The vendor is required to provide that targeted case management (TCM) provider for adults shall:
• Place no restrictions on the qualified participant’s right to elect to or decline to receive mental health case management services as authorized by the department or the department's designee, or to choose a community support specialist or associate as approved by the department or the department's designee.
• Employ appropriately qualified individuals as community support specialists and community support specialist associates with relevant work experience, including experience with the populations served by the program, including but not limited to adults with a serious mental health disorder.
• Assure that a participant's initial assessment shall be completed within 20 days after the participant has been authorized by the department or the administrative services organization (ASO) and determined eligible for, and has elected to receive, mental health case management services.
• An initial care plan shall be completed within 10 days after completion of the initial assessment.
• Have formal written policies and procedures, approved by the department, which specifically, address the provision of mental health case management services to participants in accordance with these requirements.
• Be available to participants and, as appropriate, the participant’s families 24 hours a day, 7 days a week in order to refer participants to needed services and supports and in a psychiatric emergency, to refer to mental health treatment and evaluation services in order to prevent the participant from accessing a higher level of care.
• Respect the participants’ rights to decline case management services and, as applicable, document the participant’s decision to decline services in the participant's case management record.
• Designate specific qualified staff to provide mental health case management services that shall include at least one community support specialist per agency and may include a community support specialist associate.
• Refrain from providing other services to participants which would be viewed by the department as a conflict of interest.
• Be knowledgeable of the eligibility requirements and application procedures of federal, state, and local government assistance programs which are applicable to participants.
• Maintain information on current resources for mental health, medical, social, financial assistance, vocational, educational, housing, and other support services.
• Safeguard the confidentiality of the participant's records in accordance with state and federal laws and regulations governing confidentiality.
• Comply with the department's fiscal reporting requirements and submit reports in the manner specified by the department.
• Comply with the requirements for the delivery of mental health services outlined by the department.
- Case record requirements:
• An initial referral and intake form with identifying information, including, but not limited to, the individual's name and Medicaid identification number;
• A written agreement for services signed by the participant or the participant's legally authorized representative and by the participant's community support specialist;
• An assessment as specified in COMAR 10.09.45.06
• A care plan, updated at a minimum of every 6 months, which contains at a minimum:
1. A description of the participant's strengths and needs;
2. The diagnosis established as evidence of the participant's eligibility for services under this chapter;
3. The goals of case management services, with expected target dates;
4. The proposed intervention;
5. Designation of the community support specialist with primary responsibility for implementation of the care plan; and
6. Signatures of the community support specialist, participant, or the participant's legally authorized representative, and significant others, if appropriate.
• An ongoing record of contacts made on the participant's behalf, which includes all the following:
1. Date and subject of contact;
2. Individual contacted;
3. Signature of community support specialist or community support specialist associate making the contact;
4. Nature, content, and unit or units of service provided;
5. Place of service;
6. Whether goals specified in the care plan have been achieved;
7. The timeline for obtaining needed services;
8. The timeline for reevaluation of the plan;
9. The need for and occurrences of coordination with other case managers; and
10. Monthly summary notes, which reflect progress made towards the participant’s stated goals.
- Pre-Bid Proposal Conference Date: March 07, 2025