How to access Medicaid Case Management Services

Navigating the disability system can be a pretty daunting task. Where do you start? Who do you call? How do you fill out all that paperwork and gather all the information everyone wants. How do you walk your way through the minefield of voicemail, email, snail mail, faxes and referrals? Fortunately Medicaid understands the complexity of the disability system and has created a service called case management that is designed to provide individuals with an advocate to come along side them and help them navigate the system so that they can find and contract the supports they need.

A case manager is a person with a bachelors degree in a human services related field and with a minimum of one year of experience in the delivery of services to persons with a disability. A case manager can also be a person that has an Iowa license to practice as a registered nurse and has at least three years of experience in the delivery of services to persons with a disability. Wright County adds to these requirements that the case manager be a person who believes in their clients and has high expectations for themselves and their clients.

In order for a person to be eligible for Medicaid Case Management Services they have to have a qualifying diagnosis and have Title XIX (Nineteen) without a spend-down payment. Once a person is approved for case management services a case manager will be assigned to them. The case manager will complete a social history, assessment and Individual Comprehensive Plan for the individual. these documents are designed to collect the necessary background needed to assist the case manager in determining what supports are needed and what goals and objectives should be in the Individual Comprehensive Plan. It is important to remember that the client creates their own plan with the case manager.

Once a plan is created, supports are acquired to help pursue the goals and actions steps designed in the plan. The case manager then monitors the ongoing progress of the supports and coordinates any changes or additions/subtractions to the plan and supports as necessary. This includes the development and tracking of several reports such as Quarterly Progress Reports, Incident Reports and conducting Annual Reviews. Once the individual receiving the service is at a point in their life where they have met most or all of their goals and no longer require the coordination and monitoring of a case manager the service will end. If this is a service that you or your loved one is interested in, an initial application can be made over the phone or by printing off an application and returning it to the Wright County Community Services Office.

Cost Report

Rate Development How the rate for the service is developed and submitted to IME

Chapter 24

Rules governing the program Administrative Rules created by IME for Case Management Programs

Policy and Procedures

Methods of the program Read about the inner workings of the program and its delivery

Application

Apply for the service Submit an application to receive Targeted Case Management Services

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