Case management shall be central to the operation of the interdisciplinary treatment team and shall be based on the diagnosed level of care needed by the primary consumer. Case managers for APIA consumers shall require special skills in advocacy, access of community-based services and systems, and interagency coordination. Case management shall also be consumer- and family-driven. Case managers shall be accountable for the cost and appropriateness of the services they coordinate. The Managed Care Plan shall maintain responsibility for the successful and appropriate implementation of the Case Management Plan and the provision of adequate administrative resources and endorsement.
- Case managers working with APIA consumers and their families shall be demonstrate their level of APIA cultural competence as part of their privileging and credentialing standards within the Plan as a condition of their employment, or in consultation with, an APIA culturally competent Mental Health Specialist.
- Case managers shall be knowledgeable about APIA populations, their resources, and natural supports.
- Case managers shall have access to flexible funds for the provision of wrap-around services to APIAs.
- Case management shall be continuous and proportional to the degree of the APIA consumer’s need, level of impairment, and person/family resilience. The case manager shall act as a single point of contact and have responsibility across all levels of the system of care.
- The Health Plan shall define and enforce caseloads for APIA consumer case managers consistent with industry standards, accounting for severity of consumer impairment/case mix and associated cultural stressors. These shall enable case managers to effectively serve APIA consumers and prevent burnout and unacceptable levels of turnover. There shall be recognition that case or care management for APIA consumer who have limited English proficiency and/or have a broadly defined "client-defined family" and/or social network (i.e., clan leader) relevant to their care, may require additional time.
- Practice privileges shall be afforded to case managers serving APIA consumers and their families, across the entire system of care including settings such as inpatient facilities.
- Each member of the APIA consumer’s Treatment Plan has responsibility for developing progress notes and reports as appropriate.
- The primary provider/case manager shall periodically review the APIA consumer’s progress in accordance with the Treatment Plan. Changes in the components of the Treatment Plan shall be reviewed with the APIA consumer before implementation.
Recommended Performance Indicators
- APIA cultural competence requirements commensurate with level of responsibility (including, supervision) of case managers who serve APIA consumers.
- APIA cultural competence training for all case managers as part of a credentialing process.
- APIA community resources and natural supports included in all care plans.
- Use of flexible funding for APIA consumers, comparable to others.
- Sufficient numbers of case managers to support caseload and workload standards for APIA consumers.
- APIA consumer and case manager involvement treatment decisions across all levels of care.
- APIA consumer and family satisfaction with selection of services.
Benchmark: 90% satisfaction
- APIA reduction in utilization of and lengths of stay in more restrictive levels of care.
Benchmark: Comparable to overall community and decreasing over time
- APIA access to APIA culturally competent mental health care across all levels of care within the system.
Benchmark: Comparable to overall community and decreasing over time.