Child Welfare Targeted Case Management (CW-TCM) activities coordinate social and other services designed to help the child under 21 years old and the child's family gain access to needed social services, mental health services, habilitative services, educational services, health services, vocational services, recreational services, and related services including, but not limited to, volunteer services, advocacy, transportation, and legal services.
Case management services include developing an individual service plan, helping the child and child's family obtain needed services through coordination with other agencies, and assuring continuity of care. Case managers must assess the delivery, appropriateness, and effectiveness of services on a regular basis. (Minnesota Statutes § 256B.094, subd. 1)
County and tribal social service agencies must be certified to receive Medical Assistance (MA) reimbursement for CW-TCM. To become certified, these agencies apply to the Minnesota Department of Human Services (DHS). A certified provider may contract with a qualified vendor to provide the case management services to clients referred by the certified provider.
Case managers must be employed by a certified CW-TCM provider or a qualified vendor contracting with a certified CW-TCM provider to provide CW-TCM services and must:
Beginning July 2004, federally recognized tribal governments within the state of Minnesota may authorize individuals to serve as tribal child welfare case managers pursuant to section 256B.02, subdivision 7, paragraph (c), and determined as meeting applicable standards. (MN section § 256F.10, subd. 5)
County and tribal social services agencies may contract with qualified vendors to provide CW-TCM services for their clients. The following requirements apply:
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Children under the age of 21 on MA or MinnesotaCare who meet one of the following criteria:
Children who are developmentally disabled are not automatically eligible for CW-TCM services. They must meet one of the above criteria to be eligible to receive services.
The county agency responsible for child welfare services must make this determination. The activities involved in the determination of eligibility are not claimable as CW-TCM. Submit a CW-TCM claim only after recording in the case file the determination of eligibility for CW-TCM services, the case finding (including a brief description of the circumstances that support the finding), and case plan.
A child who meets the eligibility criteria for both CW-TCM and MH-TCM may receive both services from the same agency and the agency may claim both services in the same month as appropriate. The two services must be distinctly different to be claimed in the same month.
Case management activities are those that help the eligible recipient gain access to needed medical, social, educational, and other services as identified in an individual service plan. Only services delivered on a face-to-face basis are claimable as CW-TCM unless the client is in placement more than 60 miles beyond county or reservation boundaries. In such a case, a telephone contact may be claimed in two consecutive months. There must be a face-to-face contact in the month preceding the eligible telephone contacts. Examples of CW-TCM activities include, but are not limited to the following:
Documentation of CW-TCM Services
CW-TCM is child-specific. Therefore, each child must have his or her own case file, even though the documentation may also be part of an existing family case file. The following information must be in each child’s case file:
Case plans for CW-TCM may be incorporated into other plans such as child protection plans, family service plans, out-of-home placement plans, etc., but the portion of the plan that pertains to CW-TCM needs to be clearly identified. The CW-TCM plan must be child-specific for each child in the family that qualifies for the service. Children’s needs vary and need to be acknowledged on an individual basis. If a family plan is used, address each individual’s needs, as well as the needs of the family as a whole.
Case plans must describe the services the client needs to help achieve the goals of the case plan and how the case manager will help the client access these services. If more than one case manager will work with the family, document the justification for dual case management and the distinct role each case manager will fill.
In situations where case managers from more than one agency are working with the family, the case managers must develop case plans jointly or in coordination with each other and each case manager will have a copy of the resulting case plan in the file. If case managers develop case plans individually, they must exchange plans and amend their plans as appropriate.
For convenience, attach or include with the case plan a family and collateral contact list. Include on the contact list all family members and other people integral to achieving the goals of the case plan and the name and relationship to the client of each person. This will eliminate the need to mention this relationship each time you refer to that person in the case or contact notes.
Those responsible for their success should sign the case plans. This may include parents, guardians, case managers, children, etc. Whoever any revisions most affect must initial the revisions, when possible.
While statutory language requires only an annual review of the case plan, more frequent review and revision are often necessary to keep the case plan current and relevant.
Contact and Case Notes
The following information describes the types of activities that must be included in the contact and case notes to constitute a billable event.
Case management services include the following:
Case managers must assess the delivery, appropriateness, and effectiveness of services on a regular basis. (Minnesota Statutes 256B.094, subd. 1.
Contact or case notes need to include the who, what, when, where, and why of the contact, including the following: as
Most children who receive CW-TCM services need only one case manager. However, at times a child will require services from both the county social services agency and a tribal agency or the agency’s qualified contracted vendor. When this occurs, do not duplicate services because federal regulations prohibit Medicaid from paying for duplicate services.
