TIP 27: Comprehensive Case Management for Substance …

1 Substance abuse and Mental Health Services Administration Center for Substance abuse Treatment Comprehensive case Management for Substance abuse Treatment Treatment Improvement Protocol (TIP) Series 27. Comprehensive case Management for Substance abuse Treatment Treatment Improvement Protocol (TIP) Series 27. DEPARTMENT OF HEALTH AND HUMAN SERVICES. Substance abuse and Mental Health Services Administration Center for Substance abuse Treatment 1 Choke Cherry Road Rockville, MD 20857. Acknowledgments Electronic Access and Printed Copies This publication was produced under contract This publication may be ordered from or number 270-95-0013 for the Substance abuse downloaded from SAMHSA's Publications and Mental Health Services Administration Ordering Web page at (SAMHSA), Department of Health and Or, please call SAMHSA at 1-877-SAMHSA-7 (1 . Human Services (HHS). Sandra Clunies, , 877-726-4727) (English and Espa ol).

2 ICADC, served as the Government Project Officer. Recommended Citation Center for Substance abuse Treatment. Disclaimer Comprehensive case Management for Substance The opinions expressed herein are the views of abuse Treatment. Treatment Improvement the consensus panel members and do not Protocol (TIP) Series, No. 27. HHS Publication necessarily reflect the official position of No. (SMA) 15-4215. Rockville, MD: Center for SAMHSA or HHS. No official support of or Substance abuse Treatment, 2000. endorsement by SAMHSA or HHS for these opinions or for the instruments or resources Originating Office described are intended or should be inferred. Quality Improvement and Workforce The guidelines presented should not be Development Branch, Division of Services considered substitutes for individualized client Improvement, Center for Substance abuse care and treatment decisions. Treatment, Substance abuse and Mental Health Services Administration, 1 Choke Cherry Road, Public Domain Notice Rockville, MD 20857.

3 All materials appearing in this volume except those taken directly from copyrighted sources HHS Publication No. (SMA) 15-4215. are in the public domain and may be Printed 2000. reproduced or copied without permission from Revised 2002, 2003, 2006, 2008, 2010, 2012, and SAMHSA or the authors. Citation of the source 2015. is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, HHS. ii Contents What Is a TIP?.. v Editorial Advisory vii Consensus Panel .. ix xi Executive xiii case Management and Substance abuse Treatment .. xiii Interagency case Management .. xiv Evaluation and Quality Assurance of case Management Services .. xv case Management for Clients With Special Needs .. xvii Funding Under Managed Care ..xviii Chapter 1 Substance abuse and case Management : An Why case Management .

4 2. case Management A Brief History ..4. Definitions and Models of case Management with Substance Abusers ..6. Chapter 2 Applying case Management to Substance abuse Treatment ..13. case Management Principles ..13. case Management Practice Knowledge, Skills, and Attitudes ..15. The Substance abuse Treatment Continuum and Functions of case Management ..17. Chapter 3 case Management in the Community Context: An Interagency Perspective ..29. Characteristics of the Three Models ..30. Forging the Linkages ..33. Identifying Potential Partners ..35. The Agency Environment ..36. Potential Conflicts ..39. Chapter 4 Evaluation and Quality Assurance of case Management Services ..41. A Brief Overview of the Research Literature ..41. iii Contents Evaluating case Management Future Chapter 5 case Management for Clients With Special Needs ..51. Minority Clients ..51. Clients With HIV Infection and Clients With Mental Homeless Women With Substance abuse Problems.

5 55. Adolescent Substance Abusers ..57. Clients in Criminal Justice Settings ..57. Clients With Physical Disabilities ..62. Gay, Lesbian, Transgendered, and Bisexual Clients ..63. case Management in Rural Areas ..64. Chapter 6 Funding case Management in a Managed Care Funding case Management in a Managed Care World ..65. Preparing a Program for Managed Future Directions ..71. Appendix A Appendix B Practice Dimensions ..87. Referral ..87. Service Coordination ..90. Appendix C Managed Healthcare Organizational Readiness Guide and Checklist: Special Introduction ..99. Goals and Objectives ..100. Ways To Use the Guide and Managed Healthcare Organizational Readiness Checklist ..104. Summary of Answers ..111. Common Questions and How Can We Design an Action Program for Change? ..113. Summary and Conclusion ..113. References ..114. Appendix D Resource Panel ..115. Appendix E Field Reviewers ..117. iv What Is a TIP?

6 T. reatment Improvement Protocols (TIPs) are Although each consensus-based TIP strives to developed by the Substance abuse and include an evidence base for the practices it Mental Health Services Administration recommends, SAMHSA recognizes that behavioral (SAMHSA) within the Department of Health health is continually evolving, and research and Human Services (HHS). Each TIP involves the frequently lags behind the innovations pioneered in development of topic-specific best-practice the field. A major goal of each TIP is to convey guidelines for the prevention and treatment of "front-line" information quickly but responsibly. If Substance use and mental disorders. TIPs draw on the research supports a particular approach, citations are experience and knowledge of clinical, research, and provided. When no citation is provided, the administrative experts of various forms of treatment information is based on the collective clinical and prevention.

