Using a systems approach to serving individuals with complex needs Identifying Complex Needs Human Service Agencies Social Services 911211 Systems Mental HealthSubstance Abuse Systems Schools ID: 652404
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Slide1
Community Case Management
Using a systems approach to serving individuals with complex needsSlide2
Identifying Complex Needs
Human Service Agencies
Social Services
911/211 Systems
Mental Health/Substance Abuse Systems
Schools
Hospital Systems
Courts & Correctional Systems
Community Support Agencies
Law Enforcement
Family & Friends
Community at Large
Etc, etc, etcSlide3
System of Care
A valued-based approach/philosophy for serving people with complex needs that is client driven, community-based, and culturally and linguistically competent.Slide4
Case Management
Case management is a collaborative service that provides assessment, planning, facilitation and advocacy for options and services to meet an individual’s holistic needs through communication and available resources to promote quality cost-effective outcomes.Slide5
Historical Overview
Child, Adult and/or Family
Mental Health
Social Services
Court Services
Corrections
Alcohol & Drug
Schools
Human ServicesSlide6
Historical Overview
Child, Adult and/or
Family
Mental Health
Social Services
Court Services
Corrections
Alcohol & Drug
Schools
Human ServicesSlide7
SOC Approach
Child, Adult and/or Family
Mental Health
Social Services
Court Services
Corrections
Alcohol & Drug
Schools
Human Services
Informal Community SupportsSlide8
ASSISTANCE
COMMUNITY
RESOURCES
EMPOWERMENT
SYSTEMS
of CARE
Community Case
ManagementSlide9
Pennington County Health and Human Services
Changing Lives….. Changing Courses…..
A diversion program empowering people to make positive changes!Slide10
Community Resources Committed to Rebound MembersSlide11
Intensive case management provides the tool in reducing the barriers clients often face when obtaining services.
Since 2006, Rebound caseworkers have made
2,948
physical contacts with
709
members in the program.
Pennington County Health and Human Services
Rebound
Community Referrals to Rebound Program
12/01/2006 to
04/30/2012Slide12
Barriers that once complicated members success have been resolved.
Multiple agencies have come together to assist in the success of these individuals.
Pennington County Health and Human Services
Rebound
Rebound Referrals to the Community
01/01/2011 to
04/30/2012Slide13
Slide14
Pennington County Health and Human Services
John T. Vucurevich Foundation Grant
Referrals From Community Agencies
01/01/2011 to
12/31/2011
TOTAL:
310 ReferralsSlide15
Pennington County Health and Human Services
John T. Vucurevich Foundation Grant
Financial Assistance Provided on Behalf of Community Referrals Received
01/01/2011 to
12/31/2011
$35,000.00
Total ExpendedSlide16
Pennington County Health and Human Services
John T. Vucurevich Foundation Grant
Financial Assistance by the Type of Service Provided
01/01/2011
to12/31/2011
$35,000.00
Total ExpendedSlide17
Pennington County Health and Human Services
John T. Vucurevich Foundation Grant
Cost Share with Client and Agency
01/01/2011 to 10/17/2011
Total: 248Slide18Slide19
From January 1, 2011 through April 30,
2012, a total of
219
new individuals were referred to HHS/transitional case management (TCM) for services.
HHS/TCM
now tracks ongoing previous referrals receiving case management services from HHS/TCM.
In April
2012 HHS/TCM worked with 9
ongoing CCC clients
.
Crisis Care Center
Transitional Case ManagementClient Referrals
01/01/2011 to 04/30/2012Slide20
As of
April 30, 2012
transitional case management staff have coordinated services with 24 community agencies. A total of
165
referrals have been made to these agencies.
Crisis Care Center
Transitional Case Management
Referrals
to Community Agencies
01/01/2011 to
04/30/2012
Total: 165Slide21
As of
April 30,
2012 Health & Human Services Transitional Case Management staff, as well as varied community agencies, have coordinated and provided a total of
230 services
for Crisis Care Clients.
Crisis Care Center
Transitional Case Management
Coordinated/Provided Services
01/01/2011 to
04/30/2012
Total: 230Slide22
Physical client contacts refer to actual face-to-face contact with a CCC client.
Agency transport refers to transports given to a CCC client by Transitional Case Management with a company vehicle for the purposes of getting to appointments, obtaining food, shelter, clothing, etc.
Phone calls made by Transitional Case Management to both the CCC client and community agencies on the clients behalf.
Crisis Care Center
Transitional Case Management
Caseworker Activity
01/01/2011 to
4/30/2012
Total: 1,049Slide23
Pennington County Health and Human Services
Rebound, JTV Grant and Crisis Care Transitional Case Management
Total Referrals
IN FROM
Community Agencies
01/2011
to 02/29/2012
Total: 879Slide24
Pennington County Health and Human Services
Rebound, JTV Grant and Crisis Care Transitional Case Management
Total PCHHS Referrals
OUT TO
Community Agencies
01/01/2011 to 02/29/2012
Total: 1,137Slide25
Agencies Working Together
Motivational Interviewing
Effective Case Managers
Creates
Changed Lives
Empowered Clients
Moving to the
Slide26
Steps for Getting There
An agreed upon definition and role of community case management.
A forum for training new case managers and linking new and seasoned case managers together.
Develop processes that result in integrated community case service plans.
Develop web-based software to monitor services to individuals with complex needs.