A very concerning safety risk is that the manual states that a referral will dictate that a case manager must make a home visit to complete assessment for service planning and complete an MPAI. This is a concern as there is no know information about the individual and what a home visit may entail and if it is safe. There is no background check process before just immediately completing an assessment in their home. There are many instances in which home visits are a challenge for services due to dual diagnosis information, family dynamics, accessibility and safety of homes, issue of weapons unsecured in homes and the list goes on. 

Routine process of a referral requires collection of medical records, talking with other providers to gather additional information, and obtain permission to complete this process. An MPAI is not completed until after eligibility and active case management services begin to ensure participation. This is a LOT of upfront service initiation that may not even result in eligibility for TCM that goes away from safety practices.