Goal 09: Improve the flexible availability and continuity of community-based recovery supports.
Performance Targets: By July 2014, (1) Establish a continuum of TCM services that includes four components: Intensive, Crisis, Level I (regular case management), and Recovery; and (2) Increase the number of TCM slots by 6% (90) over the 2012 baseline (1,472).
Tactical Objective 9.1: Develop, pilot, and implement a mechanism for flexible utilization management that supports individualized matching of service intensity with the continuum of case management and other recovery supports.
Tactical Objective 9.2: Develop, pilot, and implement procedures to move from higher to lower levels of support (and conversely) in response to changing circumstances, e.g., crisis.
Progress on Targets and Objectives: Performance Targets 1 and 2 have been achieved. In April 2013, contracts were awarded to Bell Therapy for Level I Targeted Case Management (TCM) and to Milwaukee Mental Health Associates (MMHA) to pilot Recovery Case Management. Two caseloads of Level I TCM were added for Bell Therapy to serve 50 additional individuals. Recovery Case Management, which is a new level of care, allows case managers to maintain a caseload of 40 and is intended for clients who require less intensive services than what is provided in TCM Level I. A pilot for this new level of TCM was therefore created for individuals who require case management services as a condition of their residential living arrangement such as Shelter Plus Care, Permanent Supportive Housing, or a supported apartment. MMHA realigned their existing case management caseloads and identified those clients that could benefit from the Recovery Case Management level of care and also made this level of care available to other TCM agencies thus allowing for additional Level 1 capacity.
There is now a service continuum within TCM that did not exist before. Level II is the clinic-based model of TCM and is the most intensive level of TCM, then followed by crisis TCM, Level I TCM, and Recovery Case Management. Intensity is defined by service provision and availability and caseload capacity.
Implementation Challenges: Nothing unusual with the start-up of a new agency, new level of care.
Key Points for Redesign Task Force: Achieving these Performance Targets would not have been possible without the Community Reinvestment funds. Those funds are financing the TCM Level I expansion with Bell Therapy and the Recovery Case Management pilot with MMHA.
(Update provided by Sue Gadacz)