Sec. 10.09.81.24. Covered Services — Case Management

A. Definition. "Unit of service" means a 15-minute increment of service rendered by a qualified provider to a participant or the participant's representative.

B. Case management services shall be targeted to address the individualized needs of the participant and be sensitive to the educational background, culture, and general environment of the participant.

C. Case management services include time spent by a qualified provider conducting any of the following activities:

(1) Assisting with an initial or annual ICS Program eligibility process;

(2) Assisting with an application and maintaining all public and private benefits, resources, and entitlements;

(3) Conducting an assessment of needs, and developing a person-centered plan of services, to include all services needed to live safely in the community;

(4) Assisting with referral, access, and coordination of services, both Medicaid and non-Medicaid, to address the individual's needs including, but not limited to:

(a) Community integration;

(b) Medical services;

(c) Social services;

(d) Educational services;

(e) Behavioral health;

(f) Legal services; and

(g) Housing;

(5) Contacting ICS Program providers and Medicaid State Plan providers not less than monthly and documenting that services were received in the amount, type, frequency, and duration described in the plan of services;

(6) Ensuring timely receipt of all other services and documenting follow-up;

(7) Facilitating referral to other programs if the individual is denied ICS Program services; and

(8) Using information technology systems developed by the Department.