What is Targeted Case Management
Medicaid Targeted Case Management (TCM) is a service that manages multiple resources for Medicaid members. It is designed to help persons with intellectual disabilities, brain injury, or developmental disabilities gain access to appropriate and necessary medical services and interrelated social and educational services.
DHS TCM Provider Qualifications
- Nationally accredited by the Council on Accreditation.
- Accredited by 441 Iowa Administrative Code - Chapter 24: Accreditation of Providers.
- Meets training, staff qualification, and other state and federal requirements for case management/care coordination services.
- Meets federal criteria for conflict-free case management.
Role of Targeted Case Managers
Targeted Case Managers facilitate the community-based assessment and planning process by working with consumers, families, service providers, and other agencies and individuals to create an individualized plan based on a comprehensive assessment of needs for each person. In addition, case managers assist consumers and/or parents or guardians in navigating the service system.
Typical responsibilities of targeted case managers include:
Assessing needs and completing a comprehensive assessment,
Developing an individualized care plan, including a crisis plan,
Referral for services,
Coordination of services
Ongoing monitoring to assess the consumer's safety, well-being, and stability, as well as monitoring the progress toward the goals identified in their individual care plan.
Eligible Providers of Case Management
Populations eligible for DHS TCM Services are:
Adults and Children with Intellectual Disabilities
Adults with Developmental Disabilities
Individuals with Brain Injury
The following factors are considered when determining the need for case management:
The consumer has a need for case management to manage multiple resources pertaining to medical and interrelated social and educational services for the benefit of the consumer;
The consumer has functional limitations and lacks the ability to independently access and sustain involvement in necessary services; and
The consumer is not receiving other paid benefits under the medical assistance program or under a Medicaid managed health care plan that serves the same purpose as targeted case management.
Medicaid Targeted Case Management is required for all persons with an Intellectual Disability receiving services in the Medicaid Home and Community Based Waiver Program.
- Services are delivered locally - at home, in the community, and in other places where people need them the most.
- Health Home Approach - to integrate and coordinate primary care, behavioral health services, and long-term community based services and supports.
- Population health management resulting in long-term community tenure with individuals with disabilities.
- Provides 24 hour, 7 days a week, 365 days a year, live crisis telephone response.
- Employment Specialists to achieve competitive employment.
- Nursing staff who conduct medication reviews, medical consultation, and training.
DHS Targeted Case Management Program
DHS Targeted Case Management:
Provides services to 4,300 individuals
Employs 202 staff
Has 29 offices that promote service continuity across the state
DHS TCM served 4,228 consumers in fiscal year 2015 broken down as follows:
|Intellectual disabilities (adult):
|Intellectual disabilities (children):
Targeted Case Management office locations map
Contact Information for DHS Targeted Case Management
Please feel free to contact the following individuals with any questions or concerns regarding DHS Targeted Case Management.
Social Work Administrator - East
Social Work Administrator - West
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