Ohio Case Management for Mental Health

Case Management in Ohio

Case management plays a crucial role in providing support and coordinating services for individuals with mental health and addiction needs in Ohio. Let's explore an overview of case management and the specifics of targeted case management in Ohio.

Overview of Case Management

Case management is a collaborative process that involves assessing, planning, coordinating, and monitoring services to meet the unique needs of individuals. In the context of mental health and addiction treatment, case managers work closely with individuals to ensure they receive comprehensive and integrated care.

Case managers in Ohio help individuals navigate the complex healthcare system, connect with appropriate resources, and develop individualized care plans. They facilitate communication between healthcare providers, social service agencies, and other stakeholders to ensure a holistic approach to treatment and recovery.

Targeted Case Management in Ohio

Targeted case management in Ohio specifically focuses on individuals with substance use disorders. It includes comprehensive assessment, care plan development, referral services, and monitoring activities to address the medical, social, educational, and other needs of eligible individuals. Targeted case management helps individuals access the necessary resources and support to aid in their recovery process.

To be eligible for targeted case management services in Ohio, individuals must meet certain criteria and requirements. Case managers work closely with individuals to assess their needs and develop personalized care plans that address their specific challenges and goals. Regular monitoring is performed to ensure the ongoing effectiveness of the care plan.

It's important to note that certain activities, such as transportation, waiting for appointments, direct services, and internal quality assurance activities, are ineligible for reimbursement as targeted case management in Ohio. Additionally, targeted case management services will not be separately reimbursed in Ohio when a recipient is enrolled in a substance use disorder residential treatment facility. Prior authorization from the Ohio Department of Medicaid designated entity is required for targeted case management services when a recipient is enrolled in an assertive community treatment (ACT) or intensive home-based treatment (IHBT) team.

In conclusion, case management in Ohio plays a vital role in supporting individuals with mental health and addiction needs. Targeted case management specifically focuses on individuals with substance use disorders, providing comprehensive assessment, care planning, referral services, and monitoring activities. By utilizing case management services, individuals can receive the necessary support and resources to aid in their recovery journey.

Regulations and Guidelines

When it comes to case management for mental health in Ohio, there are specific regulations and guidelines that govern the provision of services. These regulations ensure that individuals receive the appropriate care and support they need. In this section, we will explore the Ohio Administrative Code requirements and exclusions from targeted case management.

Ohio Administrative Code Requirements

The Ohio Administrative Code outlines the requirements for targeted case management services in Ohio. These services aim to address the medical, social, educational, and other needs of eligible individuals with substance use disorder. The requirements include comprehensive assessment, care plan development, referral services, and monitoring activities.

One of the key aspects of targeted case management is the requirement for annual monitoring. This ensures that individuals' needs are continuously evaluated and that appropriate adjustments are made to their care plans as necessary.

Exclusions from Targeted Case Management

While targeted case management is an essential service, there are certain exclusions outlined in the Ohio Administrative Code. Unlicensed practitioners, such as qualified mental health specialists and peer recovery supporters, are excluded from providing targeted case management services in Ohio [1]. This ensures that individuals receive care from qualified professionals with the necessary expertise and training.

Additionally, certain activities are ineligible for reimbursement as targeted case management services. These activities include transportation, waiting for appointments, direct services, and internal quality assurance activities. It's important for case managers to be aware of these exclusions to ensure compliance with the regulations.

Furthermore, targeted case management services will not be separately reimbursed in Ohio when a recipient is enrolled in a substance use disorder residential treatment facility. This is to avoid duplication of services and ensure efficient use of resources.

Prior Authorization Requirements

In certain cases, prior authorization from the Ohio Department of Medicaid designated entity is required for targeted case management services. This requirement applies when a recipient is enrolled in an assertive community treatment (ACT) or intensive home-based treatment (IHBT) team. The prior authorization process helps to ensure that individuals receive the appropriate level of care and support.

By adhering to the regulations and guidelines outlined in the Ohio Administrative Code, case managers can provide effective and compliant targeted case management services to individuals with mental health needs. Understanding these requirements and exclusions is essential for delivering high-quality care and supporting individuals on their path to recovery. For more information on case management for addiction and behavioral health treatment in Ohio, check out our article on ohio's top case management for addiction.

