As a clinician providing case management services through the CSB, I am just trying to understand the goals of the proposed changes.   What is not working with the current arrangement for case management and what is the plan designed to improve?

Under the Medical necessity section, the language does not include QMHP/QMHCM regarding documentation of SED/at risk or SMI.  This is contradictory from the Required Activities section that list both QMHP/QMHCM and LMHP types are able to complete the assessment documentation.    Does this mean that the SED/at risk or SMI documentation would require LMHP types to complete??  What is the purpose of this difference for that piece of documentation?

Under the Staff Caseload Requirements, several questions arise.   It states that Categories should be reviewed at a minimum of every 90 days.   Would this be the quarterly review?  Will there be another tool to use to review the category for each consumer?  Would this be additional documentation for staff providing the services?  If not the quarterly review, an additional form/assessment tool?

In addition, the categories and levels are vague.  They are subjective and open to a great deal of confusion/misunderstanding/incorrect labeling.   Reimbursement levels and number of hours required for case management activities for each level are the same at this time.  If that remains the same, what is the benefit/reason for assigning a level?

How do we manage ratios for mixed caseloads?   The weight of the caseloads could vary frequently causing individuals in services to be moved from caseload to caseload due to ratios. This would mean a consumer’s needs/preferences may not be able to be factored in as much as the caseload ratios.   This does not seem very consumer friendly or consumer centered.  Our individuals take time to build rapport and develop trust, changing caseloads frequently would impact their care.

As a manager/supervisor of case management staff, this sounds very challenging to navigate and manage for consumers and families primarily.   Various staff and locations of staff would be challenging to manage as well.