ARM 37.90.425. HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS: CASE MANAGEMENT, REQUIREMENTS

(1) Case management is the planning for, arranging for, implementation of, and monitoring of the delivery of services available through the program to a recipient. (2) Case management services include: (a) developing a plan of care for a recipient; (b) monitoring and managing a plan of care for a recipient; (c) establishing relationships and contracting with service providers and community resources; (d) maximizing a recipient's efficient use of services and community resources such as family members, church members, and friends; (e) facilitating interaction among people working with a recipient; (f) prior authorizing the provision of all services; and (g) managing expenditures. (3) A case management team must consist of: (a) a registered nurse currently serving on a case management team serving persons who are recipients through the program of home and community services for the elderly and persons with physical disabilities; and (b) a social worker currently employed by a licensed mental health center with two consecutive years experience providing case management services to adults with mental illness. (4) The case management team must: (a) be a legal entity contractually retained by the department to provide Medicaid funded home and community case management services to persons who are elderly or who have physical disabilities; (b) function as directed by the department; (c) assure that services provided to recipients are of appropriate quality and cost effective; (d) provide case management services to no more than the number of persons specified by the department; (e) manage expenditures within the allocated monies; and (f) meet the department's reporting requirements.