City of Albuquerque: Intensive Case Management Services

The City of Albuquerque seeks innovative solutions to design, implement and provide intensive case management services (ICM) for individuals with substance use problems to overcome the historically weak linkage system, facilitate longer engagement in treatment, and improve the quality of life for individuals. ICM should help individuals navigate and negotiate a complex service system and obtain access to treatment and services that support and sustain their recovery, based on goals generated in the client ICM service plan. ICM emphasizes the importance of small caseload, more frequent contact and potentially a longer duration of contact. Additionally, ICM provides opportunity to expand the network of services for individuals by formally navigating through a continuum of interagency community resources to help clients attain necessary assistance. The interventions need to be gender responsive and gender specific, addressing race, ethnic and gender equity. Comprehensive ICM services help identify individual needs and resources, including provider linkages and potential gaps in services for clients to meet social, health, welfare, housing, vocational, and other needs to attain and sustain recovery.

ICM is also a program of assistance to help clients meet their basic needs, such as: accompanying the client to appointments to provide introductions and support; arranging for clients to receive individual therapy and group therapy; ensuring the essential needs of the client are being met, including access to food, clothing, housing, health care–including medication assisted treatment (MAT), and social supports. A client service plan of tracked goals and activities, developed between the case manager and client, is a fundamental tool that is based on the client needs assessment. The program may create a step-down level of client assistance based on defined benchmarks.

While informal exchange or “social service bartering” among different agencies is intrinsic to case management, in ICM, a more formalized connection among agencies is required to ensure data sharing specific to the client, as well as ensuring access to services among all entities. Examples include memoranda of understanding (MOU) and interagency agreements and contracts; with each of these methods for formalizing expectations used collaboratively in single agency models, informal partnerships, and formal consortia for the ultimate benefit of the client.

Characteristics of ICM include:

• One-on-one case manager to client relationship using a recovery-oriented strength-based approach, with the case manager carrying a smaller case load
• The case manager conducts a needs assessment and develops a service plan in conjunction with the client to meet his or her needs
• The case manager personally assists a client to obtain access to mainstream services that the client identifies as needed to attain his or her goals
• The case manager accompanies clients to meetings and appointments when necessary to support their goals/needs
• Case managers are available on a regular schedule; caseloads are often shared to assure adequate coverage through the week, including on-call services
• The duration of the service is determined by the needs of the client, with the goal of transitioning to a lower level of service need (step-down service) and stable recovery

The target population includes individuals 18 years and older who have substance use issues as a presenting problem and/or co-occurring behavioral health problems, who have difficulty accessing services, maintaining treatment, and may become disconnected from community supports. Primary criteria for eligibility would include one or more of the following:

• Individuals in outpatient substance use treatment programs in need of assistance and supports to stay in treatment
• Individuals discharged from substance use inpatient treatment (e.g. MATS, Turquoise Lodge, emergency departments) that need follow up supports to access services and engage in additional substance use treatment
• Individuals discharged from outpatient treatment that need intensive case management to access ongoing services
• Individuals referred by the courts who require substance use and behavioral health outpatient treatment services
• Clients with high barriers to accessing services and/or who are at high risk of being disconnected from existing supportive services
• Clients with high attrition or at risk of dropping-out of outpatient treatment
• Clients with high admission rates in hospital emergency or detox services due to substance use
• Clients with high encounters with the criminal justice system due to substance use

Amount: Up to $750,000 is available.

Eligibility: An agency which is a unit of state or local government and/or an agency currently incorporated as a nonprofit corporation, duly registered and in good standing with the New Mexico Public Regulation Commission, which has nonprofit status under 501(c)(3) of the U.S. Internal Revenue Service Code and which has demonstrated capability in providing the services for which it is applying. Programs must target residents of Albuquerque whose annual family incomes are at or below 80% of the median family income for the Albuquerque Metropolitan Statistical Area (MSA).

Link: https://www.cabq.gov/family/documents/rfps/rfp-dfcs-bhw-18-02

Note: A mandatory pre-proposal conference will be held on Tuesday, March 6, 2018 at 1:00 PM at the following location:

City Council Committee Room
New City Hall Building
9th floor
One Civic Plaza
Albuquerque, NM 87102

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