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A New Service: Targeted Case Management (TCM) Plus

Beth Hess - Thursday, August 25, 2016

The Behavioral Health Administration has initiated a new program designed to support children and youth with intensive mental health and/or substance use issues and their families, called TCM Plus. TCM Plus provides services in addition to those provided by Targeted Case Management (TCM). They include family-to-family peer support and funding for customized goods and services that have been determined necessary in order to implement a Plan of Care.  Unlike TCM, a youth need not be Medicaid-eligible to receive TCM Plus. There are 300 slots available for TCM Plus: 250 for youth with Medicaid, and 50 for youth with private insurance or no insurance. 

About Targeted Case Management (TCM)

Targeted Case Management is a method of delivering services to assist children and youth with intensive mental health and/or substance use problems and their families.

Each jurisdiction has at least one Care Coordinating Organization (CCO) that oversees TCM services.  CCOs assign a Care Coordinator to each family, whose job it is to help the family to develop a Plan of Care.  Plans of Care include:
  • Team meetings which consist of the Care Coordinator, the child, the family and other significant people whom the family wants present, such as social workers, educators and others involved with the child
  • Goals for the family and child
  • A pathway to achieve those goals, including linkages to resources and services
  • A crisis plan

A child must be Medicaid-eligible to receive TCM, along with meeting other clinical eligibility requirements as determined by assessments.  A child may be referred to TCM by an outpatient provider, hospital staff, or residential treatment center.  A family may also request a referral to TCM from a provider or facility, or may self-refer to TCM by contacting their local CCO.

About TCM Plus

TCM Plus includes all the services provided by TCM, plus two additional services:

  • Family-to-family peer support services: Family Peer Support Specialists, who have lived experience caring for a child with behavioral health needs, provide assistance and will attend meetings with families, help a family advocate for themselves and their child, and help a family access various resources
  • Customized goods and services: funds for services, activities and/or items identified in the Plan of Care that have a clear therapeutic benefit and have been approved by the Behavioral Health Administration
TCM Plus eligibility:
  • For Medicaid, youth must first be eligible for TCM, and then, in addition, meet one of the below criteria
  • For youth with private insurance or no insurance, youth need only meet one of the below criteria

TCM Plus Criteria

  1. Child/youth is being discharged from a Residential Treatment Center placement with a discharge plan that recommends community-based services.
    Or
  2. Child/youth is enrolled in a Home and Hospital Program.
    Or
  3. Child/youth is experiencing a combination of the risk factors listed below and would benefit from cross-discipline and multiple-agency resources.  To be eligible, the child/youth must present with at least two of the risk factors from those listed below. (The risk factors listed under “c” are considered separate risk factors that can be counted separately.)
           a. Child/youth has run away from home
           b. Child/youth uses substances illegally
           c. Child/youth has significant behavioral problems at school which could include the following:
               i. School suspensions/expulsions
               ii. Chronic absenteeism, defined as a student being absent more than 20% of school days in the last 12 months
               iii. Academic failure, defined as either receiving lower than a grade of D as a final grade for any class in any marking period or receiving an indication that the student is in danger of receiving a grade lower than a D as a final grade for any class
               iv. Display of school avoidance behaviors (a pattern of avoiding or refusing to attend school)
               v. Significant involvement with the school student support team
           d. Child/youth has been arrested or has had previous or continuing involvement with the Department of Juvenile Services
           e. Child/youth has failed to successfully complete the terms or conditions of a Teen Court program
           f. Child/youth has been a victim of maltreatment which may include, abuse, neglect or being a witness to domestic violence

To access TCM Plus, contact your local MCF Family Peer Support Specialist or your local Core Service Agency. Please note: some jurisdictions are temporarily without a COO and services may not immediately be available--don't let this discourage you from reaching out for help. 

 

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