Children's Targeted Case Management
Practice Guidelines

INTAKE POLICIES & PROCEDURES

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Intake Policies & Procedures
Access
Time Frames
Central Enrollment
Wait List
Safety of Staff 

INTAKE POLICIES & PROCEDURES 

The values of the Wraparound Process should be conveyed from the very beginning of the intake process when the relationship with the family is first formed (Grealish, 2000). 

The agency must have a written protocol for providing a standard intake evaluation for all children and families served.  The written protocol will delineate agency policies and procedures regarding the following:  

a)        responding to the initial phone call or initial referral;

b)        referral information to be gathered and the method (oral, written, face to face) in which it may be gathered;

c)        incorporation of the Children’s Enrollment Form (CEF) into the referral and intake process;

d)        criteria and procedures for transferring families from the wait list to active case management; and

e)        consistency of intake process with the Risinger Timeliness Standards set forth in 14 472 CMR Ch XX.  (See Service Time Frame on Page 17 for specifics.)

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ACCESS 

The agency must have written policies and procedures describing how targeted case management services may be accessed by families, health care providers, schools, state agencies or others making a referral on behalf of a family. These policies will describe access for both a) non-emergency needs and b) crisis or emergency services. 

DHHS-CBHS system of care clearly asserts the family/legally responsible person as having primary responsibility for fulfilling the needs of the child which includes participating in their child’s treatment. Referrals/requests for targeted case management that are not directly initiated by the family must include the family as active, informed, and consenting participants.  (See “Youth Accessing Services” in Rights of Recipients of Mental Health Services Who are Children in Need of Treatment, Part C, Section III-C.) 

The agency must have a written policy regarding how they will inform each child and family of their rights as recipients of services in accordance with DHHS-CBHS Rights of Recipients of Mental Health/Mental Retardation Services Who are Children in Need of Treatment.

The Children’s Enrollment Form (CEF) will be used to gather basic demographic information for all children and families from all departmental populations (mental health, mental retardation/developmental disabilities, autism, and substance abuse) and sent to DHHS-CBHS within five (5) days.  The CEF will be used at the first point of contact with the agency, wherever that occurs.

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TIME FRAMES 

Providers of Children’s Targeted Case Management Services must deliver services within specified time frames as delineated in DHHS Mental Health Licensing Standards, where applicable, and Risinger Timeliness Standards. 

The service time frame guidelines below identify targeted case management activities completed within specific time frames.  

Service Time Frame 

WITHIN 5 DAYS:

• A referral/request for service is made.
• The parent(s) have been contacted and want services.
• A Children’s Enrollment Form has been completed and sent to DHHS-Children’s Behavioral Health Services.
• Timeline standards for Risinger start with either a request for service OR the date of MaineCare eligibility—whichever is later.

WITHIN 30 DAYS:

• Secure releases.
• Collect treatment information/confirm service eligibility (a letter from an MD or arrange for a timely clinical assessment to be provided).
• Evaluations can be conducted by a psychiatrist, physician, licensed clinical psychologist, advanced practice psychiatric nurse, licensed clinical social worker, licensed master of social work/conditional, licensed clinical professional counselor, or a licensed clinical professional counselor/ conditional, which includes primary and secondary diagnoses in accordance with the Diagnostic and Statistical Manual of Mental Disorders IV or the Diagnostic Classification: 0-3 Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood.  Diagnoses of mental retardation and autism will be accepted from a physician or a licensed clinical psychologist.
• Determine MaineCare eligibility. If not currently receiving MaineCare services, assist family in applying for benefits.
• Determine initial level of care.
• A case manager is assigned and will contact child & family within 5 business days.
• The child is in active service once first face-to-face contact has occurred and informed consent has been established.
• Explain the rights of recipients of mental health services and establish informed consent.
• A comprehensive assessment consistent with the Wraparound Process, which identifies the strengths and needs of the child and family across the life domains, is completed.
• DHHS-CBHS approved assessment tools are completed, consistent with the Child/Adolescent Assessment Program Manual, September 2003.
• ISP is completed within 30 days of child being in active service.

Within 180 days of request of services or date of MaineCare eligibility (whichever is later), all the above items must be completed in accordance with Risinger Timeliness Standards (14 472 CMR CH. XX CBHS Rule).

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CENTRAL ENROLLMENT 

Enrollment is a unified process of determining baseline eligibility for services in accordance with Title 34B and Chapter 790, which governs the scope of DHHS-Children's Behavioral Health Services, (formerly BDS, Services For Children with Special Needs).  

When a referral for MaineCare Section 13.12 Targeted Case Management Services, Section 65 H Behavioral Health Services, or Section 24 Day Habilitation Services is submitted on a Children's Enrollment Form to the Department, a child is enrolled into the Department’s system of care and the referral for service is entered into the Enterprise Information System.

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WAIT LIST 

All agencies providing Section 13.12 Targeted Case Management Services shall maintain a wait list.  Separate, unduplicated wait lists shall be kept for the referrals to targeted case management services, using the child’s full name.  Siblings who have been determined to need the same services shall be maintained on the wait list as individuals, not as family groups. 

Agencies shall have documented contact with the child’s guardians, reevaluating the continuation of referral for service at least every 30 days.  Copies of the wait lists themselves shall be provided to the Department by the 10^th day of each month. 

A child name is added to a wait list when:

• Parent/Guardian requests or confirms desire for service.
• MaineCare eligibility is confirmed/in place for the child.
• Diagnosis of eligibility is available and documented.

While a child is on a wait list, the following happens:

• The child has been offered or provided information and referral regarding other support and treatment services.
• The child is referred to other appropriate services including other TCM providers.
• The agency has contact with parent/guardian every thirty (30) days.

 Removing a child from the wait list will occur when:

• The child’s case is open for targeted case management services.
• The family declines service.
• Eligibility cannot be determined.
• The child is assigned to another TCM agency.
• The child is assigned to other appropriate services and no longer needs TCM services.
• The child moved out of the catchment area.
• The child is not eligible for services at this time.

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SAFETY OF STAFF 

The agency will have written policies and procedures to maintain staff safety when faced with issues of potential violence, public health issues, or other situations potentially dangerous to staff in the office or community. Every effort should be made to ensure the health and safety of staff while still meeting the needs of families. This may involve agreements to meet outside of the home to avoid significant health issues or potentially violent family members while assisting the family in addressing these issues. It is reasonable to share expectations of behavior and environmental health and safety with families, preferably as part of the informed consent sign-on process (intake). Termination or denial of services for these reasons is seen as a last resort, only if all other potential accommodations are exhausted.

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