Case Management Policy and Procedures

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Miranda Hodge
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1 Case Management Policy and Procedures Subject: Priority Populations Pregnant Women Interim Services (Form Attached) Policy #: M Effective Date: 7/1/08 Revision Date:11/09 (Language changes to Referral Form) 7/10 (Addresses added to form for Health Clinic resources) 2/10/14 : Phone number change for Womanspace; remove New Directions The CM Provider must address the needs of each pregnant woman as follows: Screen for emergent care needs. If emergent care needs are identified, a referral must be made to the appropriate service. If no emergent care needs are identified then; Conduct a level of care assessment to determine the need for treatment. If treatment is indicated then; Refer the woman to a treatment provider that has the capacity to provide treatment services to the woman within 14 days of the assessment. If no treatment facility has the capacity to admit the woman, then; Make available interim services to the woman within 48 hours after the assessment. Interim Services are defined as services to reduce adverse health effects of substance abuse; to promote the health of the individual; and to reduce the risk of transmission of a disease until the individual is admitted to a treatment program. At a minimum, interim services include: Counseling and education about HIV and TB; Counseling and education about the risks of needle sharing; Counseling and education about the risks of transmission to sexual partners and infants; Counseling and education about the steps that can be taken to ensure that HIV and TB transmission do not occur; A referral for HIV and TB treatment services, if necessary; Counseling on the effects of alcohol and drug use on the fetus; and A referral for prenatal care.

2 Subject: Priority Populations Pregnant Women Policy #: M Effective Date: 7/1/08 Revision Date:7/1/10; 2/10/14 Page 2 of 5 Case Managers are charged with the responsibility to ensure that federal requirements are met related to the provision of interim services to pregnant women. The SCA utilizes the attached form Information & Referral Interim Services for Priority Populations (also contained in Appendices and marked as Appendix AA ). The SCA ensures that the availability of preferential treatment services to pregnant women is publicized. This is done by means of ongoing public service announcements, regular advertisements in local/regional print media, posters placed in targeted areas, and frequent notification of availability of such treatment distributed to the network of community based organizations, health care providers and social service agencies. Also see policy M regarding preference in placement for pregnant women.

3 Information & Referral Interim Services for Priority Populations NAME: CLIENT ID #: I have been informed that my placement in treatment is a priority if I am: A Pregnant Injection Drug User A Pregnant Woman An Injection Drug User However, if my placement in treatment cannot occur within 14 days, at any level of care, as a Pregnant Injection Drug User or a Pregnant Woman, within 48 hours of my assessment, the following Interim Services will be made available through referral to an appropriate agency and have been explained to me. Interim Services for a Pregnant Woman include: Counseling and education about HIV & Tuberculosis (County Health Dept or Project Hope) Counseling and education about the risks of needle sharing (County Health Dept or Project Hope) Counseling and education about the risks of transmission to sexual partners and infants (County Health Dept or Project Hope) Counseling and education about steps that can be taken to ensure that HIV and TB transmission does not occur (County Health Dept or Project Hope) Referral for HIV and TB treatment if necessary (County Health Dept or Project Hope) Counseling and education about the effects of alcohol/drug use on the fetus (Planned Parenthood) A referral for Prenatal Care (Planned Parenthood) I further understand that if I choose to wait for treatment I will be contacted by telephone every two (2) days by staff from the assessment agency, during the 14 day time period, to determine if it is my desire to continue to wait for treatment, to be admitted to another level of care and to see if I have followed through with contacts for interim services. This contact by agency staff will be documented in my records. Also, if my placement in treatment cannot occur within 14 days, at any level of care, as an Injection Drug User, within 48 hours of my assessment, the following Interim Services will be made available and have been explained to me: Counseling & Education about HIV & Tuberculosis (County Health Dept or Project Hope) Counseling and education about the risks of needle sharing (County Health Dept or Project Hope) Counseling and education about the risks of transmission to sexual partners and infants (County Health Dept or Project Hope)

4 Counseling and education about the steps that can be taken to ensure that HIV and TB transmission does not occur. (County Health Dept or Project Hope) Referral for HIV and TB testing and treatment, if necessary (County Health Dept or Project Hope) It has also been explained to me that as an Injection Drug User, placement in treatment must occur no more than 120 days of my initial assessment for treatment services. This treatment may occur at any level of care. I further understand that if I choose to wait for treatment I will be contacted by telephone every two (2) weeks by staff from the assessment agency, during the 120 day time period, to determine if it is my desire to continue to wait for treatment, to be admitted to another level of care and to see if I have followed through with contacts for interim services. This contact by agency staff will be documented. Interim Services may be obtained at the following places: Montgomery County Health Department HIV & TB/STD testing & Childhood Immunizations Norristown Clinic,1430 DeKalb Pike (610) Pottstown Clinic, 364 King Street, (610) Willow Grove Clinic, 102 York Rd, Suite 401, (215) Planned Parenthoods Pre-Natal Care & Pregnancy Testing Norristown, 1221 Powell St, (610) Pottstown, 644 High St, (610) Ambler, 19 Lindenwold Ave, (215) Montgomery County Emergency Services (610) Stanbridge and Sterigere Sts, Norristown Psychiatric Crisis Services Project Hope, 3125 Ridge Pike, Eagleville (610) HIV/AIDS Counseling, Testing & Case Management The following alternative treatment and support options have been explained and offered to me: AGENCY TREATMENT PHONE # Gaudenzia Outpatient Creative Health Services Outpatient Livengrin Counseling Outpatient Children s Aid Helpline Outpatient Penn Foundation Outpatient/Inpatient Valley Forge Medical Inpatient Eagleville Hospital Inpatient Womanspace Inpatient Family House Inpatient Alcoholics Anonymous Support Groups Narcotics Anonymous Support Groups Cocaine Anonymous Support Groups Methadone Center Methadone Maintenance Aldie Counseling Methadone Maintenance

5 My signature below certifies that I have had interim services explained to me and have been offered alternative treatment services. I have chosen to wait for the treatment service recommended for me at my assessment. In addition, I have been informed that I will be contacted every two days if I am a Pregnant Injection Drug User or Pregnant Women or every two weeks if I am an Injection Drug User for follow-up with interim services; however, I choose not to be contacted every two days as a Pregnant Injection Drug User or a Pregnant Woman: Yes Initials No Initials N/A Initials I choose not to be contacted every two weeks as an Injection Drug User : Yes Initials No Initials N/A Initials Client Signature Case Manager/Therapist Signature Date Date Client Accepted Rejected a copy of this form. Revised 11/09, 7/10

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