CASE MANAGEMENT 101

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CASE MANAGEMENT101

• A Presentation for the 2006 Best Practices
  Conference Focus on Supports for People with
  Developmental Disabilities
• April 10, 2006
• Rayne Caudill Marie Kelley

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THE DEPARTMENT OF HEALTH AND HUMAN SERVICES
(DHHS)

• The mission of the North Carolina Department of
  Health and Human Services (DHHS) is to serve
  people of North Carolina by enabling individuals,
  families, and communities to be healthy, secure
  and to achieve social and economic well being.

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THE DEPARTMENT OF HEALTH AND HUMAN SERVICES
(DHHS)

• DHHS is the largest agency in state government
  responsible for ensuring the health, safety and
  well being of all North Carolinians.
• Touches the lives of virtually every North
  Carolinian form birth to old age through prenatal
  programs, child development programs, and adult
  care home regulation.

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THE DIVISION OF MH/DD/SAS

• The Divisions organizational structure is
  designed to implement the State Plan and reform
  efforts.
• The Divisions central administration consists
• Directors Office
• State Operated Services
• Community Policy Management
• Resource/Regulatory Management
• Advocacy and Customer Services
• Operations Support

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THE PEOPLE WE SERVE

• Providing services to individuals with the most
  severe disabilities in communities of their
  choice is the primary focus of the re-designed
  MH/DD/SAS system.
• Anyone can seek services through the public
  MH/DD/SAS system.
• Anyone who is eligible for Medicaid and meets
  medical necessity for covered MH/DD/SAS
  services is entitled to those services, supports,
  treatment and/or care.

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THE PEOPLE WE SERVE

• DHHS has established target populations for
• -Adult Mental Health
• -Child Mental Health
• -Developmental Disabilities
• -Substance Abuse
• Individuals in these groups must meet specific
  diagnostic and functional criteria

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MISSION OF THE DIVISION OF MENTAL HEALTH,
DEVELOPMENTAL DISABILITIES AND SUBSTANCE ABUSE

• North Carolina will provide people with, or at
  risk of, mental illness, developmental
  disabilities and substance abuse problems and
  their families the necessary prevention,
  intervention, treatment, services and supports
  that they need to live successfully in
  communities of their choice.

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GUIDING PRINCIPLES OF THE STATE PLAN

• Participant Driven Treatment, services and
  supports to individuals and their families shall
  be appropriate to needs, accessible and timely,
  consumer-driven, outcome oriented, culturally and
  age appropriate, built on individual strengths,
  cost effective and reflect evidence based or best
  practices.
• Prevention Focused Research, education and
  prevention programs lower the prevalence of
  mental illness, developmental disabilities and
  substance abuse reduce the impact or stigma and
  lead to earlier intervention and improved
  treatment.

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GUIDING PRINCIPLES OF THE STATE PLAN

• Community Based Services should be provided in
  the most integrated community setting suitable to
  the needs and preferences of the individual
  planned in partnership with the individual and/or
  family.
• Outcome Oriented Individuals should receive the
  services needed based on a person-centered plan
  and in consideration of any legal restrictions,
  varying levels of disability, and fair and
  equitable distribution of system resources.

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GUIDING PRINCIPLES OF THE STATE PLAN

• Reflects Evidence Based/Best Treatment Services
  shall meet measurable standards of safety,
  quality and clinical effectiveness at all levels
  of the mental health, developmental disabilities
  and substance abuse system and shall demonstrate
  a dedication to excellence through adoption of a
  program for continuous quality improvement.

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GUIDING PRINCIPLES OF THE STATE PLAN

• Cost Effective All components of the mental
  health, developmental disability and substance
  abuse system shall operate efficiently. System
  professionals will work with individuals and
  their families to help them get the most from
  services.

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VISION

• Public and social policy toward people with
  disabilities will be respectful, fair and
  recognize the need to assist all that need help.
• The states service system for persons with
  mental illness, developmental disabilities and
  substance abuse problems will have adequate,
  stable funding.

