Comprehensive, Continuous, Integrated Systems of Care Model CCISC

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Comprehensive, Continuous, Integrated Systems of
Care Model (CCISC)

• CASE MANAGEMENT ISSUES

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Role of the Case Manager

• Be Prepared
• Create an Alliance
• Coordinate Care
• Track Outcomes
• Adapt New Strategies

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Preparation

• Read the Literature
• Develop Technical Expertise
• Seek Supervision

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Create an Alliance

• Build Rapport
• Be Empathic
• Non-judgmental
• Motivational

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Coordinate Care

• Screen Assess
• Develop a Comprehensive Individualized Plan
• Coordinate Team Meetings
• Provide Continuous On-Going Support

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Tracking Outcomes

• Utilization of Inpatient Care
• Housing Stability
• Time in Jail
• Improvement in Symptoms
• Medication Treatment Compliance
• Substance Abuse/Relapse
• Quality of Life

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Adapt New Strategies

• Rinse Repeat

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Barriers to Treatment

• Service Fragmentation
• Technical Expertise
• Cultural Competence
• Staff Turnover
• Funding

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Service Fragmentation

• Failure to Address Both Substance Abuse Mental
  Illness Simultaneously
• Communication Problems
• Inconsistent or Conflicting Approaches to
  Treatment
• Failure to Accept Primary Responsibility

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Technical Expertise

• Lack of experience with screening assessment
  tools across disciplines
• Unfamiliarity with Stages of Change Theory
• Inconsistent use of Motivational Interviewing

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Cultural Competence

• Failure to understand the environment
• Unfamiliarity with the consumers culture
• Language barriers

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Staff Turnover

• Inconsistent Treatment
• Disruption of the Therapeutic Relationship
• Poor Continuity of Care

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Funding

• Fragmented Funding Streams
• Co-lateral or Wrap Around Supports are
  Under-funded
• Staff is under-paid/under-valued

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Resources

• Colleagues
• Core Service Agency
• Center for Substance Abuse Treatment
• National Alliance on Mental Illness (NAMI)
• National Institutes of Health (NIH)
• Network of Care (www.networkofcare.org)
• Substance Abuse Mental Health Services
  Administration (SAMHSA)

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Questions
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Thank You

• Sondra Tranen
• Partnership Development Group, Inc.
• 804 Landmark Drive, Suite 118
• Glen Burnie, MD 21061
• V 410-863-7213 F 410-863-7205
• sondra_at_pdgrehab.com