(a) Assessment. An individual is assessed according to §412.406 of this title (relating to Authorization for MH Case Management Services) to determine the LOC necessary to address the individual's needs. If the individual needs either routine or intensive case management the provider must assign a case manager according to §412.404(b) of this title (relating to Provider Requirements). MH case management services, as well as attempts to provide case management, must be documented according to §412.413 of this title (relating to Documenting MH Case Management Services).
(1) MH case management services must:
(2) Case managers must recognize that:
(b) Routine case management. Routine case management is provided to eligible adults, children, or adolescents and is primarily a site-based service. A case manager assigned to an individual who is authorized to receive routine case management services must:
(1) meet face-to-face with the individual and the individual's LAR or primary caregiver within 14 days after the case manager is assigned to the individual or document why the meeting did not occur;
(2) assist the individual in identifying the individual's immediate needs and in determining access to community resources that may address those needs;
(3) identify the strengths, service needs, and assistance required to address the identified needs;
(4) identify the goals and actions required to meet the individual's identified needs;
(5) specify the goals and actions to be accomplished;
(6) develop a timeline for obtaining the needed services;
(7) take the steps that are necessary to accomplish the goals required to meet the individual's identified needs by using referral, linking, advocacy, and monitoring;
(8) meet face-to-face with the individual upon the individual's, the LAR's, or the primary caregiver's request, or document why the meeting did not occur;
(9) reassess the individual's needs at least annually or as changes occur;
(10) meet face-to-face with the LAR, with or without the child or adolescent being present, to provide a service that assists the child or adolescent in gaining and coordinating access to necessary care and services;
(11) meet face-to-face with the individual and the LAR or primary caregiver upon notification of a clinically significant change in the individual's functioning, life status, or service needs, or document why the meeting did not occur;
(12) if notified that the individual is in crisis, coordinate with the appropriate providers of emergency services to respond to the crisis, as described in Chapter 412, Subchapter G, specifically §412.321 of this title (relating to Crisis Services); and
(13) develop a timeline for reevaluating the individual's needs.
(c) Intensive case management. Intensive case management is provided to eligible children and adolescents and is primarily community-based. A case manager assigned to a child or adolescent who is authorized to receive intensive case management services must:
(1) develop an intensive case management plan (plan) based on the child's or adolescent's needs that may include information across life domains from relevant sources, including:
(2) meet face-to-face with the child or adolescent and the LAR or primary caregiver:
(3) meet face-to-face with the child or adolescent and the LAR or primary caregiver according to the child's or adolescent's plan or document why the meeting did not occur;
(4) identify the child or adolescent's strengths, service needs, and assistance that will be required to address the identified needs in the plan;
(5) comply with subsection (b)(4) - (13) of this section;
(6) incorporate wraparound process planning or other department-approved model in developing a plan that addresses the child's or adolescent's unmet needs across life domains, in accordance with the department's utilization management guidelines and subsection (d) of this section;
(7) take steps that are necessary to assist the child or adolescent in gaining access to the needed services and service providers, including:
(8) monitor the child's or adolescent's progress toward the outcomes set forth in the plan, including:
(d) Wraparound process planning. Wraparound process planning or other department-approved model may include, but is not limited to:
(1) a list of identified natural strengths and supports;
(2) a crisis plan developed in collaboration with the LAR, caregiver, and family that identifies circumstances to determine a crisis that would jeopardize the child's or adolescent's tenure in the community and the actions necessary to avert such loss of tenure;
(3) a prioritized list of the child's or adolescent's unmet needs that includes a discussion of the priorities and needs expressed by the child or adolescent and the LAR or primary caregiver;
(4) a description of the objective and measurable outcomes for each of the unmet needs as well as a projected time frame for each outcome;
(5) a description of the actions the child or adolescent, the case manager, and other designated people take to achieve those outcomes; and
(6) a list of the necessary services and service providers and the availability of the services.
Source Note: The provisions of this §306.263 adopted to be effective February 14, 2013, 38 TexReg 647; transferred effective February 15, 2020, as published in the Texas Register January 17, 2020, 45 TexReg 469