Case management assists participating providers in the care of members with special needs or complex mental health problems. Case management is available plan-wide.
The following types of cases are most commonly referred to mental health case management:
- Pregnant and substance-abusing members with treatment compliance and relapse problems.
- Two or more readmissions within three months.
- Chronic lethality risk with history of suicide attempts.
- Chaotic family contributing to high use of service/cost of service.
- Dual-diagnosed (substance abuse and mental health) members with more than two admissions in a three-month period and treatment compliance problems.
- Children and adolescents at risk of out-of-home placement or loss of parental custody as indicated by either prior, current, or record of considerations of out of home placement or removal of parental custody.