Case Management Services

Effective case management services play a crucial role in supporting individuals with mental health needs in Ohio. These services ensure that individuals receive the necessary assistance and support to navigate the complexities of the behavioral health system. Two essential aspects of case management services in Ohio are reimbursement eligibility and prior authorization requirements.

Reimbursement Eligibility

In Ohio, targeted case management services are eligible for reimbursement, providing essential financial support for organizations and professionals delivering these services. However, it's important to note that reimbursement is not available when a recipient is enrolled in a substance use disorder residential treatment facility [1]. This exclusion ensures that individuals in these facilities receive specialized care tailored to their specific needs.

Prior Authorization Requirements

To ensure the appropriate delivery of targeted case management services in Ohio, prior authorization is required in specific situations. When a recipient is enrolled in an assertive community treatment (ACT) or intensive home-based treatment (IHBT) team, prior authorization from the Ohio Department of Medicaid designated entity is necessary [1]. This requirement helps maintain the quality and effectiveness of case management services, ensuring that individuals receive the most appropriate and tailored support for their mental health needs.

When providing targeted case management services, it's important to adhere to the guidelines and regulations set forth by the Ohio Administrative Code. Certain activities, such as transportation, waiting for appointments, direct services, and internal quality assurance activities, are ineligible for reimbursement as targeted case management in Ohio [1]. Understanding these guidelines helps case managers provide services within the scope of reimbursement and ensure compliance with the regulations.

By following reimbursement eligibility criteria and prior authorization requirements, case managers in Ohio can ensure that their services are appropriately compensated and meet the necessary standards for effective mental health support. These processes help maintain the integrity of case management services and ensure the provision of high-quality care to individuals in need.

For more information on case management in Ohio and how it aids in recovery, visit our article on ohio's top case management for addiction.

Training and Certification

To ensure that case managers in Ohio have the necessary skills and knowledge to provide effective services, Ohio University offers a comprehensive certification program specifically designed for case managers in the healthcare field. This program, known as the Case Manager Certification Preparation Program Series, is offered through the College of Health Sciences and Professions.

Ohio University's Certification Program

Ohio University's Case Manager Certification Preparation Program Series is specifically tailored for healthcare professionals seeking to expand their knowledge in population health, value-based care concepts, and delivery models. The program is beneficial for individuals involved in care coordination and can enhance the expertise of inter-professional team members, including case managers in the behavioral health field [2].

The program is designed to be accessible and flexible, offering an online format that allows clinicians to register and complete the courses at their convenience from anywhere. This format also makes the program more affordable, as it eliminates the need for travel expenses or time away from work [2].

Program Structure and Benefits

The Case Manager Certification Preparation Program Series consists of five courses that cover various essential topics in case management. These courses are designed and taught by experienced healthcare professionals, ensuring that the content is relevant and up-to-date. Some of the key topics covered include care delivery and reimbursement methods, ethical and legal standards, care coordination, psychosocial concepts, support systems, quality evaluation, and outcomes measurement in case management.

Completing this comprehensive program provides healthcare professionals with the opportunity to earn continuing education credits. Additionally, individuals employed by Ohio University's healthcare partners may be eligible for discounts on the program fees. The cost for the entire program is $520, or $115 for each individual course. These fees provide participants with valuable knowledge and skills that can positively impact their practice as case managers [2].

Furthermore, the workshops within the program have been approved for continuing education hours by the State of Ohio Counselor, Social Worker, and Marriage and Family Therapist Board in Columbus, Ohio. This approval is valid through January 31, 2027, ensuring that participants receive recognized professional development opportunities.

By successfully completing Ohio University's Case Manager Certification Preparation Program Series, healthcare professionals can enhance their knowledge and skills in case management. This certification can contribute to their professional growth and effectiveness in supporting individuals with mental health needs in Ohio.

Mental Health Initiatives in Ohio

As part of its commitment to promoting mental health and wellness, Ohio has implemented various initiatives to address the mental health needs of its residents. Two key initiatives aimed at protecting youth mental health are the Protecting Youth Mental Health program and the Ohio School Wellness Initiative.

Protecting Youth Mental Health

In response to the rise in mental health symptoms among young people, the Protecting Youth Mental Health program was established. The U.S. Surgeon General's Advisory noted an increase in depression, anxiety, and suicidal ideation during the ten years leading up to the pandemic.

