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1. What are the BIG
1. Needs Assessment
NINE / Big IX in
2. Service Plan Development
Case
3. Referral
Management?
4. Linkage
5. Advocacy
6. Follow-Up / Stay Engaged In Treatment
7. Monitoring / Support
8. Outreach
9. Crisis Diversion
2. Needs psychological, educational, medical, and social information for the
Assessment purpose of individual plan of care development
consists of
Face-to-Face meetings with the member and / or the parent / guardia
3. Service Plan / family member for the implementation of activities delineated in the
Devel- opment individual plan of care (service/treatment plan)
4. Referral When an individual / family is in need of specific resource information
(name, phone number, address) and can take the information and
make the linkage and advocate for themselves
5. Linkage When an individual / family is in need of specific resource information
and
needs assistance with linking up with that resource.
6. Advocacy When an individual / family is unable to successfully express their
needs
and interests and needs assistance with communication to access a
specific resource
7. Follow-Up Follow up with the individual and / or family to HELP them STAY
engaged in
treatment
, ODMHSAS Case Management Exam 2025 Questions And Answer
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8. Monitoring / Support
, ODMHSAS Case Management Exam 2025 Questions And Answer
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monitoring and support related to the individual CM plan of care-assessing
progress and barriers, and reassessing goals/objectives
9. Outreach Outreach with the individual and / or family to help them stay engag
in
treatment / appointments.
10. Crisis Diversion Unanticipated / Unscheduled situation requiring supportive assistance
face-to-face or telephone, to resolve immediate problems before they
be- come overwhelming and severely impair the individual's ability to
function or maintain in the community, to assist members from
progression to a higher level of care.
11. Excluded Services 1. physically escorting / transporting to appointments or staying
in Case with con- sumer during appointments
Management:
2. managing finances
3. providing shopping or paying bills services
4. delivering bus tickets, food stamps, money etc
5. counseling, rehabilitative services, psychiatric assessmets, or
discharge planning
6. filling out forms or applications on behalf of consumer when
the MEMBER IS NOT PRESENT
7. filling out Soonercare forms, applications
8. mentoring or tutoring
9. Case Management to the same family by two ditterent agencies.
12. Excluded Services 1. non-face-to-face time spent preparing the assessment
in Case document and the service plan paperwork
Management: 2. monitoring financial goals
3. services to nursing home residents
4. psycho-therapeutic or rehabilitative services, psychiatric
assessment, or discharge
, ODMHSAS Case Management Exam 2025 Questions And Answer
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5. services to members residing in ICF/IID facilities
(Intermediate Care Facilities / Individuals with Intellectual
Disabilities)
13. Excluded
Individuals for 1. Children / Families for whom behavioral health case
Case Manage- management ser- vices are available through OKDHS/OJA statt
ment Services: without special arrangements with OKDHS, OJA, and OHCA
2. members receiving Residential Behavioral Management
Services (RBMS) in foster care or group home settings unless
transitioning into the commu- nity
3. residents of ICF/IID and nursing facilities unless
transitioning into the community
4. members receiving services under a Home and Community
Based Service (HCBS) waiver program
14. Travel is a reim-
ODMHSAS reimburses travel but Medicaid does not
bursable service
CM through?
15. I have a client in spe-
Abuse cial education,
his mother would like
to take him to my
anger management
group,
so I will bill one
hour of rehab on
him, as long as he
comes and stays
the hour.
This is an example
of Fraud or
Abuse?