What is Targeted Case Management
Medicaid Targeted Case Management is a service that manages multiple resources for Medicaid members. It is designed to help persons with intellectual disabilities, chronic mental illness, brain injury, serious emotional disorders, or developmental disabilities gain access to appropriate and necessary medical services and interrelated social and educational services.
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:
Who Provides Targeted Case Management
Iowa limits the providers of Targeted Case Management Services for individuals with disabilities to the county or the Department of Human Services. County Boards of Supervisors are required to select the TCM provider per Iowa Code Section 225C.20. However, the Iowa Code allows a county to subcontract for the provision of case management services.
Targeted Case Management Staff and Provider Requirements
There are over 465 Medicaid targeted case managers for persons with intellectual disabilities. Most serve persons with chronic mental illness and developmental disabilities, which includes persons with intellectual disabilities. DHS-TCM employs 135 case managers. The additional 330 case managers are employed by the case management entities selected by the counties.
TCM providers must meet the standards established under 441-24 of the Iowa Administrative Code. Providers are accredited by the Division of MHDS and receive accreditation for up to 3 years. These standards set forth expectations for staff qualifications, staff development, case planning and service delivery, and documentation.
Targeted case manager requirements:
To become and to remain a Medicaid enrolled TCM provider, the entity must be accredited under Chapter 24. In addition, TCM providers must comply with the provisions of IAC 441-90 which operationalizes the provisions in the state's Medicaid Plan that is approved by the Center for Medicare and Medicaid (CMS).
Populations eligible for TCM Services are:
The following factors are considered when determining the need for case management:
DHS Targeted Case Management Program
DHS Targeted Case Management has formal, written contracts with each county they serve. The DHS-TCM contract with counties can be for one or a combination of the populations eligible for TCM services.
DHS Targeted Case Management:
DHS TCM served 5,584 consumers in fiscal year 2011 broken down as follows:
|Intellectual disabilities (adult):||2,674||consumers|
|Intellectual disabilities (children):||715||consumers|
|Brain injury (adult):||192||consumers|
|Brain injury (children):||131||consumers|
|Chronic mental Illness (Habilitation)||594||consumers|
|Chronic mental illness (MBC)||414||consumers|
|Children with SED||702||consumers|
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.
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