To address these alarming trends, Ohio has implemented evidence-based approaches to support student and staff wellness. One such approach is the Model Student Assistance Program (SAP), which is aligned with existing structures in Ohio schools, such as the Positive Behavioral Interventions and Supports (PBIS) Framework. These programs aim to provide targeted support to students and staff, helping them navigate mental health challenges and promoting overall well-being.

Ohio School Wellness Initiative

The Ohio School Wellness Initiative is a collaborative effort between the Ohio Department of Education and Workforce, the Ohio Department of Mental Health and Addiction Services, and the Center for School-Based Mental Health Programs at Miami University. This initiative focuses on prevention, early intervention, and support practices for K-12 students and staff within Ohio schools.

Through federal emergency relief funding, the Ohio Department of Mental Health and Addiction Services awarded Miami University $5 million to establish a School-Based Center of Excellence. This center aims to prioritize mental health and wellness for K-12 students and staff across the state. It serves as a hub for providing resources, training, and guidance to schools, helping them implement effective strategies to support mental health and wellness [3].

To further strengthen mental health services in schools, Ohio has also allocated a $1.2 million grant to advance Project AWARE (Advancing Wellness And Resiliency in Education). This grant enables schools to increase their capacity to provide mental health services and support by placing dedicated Behavioral Health and Wellness Coordinators in schools statewide. These coordinators play a crucial role in connecting students with appropriate resources and ensuring that their mental health needs are addressed [3].

These mental health initiatives demonstrate Ohio's commitment to prioritizing the well-being of its youth and fostering a supportive environment within its educational institutions. By investing in proactive measures and providing resources for mental health support, Ohio aims to create a healthier and more resilient community for its residents.

Employment Programs in Ohio

In addition to providing case management services for mental health and addiction treatment, Ohio offers various employment programs to support individuals in their recovery journey. One such program is the Comprehensive Case Management and Employment Program (CCMEP).

Comprehensive Case Management and Employment Program (CCMEP)

The Comprehensive Case Management and Employment Program (CCMEP) is a statewide initiative aimed at helping individuals overcome barriers to employment and achieve self-sufficiency. CCMEP participants receive comprehensive case management services, connecting them with resources and opportunities to enhance their employability and improve their overall well-being.

CCMEP is available to individuals who are receiving Ohio Works First (OWF) benefits or are eligible for such benefits. The program assists participants in developing and implementing an Individual Opportunity Plan (IOP) that outlines their career goals and the steps needed to achieve them. Participants work closely with their assigned case managers to identify appropriate services and supports tailored to their specific needs.

Participation in CCMEP activities requires a standard of twenty hours per week, although the lead agency has the flexibility to assign fewer hours based on the participant's needs, such as in cases of domestic violence situations or temporary barriers to participation. The program offers a variety of activities to support participants in gaining skills and experience, including:

• Unsubsidized employment
• Vocational education training
• Mental health treatment
• Rehabilitation activities
• Other workforce activities to prepare for unsubsidized employment or post-secondary education (Ohio Department of Job and Family Services)

Participation Requirements and Activities

CCMEP participants who are not in receipt of Ohio Works First (OWF) benefits are subject to semi-annual eligibility reviews to ensure they meet the criteria for receiving Temporary Assistance for Needy Families (TANF)-funded services. If a participant becomes ineligible for TANF-funded services, the lead agency must end those services and determine eligibility for Workforce Innovation and Opportunity Act (WIOA) funded services.

To track participation, CCMEP participants' activity service hours in unpaid activities for OWF work-eligible individuals must be verified monthly. Verification methods may include OWCMS-generated schedules, attendance reports, and documented phone contacts with work sites.

The CCMEP program aims to equip participants with the skills, resources, and support needed to secure and maintain employment, ultimately fostering self-sufficiency and long-term success. By providing comprehensive case management services and a range of activities, CCMEP empowers individuals in their recovery journey and helps them build a solid foundation for a brighter future.

For more information about CCMEP and other employment programs available in Ohio, individuals can consult their local Ohio Department of Job and Family Services office or visit the official website of the Ohio Department of Job and Family Services.

References

• ‍[1]: https://www.ohio.edu/chsp/continuing-education/case-manager-certification-series
• ‍[2]: https://www.colemanservices.org/services/case-management/
• ‍[3]: https://rbhealthllc.com/behavioral-health-services/case-management/