1. Program Definition and Services
Case Management Service in Arizona is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet an individual's health needs through communication and available resources. Services include:
- Initial assessment of service needs
- Development of a comprehensive, individualized care plan
- Coordination and access to appropriate health and support services
- Continuous client monitoring and reassessment
- Treatment adherence counseling
- Assistance in accessing public and private programs
2. Regulations
Case Management Services are governed by Arizona Administrative Code R9-28-510 and the AHCCCS Medical Policy Manual Chapter 570.
3. Licensing or Certification
No specific licensing or certification requirements are mentioned for Case Management Service providers in Arizona. However, case managers must meet certain qualifications and training requirements.
4. Responsible State Agency
The Arizona Health Care Cost Containment System (AHCCCS) and the Arizona Department of Economic Security (DES) oversee Case Management Services.
5. Application Process
Individuals can access Case Management Services through their AHCCCS Complete Care plan, Division of Developmental Disabilities, or by contacting the Southeastern Arizona Governments Organization (SEAGO) Area Agency on Aging for certain counties.
6. Required Documentation
- While specific documentation requirements vary, the following may be needed:
- Comprehensive, individualized care plan
- Documentation of service needs and progress
- Records of client monitoring and reassessment
7. Timeline for Approval
Case managers must ensure appropriate ALTCS placement and services are provided within 30 days of enrollment.
8. Pre-Application Process
There is no explicit mention of a pre-application process.
9. Pre-Application Training
While specific pre-application training is not mentioned, case managers must receive orientation and ongoing training in specialized subjects relevant to the populations served.
10. Additional Notes
- Case managers must not be assigned duties unrelated to member-specific case management for more than 10% of their time when they have a full caseload.
- There is specific conflict of interest rules for case managers, including not being related to or financially responsible for members on their caseload.
- Case management services can be provided through various means, including face-to-face, telehealth, and phone contact.
- The frequency and type of contact for case management services are determined by the Child and Family Team (CFT) or Adult Recovery Team (ART) during treatment planning.
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