Care Management - High and Moderate level of need
1-877-652-7624
Program Description
The Care Management Organization (CMO) is an independent, community-based organization that combines advocacy, individualized service planning and care management into a single, integrated cross-system process.
The CMO assesses, designs, implements and manages child-centered and family-focused individual Service Plans (ISP) for children and adoescents whose needs are complex and require intensive care management techniques that may cross multiple service systems. CMO responsibilities also include the following:
Through the Child and Family Team process, the CMO coordinates the development of the ISP to asure that the child and family receive individualized services that are delivered in the community where the child lives. The plan is holistic in nature and addresses areas of everyday living beyond the treatment of mental health symptoms. The CMO provides ongoing, intensive case management in contrast to other case management entities.
The Care Management Organization (CMO) is an independent, community-based organization that combines advocacy, individualized service planning and care management into a single, integrated cross-system process.
The CMO assesses, designs, implements and manages child-centered and family-focused individual Service Plans (ISP) for children and adoescents whose needs are complex and require intensive care management techniques that may cross multiple service systems. CMO responsibilities also include the following:
- Convening Child and Family Team meetings to develop and manage the ISP
- Developing and implementing a crisis management plan
- Community resource development
- Information management
- Quality assessment and improvement
- Coordination and communication with the child/youth's physical health provider
- Coordiantion of care with all providers and agencies with whom the family is involved.
Through the Child and Family Team process, the CMO coordinates the development of the ISP to asure that the child and family receive individualized services that are delivered in the community where the child lives. The plan is holistic in nature and addresses areas of everyday living beyond the treatment of mental health symptoms. The CMO provides ongoing, intensive case management in contrast to other case management entities.
Inclusionary Criteria |
The child/youth must meet A, B, and C
plus at least one from D through I. A. The child/youth/young adult is between the ages of 5 and their 21st birthday. Special consideration will be given to children under 5 years of age. B. The child/youth manifests serious emotional or behavioral health challenges resulting disturbances consistent with a DSM-IV diagnosis and resulting in significant functional impairment which adversely affects his or her capacity to function in the community; C. The Division of Childrens System of Care Assessment and other relevant information indicate that the c hild/youth needs an intensive level of case management provided by a CMO/UCM , requiring ongoing extensive service coordination and linkages. The child/youth may meet any one of the following: D. The child/youth is involved with multiple agencies or systems such as DMHS, DYFS, JJC or the court system requiring service need coordination. E. The child/youth has not demonstrated successful response to previous community based clinical interventions. F. The child/youth is at risk for serious decompensation as evidenced by specific examples of serious decompensation including: recent referral to psychiatric screening, expulsion from school, or formal legal charges. G. A risk of placement outside the home or community exists requireing intensive wraparound community planning. h. A risk of disruption of a current therapeutic placement exists; I. The youth is in an out-of-home treatment setting requiring intensive service coordination and discharge planning to facilitate successful transition back into the community J. A risk of a psychiatric hospitalization exists. K. The person(s) with authority to consent to treatment for the youth voluntarily agrees to participate. The assent of a youth who is not authorized under applicable law to consent to treatment is desirable but not required. Psychosocial, Occupational, cultural and linguistic factors: These factors may change the risk assessment and should be considered when making level of care decisions.
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Exclusion
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Any of the following criteria is sufficient for exclusion from this level of care.
A. The chid/youth's parent/guardian/custodian does not voluntarily consent to admission or treatment B. The Division of Childrens System of CAre Assessment and other releveant information indicate that the child/youth can be safely maintained and effectively supported in a less intensive level of case management. C. The Behavoral ymptoms are the result of a medical condition that warrants amedical setting for treatment as determined and d ocumented by the child's primary care physician and or Performcare's Medical Director. D. The child/youth's sole diagnosis is Substance Abuse and there are no servere emotional or behavioral disturbances that require CMO/UCM service coordination. E. All services and treatments are carefully structured to achieve reintegration into the family or community in the most time efficient manner possible. F. The ISP/treatment plan indicates that the parent/guardian/custodian is not actively involved int he child's youth's services. G. There is documentation of active discharge planning. |
UCM/CMO Discharge Criteria
Any of the following criteria is sufficient for discharge from
this level of case management.
A. The Division of Childrens System of CAre Assessment and other relevant information indicate that the child/youth no longer meets criteria for the CMO level of case management.
B. The child/youth meets criteria for a lower level of case management
C. Youth is lost to contact for 2 month duraiton or moved out of state.
D. The child/youth's documented ISP goals and objectives have been substantially met.
E. Consent for treatment is withdrawn by the person(s) with authority to consent to treat ment.
F. The person(s) with authority to consent to trea tment has not maintained compliance with current CMO/UCM treatmentpan and /or services which have been put in place.
C. Youth is lost to contact for 2 month duraiton or moved out of state.
D. The child/youth's documented ISP goals and objectives have been substantially met.
E. Consent for treatment is withdrawn by the person(s) with authority to consent to treat ment.
F. The person(s) with authority to consent to trea tment has not maintained compliance with current CMO/UCM treatmentpan and /or services which have been put in place.