Texas Case Management Services Policy Manual

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The Texas Case Management Services Policy Manual provides a comprehensive framework for delivering case management services to individuals and families in Texas, ensuring access to necessary resources and support systems. This manual aligns with federal and state regulations, including the Texas Administrative Code (§355.8091), Medicaid guidelines, and policies established by the Texas Health and Human Services Commission (HHSC). It ensures compliance with legal mandates to provide coordinated, person-centered case management services that promote health, independence, and overall well-being.
The manual outlines policies and procedures for assessing needs, developing individualized service plans, coordinating care across providers, and monitoring progress to achieve desired outcomes. It emphasizes collaboration with community resources, healthcare providers, and social service organizations to address the unique needs of each client.
Key areas covered in the manual include:
Eligibility and Enrollment: Guidelines for determining eligibility for case management services under Medicaid or other state-funded programs, including targeted case management for specific populations such as individuals with disabilities or chronic conditions.
Assessment and Service Planning: Procedures for conducting comprehensive assessments to identify client needs and developing individualized service plans (ISPs) that outline goals, interventions, and timelines.
Coordination of Services: Policies for facilitating access to medical care, behavioral health services, housing assistance, employment support, education resources, and other community-based services.
Provider Requirements: Standards for case managers, including training in trauma-informed care, cultural competency, and compliance with licensure requirements.
Documentation and Reporting: Requirements for maintaining accurate records of assessments, service plans, referrals, and client progress to ensure accountability and compliance with Medicaid billing standards.
Client Rights: Provisions to protect client rights, including confidentiality of records, informed consent for services, and access to grievance procedures.
Quality Assurance: Policies for monitoring service effectiveness through data collection, performance reviews, and adherence to evidence-based practices.
The Texas Case Management Services Policy Manual serves as an essential resource for agencies and providers to deliver coordinated care while adhering to state regulations. It supports improved client outcomes by addressing barriers to services, enhancing collaboration across systems of care, and promoting equitable access to resources.