The two agencies must notify each other and coordinate the services they provide. They must have written documentation of the reasons for dual case management and the services each agency will provide in enough detail that it leaves no question about the need for services from each agency and that the agencies are providing different services.
The Minnesota Tribal/State Agreement (PDF) states that tribes have jurisdiction over any child custody proceeding concerning an Indian child, with few exceptions. The burden of assuring that the county is not duplicating services the tribal social services agency is providing rests with the county. If the tribal capacity to provide needed services is limited, or the tribe and the county agree that the county will provide certain services, it is the responsibility of the county to deliver necessary case management services. The tribal case manager may refer the client or family to the county for county-provided services other than CW-TCM.
The tribal workers might also assess a need for additional services not specified by the court and available from tribal agencies, and would help the family access these services. The county has the responsibility of enforcing the orders of the county court and facilitating access to those services available from the county.
Examples of considerations to determine when dual case management is necessary and appropriate for a client who is a tribal member include the following:
The answers to these and other questions that may arise will guide the decision about the need for dual case management.
If you determine a client needs services from both the tribe and the county, the agencies must work closely together to keep each other informed of the activities of the other. In all instances of determination of eligibility for CW-TCM services made by the county for an Indian child, the county must notify the tribe of such eligibility within seven days according to the Minnesota Tribal/State Agreement on Indian Child Welfare and the Minnesota Indian Family Preservation Act (MIFPA). When the client needs services from both agencies, the tribal social services agency and the county agency must decide jointly what case management services the client needs and who can best provide them. Then they must develop the case plan based on these decisions and detail which agency will provide which services.
Coordination of Services for a Tribal Member
Designate a primary case manager when the client needs case management services from both the county and the tribe. When the county, tribe and family designate a primary case manager by mutual consent, clearly outline this person’s role and responsibilities in this capacity in the written case plan. If the county, tribe and family cannot reach agreement about a primary case manager, the tribal agency is responsible for making this decision with the best interests of the child in mind. Record this in the case plan. Document in detail the roles of each case manager. It must be clear that each case manager has a distinct role with the family, and the written case plan must indicate how and with what frequency case managers will communicate.
If a county and a tribal social services agency are unable to coordinate, but are providing appropriate services to the same child, both agencies must document the activity accurately and completely. If they duplicate services, they will be at risk of disallowance, that is, one of the duplicated claims may be taken back in the case of a state or federal audit.
Examples of considerations to determine when dual case management is necessary and appropriate for a client include the following:
The answers to these and other questions that may arise will guide the decision about the need for dual case management.
Coordination of Services for County and Vendor
Designate a primary case manager when the client needs case management from both the county and the vendor. When the county, agency and family designate a primary case manager by mutual consent, clearly outline this person’s role and responsibilities in this capacity in the written case plan. Document in detail the roles of each case manager. It must be clear that each case manager has a distinct role with the family, and the written case plan must indicate how and with what frequency case managers will communicate.
If duplication of services occurs, both providers will be at risk of disallowance, that is, one of the duplicated claims may be taken back in the case of a state or federal audit.
Documentation has two components – case plan and service delivery. Documentation in the case plan must be clear and detailed regarding a client’s need for more than one case manager.
The jointly developed case plan must describe the circumstances that necessitate dual case management services, and the specific non-duplicative roles each case manager will fulfill in accomplishing the goals of the case plan, including who will act as the primary case manager. The case plan should contain information about who will coordinate, assure access, and monitor each type of service needed by the client. It should also state the frequency with which contact between case managers will occur for the purpose of coordinating services. Each agency must retain a copy of the case plan in the case record.
The case record must contain a written description of each encounter of CW-TCM services provided to each individual client. This description must include the following:
The case record should contain a description of all case management activities on behalf of the client whether or not a billable contact occurs.
The following services are not covered:
The recipient must meet the eligibility criteria to receive services from a county or tribal social service agency or contracted vendor.
Refer to the following billing criteria:
Minnesota Statutes, section 256B.0625, subd.33
Minnesota Statutes, section 256B.094
Minnesota Statutes, section 256F.10, subd. 5
Minnesota Statutes, section 260C.212, subd. 1
Minnesota Statutes, section 626.556, subd. 10e
Minnesota Statutes, section 260C.007, subd. 6
Minnesota Statutes, section 256B.02, subdivision 7, paragraph (c)
Minnesota Rules, part 9505.2165
Minnesota Rules, part 9505.2175;