Effective Date: 10/01/03
Review Date: 10/01/03
Minnesota Statutes 256B.094, subd. 1, Minnesota Statutes 256F.10, Minnesota Statutes 260C.007, subd. 6, Minnesota Statutes 260C.212, Minnesota Statutes 626.556, subd. 10e, Minnesota Rules, parts 9505.2165 and 9505.2175
Child Welfare - Targeted Case Management (CW-TCM) was approved in 1993 by the Minnesota Legislature as a Medical Assistance (MA) covered service. Certified counties and tribes receive MA reimbursement for case management activities for children who are at risk of or experiencing maltreatment or out-of-home placement or are in need of protection and services as defined in Minnesota statutes.
All counties and eight tribes in Minnesota are participating in CW-TCM. Legislation allows certified providers to contract with qualified vendors for this service.
Child Welfare Targeted Case Management (CW-TCM) is a MA service that reimburses counties and tribes for case management activities provided by qualified case managers to MA and MinnesotaCare enrolled children. Reimbursement must be spent to develop and expand child welfare preventative services.
Children under the age of 21 years who are enrolled in Medical Assistance (MA) or MinnesotaCare and meet one of the following criteria:
• At risk of out-of-home placement or in placement
• At risk of maltreatment or experiencing maltreatment
• In need of protection or services
Eligibility determination for CW-TCM services must be made by the county or tribal agency responsible for child welfare/child protection services.
Dual service eligibility
A child who meets the eligibility criteria for both CW-TCM and Mental Health - Target Case Management (MH-TCM) may receive both services from the same agency and both services may be claimed in the same month as appropriate.
CW-TCM services include developing an Individual Service Plan, assisting the child and child’s family in obtaining 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.
Examples of CW-TCM activities include, but are not limited to the following:
• Assessment of the person’s need for case management services *
• Development, completion and regular review of a written individual case plan
• Routine contact or other communication with the child, child’s family or other relevant persons identified as necessary to the development or implementation of the goals of the individual case plan
• Coordinating referrals for, and the provision of, services for the child with appropriate service providers
• Coordinating with the MA facility discharge planner in the 30-day period prior to the child’s discharge into the community
• Coordinating and monitoring the overall service delivery to ensure quality of services
• Monitoring and evaluating services on a regular basis to ensure appropriateness and continued need
• Completing and maintaining necessary documentation which supports and verifies the above activities
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 telephone contacts.
* The activities involved in the determination of eligibility are not claimable as CW-TCM. A CW-TCM claim may be submitted only after eligibility for CW-TCM services has been determined, and the case finding and case plan are recorded in the case file.
Examples of non-covered CW-TCM services include:
• Assessments prior to opening of case
• Therapy and treatment services
• Legal services, including legal advocacy, for the child
• Information and referral services provided to the child who is not part of the target group or eligible for MA or MinnesotaCare
• Outreach services including those provided through the community support services program
• Services that are not documented
• Services that are otherwise eligible for payment on a separate schedule under rules of the Department
• Case management services that duplicate the same services from another case manager for the same person
• Case management services provided to patients or residents in a MA reimbursed facility (except as defined in CW-TCM activities)
• CW-TCM services for children in non-MA reimbursable foster care, group homes or residential care that do not focus on permanency planning or return to the family home and/or duplicate a facility’s discharge planning
• Transportation of the child
Provider Standards and Qualification
Certified providers of CW-TCM
County and tribal social service agencies must be certified to receive MA reimbursement for CW-TCM. To become certified, these agencies must apply to the Department of Human Services. A certified provider may contract with a qualified vendor to provide the case management services. Qualified vendors must enroll as MHCP providers and negotiate a contract with the certified provider. The contract must contain the negotiated monthly rate for case management services. A copy of the contract must be submitted to DHS for approval.
Case manager qualifications
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 meet all the following qualifications:
1. Be skilled in the process of identifying and assessing a wide range of children’s needs
2. Be knowledgeable about local community resources and how to use these resources for the benefit of the child
3. Hold either a:
• Bachelor’s degree in social work, psychology, sociology or a closely related field from an accredited four year college or university or
• Bachelor’s degree in a field other than social work, psychology, sociology or closely related field, plus one year of supervised experience in the delivery of social services to children as a social worker in a public or private social services agency