37
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

38
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

39
The End

• Questions/Comments
• Evaluation
• Adjournment
• Thank you for your participation in today's
  training!