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VISION

• System elements will be seamless consumers,
  families, policymakers, advocates and qualified
  providers will unite in a common approach that
  emphasizes support, education/training,
  rehabilitation and recovery.
• All human services agencies that serve people
  with mental health, developmental disabilities
  and/or substance abuse problems will work
  together to enable consumers to live successfully
  in their communities.

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MENTAL HEALTH TRANSFORMATION

• Service Philosophy
• Consumers may enter services through a no wrong
  door.
• Consumers most in need (target populations and
  Medicaid based upon medical necessity) will
  receive Enhanced package.
• Service descriptions and consumer eligibility are
  based on national models established through
  research.

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MENTAL HEALTH TRANSFORMATION

• Service Philosophy (continued)
• The consumers clinical home is responsible for
  crisis services.
• Focus on people living where they want, as they
  want and in charge of what happens to them.
• Less use of state facilities more
  services/supports in communities.
• Consumers involved in planning their services.

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VALUES AND PRINCIPLES OF PERSON CENTERED
PLANNING

• Builds on strengths, gifts, skills, and
  contributions.
• Supports consumer empowerment, and provides
  meaningful options to express preferences and
  make informed choices.
• Honors goals and aspirations for a lifestyle that
  promotes dignity, respect, interdependence,
  mastery and competence.

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VALUES AND PRINCIPLES OF PERSON CENTERED
PLANNING CONTINUED

• Supports a fair and equitable distribution of
  system resources.
• Creates community connections.
• Sees individuals in the context of their culture,
  ethnicity, religion, and gender.

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VALUES AND PRINCIPLES OF PERSON CENTERED
PLANNING CONTINUED

• Supports mutually respectful and partnering
  relationships, acknowledging the legitimate
  contributions of all parties.
• Partnership is built on a foundation of respect
  and trust.

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VALUES AND PRINCIPLES OF PERSON CENTERED
PLANNING CONTINUED

• Requires that everyone is clear about their
  roles, responsibilities, while being flexible.

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PERSON CENTERED PLANNING

• THE FOUNDATION OF SYSTEM REFORM
• Foundation for all planning of treatment,
  services and supports.
• Includes a planning team which consists of the
  individual and others the individual selects to
  be part of the process.

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PERSON CENTERED PLANNING

• THE FOUNDATION OF SYSTEM REFORM
• Begins with the identification of the reason the
  individual/family are seeking assistance.
• Focuses on the individuals/familys needs and
  desired life outcomes.
• Identifies goals and objectives for the
  individual and the team member responsible.

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PERSON CENTERED PLANNING

• THE FOUNDATION OF SYSTEM REFORM
• Insure the health and safety of the individual.
• Supports and treatment will be identified from a
  combination of resources including
• Purchased or funded resources
• Personal resources
• Natural supports
• Community resources

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PERSON CENTERED PLANNING

• THE FOUNDATION OF SYSTEM REFORM
• Crisis planning is part of the person centered
  plan including early known signals and triggers
  of an impending crisis.

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MODELS OF PERSON CENTERED PLANNING

• Essential Lifestyle Planning
• Circle of Friends
• MAPS (McGill Action Planning)
• PATH (Planning Alternative Tomorrows with Hope)

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Person Centered Planning 14 Required Elements

• Indication of individuals participation
• Documentation of participants in plan development
• Evidence of Diagnostic Assessment
• Services/Supports identified to address health
  issues
• Services/Supports identified to address safety
  issues
• Strengths Achievements/Accomplishments

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Person Centered Planning14 Required Elements

• Goals, objectives, and outcomes
• Supports/services identified and prioritized
• Crisis Components
• Identification of potential resources
• Identification of responsible persons for each
  activity, strategy, support, service, and/or
  treatment
• Signature of individual or legally responsible
  person
• Documentation of areas of disagreement/steps to
  address disputes
• Evidence of how updates and reviews will occur

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DIVISION OF MH/DD/SAS

• Division of MH/DD/SAS website
• http//www.dhhs.state.nc.us/mhddsas/