La. Admin. Code tit. 48 § I-4931

Current through Register Vol. 50, No. 9, September 20, 2024

Section I-4931 - Case Management/Service Coordination Services

A. Case management must consist of services to assist consumers in gaining access to the full range of needed services, including medical, social, educational and other support services. These must be ongoing services which must be accomplished through the following activities.

1. Intake, which must include determination of a consumer's eligibility for case management services as part of a targeted group of consumers and the determination of need for case management services. All consumers must be interviewed within 14 calendar days of referral to the provider.

2. Assessment/reassessment, which must include the collection and integration of formal/professional and informal information concerning a consumer's social, familial, medical, developmental, legal, educational, vocational, psychiatric and economic status, as appropriate, to assist in the formulation of a comprehensive, individualized written service plan.

a. The assessment process must include input from the consumer/guardian, and may include input from family members, friends, professionals, and service providers, as appropriate.

b. The assessment must focus on the individual's strengths and needs. The case manager must make a face-to-face contact with the consumer as part of the assessment process.

c. The consumer's status must be reassessed on an ongoing basis.

3. Service planning, which must include the development of a comprehensive, individualized written plan based on the needs and strengths of the consumer identified during the assessment process.

a. The consumer/guardian must actively participate with the case manager in development of the service plan with input from family members, professionals and service providers, as needed.

b. The objective of service planning must be to promote consistent, coordinated, timely and quality service provision.

c. The service plan must include, at a minimum: consumer strengths and needs; specific measurable goals and objectives with anticipated time-frames.

d. The service plan must be completed within 45 calendar days of the intake interview for case management services.

e. The written service plan must be reviewed at least 90 days to assure goals and services are appropriate to the consumer's needs identified in the assessment/reassessment process.

D. Linkage, which must assure that the consumer has access to and is receiving the most appropriate services available to meet needs as outlined in the service plan. Linkage must include, but is not limited to:

1. contacting the individual's support network including family, neighbors and friends to mobilize assistance for the individual; and

2. locating or assisting the consumer in locating formal and informal service providers;

3. advocacy, which may occur on behalf of the consumer when needed to assure the consumer has access to and receives appropriate services.

E. Monitoring/follow-up, which must include ongoing interaction with the consumer/guardian, family members and professionals (as appropriate), and service providers to ensure that the agreed upon services are provided in a coordinated and integrated manner and are adequate to meet the needs and stated goals of the service plan. The case manager must make at least monthly face-to-face contacts with the consumer/guardian as part of the linkage and monitoring/follow-up process.

F. Transition/closure, which must be a joint decision made by the case manager, consumer and/or family member, when appropriate. Closure must occur upon completion of all case management goals identified on the service plan except when case management is a required component of a service or a required service.

La. Admin. Code tit. 48, § I-4931

Promulgated by the Department of Health and Human Resources, Office of the Secretary, Division of Licensing and Certification, LR 13:246 (April 1987), amended by the Department of Health and Hospitals, Office of the Secretary, LR 20:888 (August 1994).

AUTHORITY NOTE: Promulgated in accordance with R.S. 28:380-451.