7 TIPs are distributed to facilities and knowledge and experience of the consensus panel. individuals across the country. Published TIPs can be accessed via the Internet at v Editorial Advisory Board Note: The information given indicates each participant's affiliation during the time the board was convened and may no longer reflect the individual's current affiliation. Karen Allen, , , Wayde A. Glover, MIS, NCAC II Director President Commonwealth Addictions Consultants and Trainers National Nurses Society on Addictions Richmond, Virginia Associate Professor Department of Psychiatry, Community Health, Pedro J. Greer, and Adult Primary Care Assistant Dean for Homeless Education University of Maryland, Baltimore University of Miami School of Medicine Baltimore, Maryland Miami, Florida Richard L. Brown, , Thomas W. Hester, Former Associate Professor Department of State Director Substance Family Medicine abuse Services University of Wisconsin School of Medicine Division of Mental Health, Mental Madison, Wisconsin Retardation and Substance abuse Georgia Department of Human Resources Atlanta, Dorynne Czechowicz, Associate Georgia Director Medical/Professional Affairs Treatment Research Gil Hill Branch Director Division of Clinical and Services Research Office of Substance abuse American National Institute on Drug abuse Rockville, Psychological Association Washington, Maryland Linda S.

8 Foley, Former Douglas B. Kamerow, , Director Director Project for Addiction Counselor Training Center for Practice and Technology National Association of State Alcohol and Assessment Drug Counselors Director Agency for Health Care Policy and Research Treatment Improvement Exchange Health Rockville, Maryland Systems Research, Inc. Washington, vii Editorial Advisory Board Stephen W. Long Richard K. Ries, Director Director and Associate Professor Office of Policy Analysis Outpatient Mental Health Services and Dual National Institute on Alcohol abuse and Disorder Programs Alcoholism Harborview Medical Center Rockville, Maryland Seattle, Washington Richard A. Rawson, Sidney H. Schnoll, , Executive Director Chairman Matrix Center Division of Substance abuse Medicine Los Angeles, California Medical College of Virginia Richmond, Virginia Ellen A. Renz, Former Vice President of Clinical Systems MEDCO Behavioral Care Corporation Kamuela, Hawaii viii Consensus Panel Note: The information given indicates each participant's affiliation during the time the panel was convened and may no longer reflect the individual's current affiliation.

9 Chair M. Susan Ridgely, , Associate Professor Harvey A. Siegal, Department of Mental Health Law and Policy Professor and Director Florida Mental Health Institute Substance abuse Intervention Programs School University of South Florida Tampa, of Medicine Florida Wright State University Dayton, Patrick Sullivan, Division Ohio Director Division of Mental Health Workgroup Leaders Family and Social Services Administration James A. Hall, Indianapolis, Indiana Associate Professor School of Social Work Panelists University of Iowa Iowa Kathleen Andolina, , , Consultant City, Iowa Center for case Management Natick, Howard Isenberg, Massachusetts Division Director Barbara A. Blakeney, , , , Outpatient Treatment Services Principal Public Health Nurse Northeast Treatment Centers Long Island Shelter Wilmington, Delaware Homeless Services and Addiction Services Public Mary Nakashian Health Commission Vice President and Director of Program Boston, Massachusetts Demonstration National Center on Addiction and Substance Elizabeth Garcia, Director abuse at Columbia University (CASA) Managed Care New York, New York Pinal Gila Behavioral Health Association Apache Junction, Arizona Richard C.

10 Rapp, Co-Investigator, Assistant Professor Substance abuse Intervention Programs School of Medicine Wright State University Dayton, Ohio ix Consensus Panel Margaret E. Hanna, Duane C. McBride, Executive Director Director of Research Bucks County Drug and Alcohol Behavioral Science Department Commission Andrews University New Britain, Pennsylvania Berin Springs, Michigan Albert Hasson, Sylvia M. Ryan, , Administrative Director Program Director Matrix Institute on Addictions Rocky Boy Health Board Pizarro Treatment Center Rocky Boy Chemical Dependency Program Los Angeles, California Box Elder, Montana Judith Levy, Anne C. Sowell, , Associate Professor Coordinator of Community Projects School of Public Health Miracle Village University of Illinois MetroHealth Medical Center Chicago, Illinois Cleveland, Ohio x Foreword T. he Substance abuse and Mental Health Federal clinical researchers, clinicians, program Services Administration (SAMHSA) is the administrators, and patient advocates debates and agency within the Department of Health discusses their particular area of expertise until they and Human Services that leads public health efforts to reach a consensus on best practices.