What is a Care Management Organization?
In 2000, New Jersey (NJ) began to restructure the system for delivering services to children and their families with behavioral health needs using a Care Management approach that is coordinated and integrated at the local level, and targeted on improved outcomes for children and their families.
Care Management Organization Structure
A Care Management Organization (CMO) is the single point of organizational accountability to support need-based intervention and achieve desired outcomes for youth with behavioral health, developmental, or substance use disorders whose ties to home and community are jeopardized.
CMOs are in charge of assisting families to identify and develop a network of support for each family that includes natural supports, informal community supports, and formal service supports. Identifying and integrating existing supports is a significant component of this, as is developing new ones based on the needs, culture, and values of those being served.
Care management organizations, or CMOs, are community-based, non-profit organizations that provide face-to-face care management and comprehensive service planning for youth, from age 5 until their 21st birthday, with special consideration given to children under age 5.
They organize Child Family Team (CFT) meetings and develop Individual Service Plans (ISP) for each youth and their family. CMOs utilize a Wraparound Approach to plan and coordinate services and supports that maintain stability and reach the goals for each child.
Their goal is to assist kids and families in establishing a long-term, sustainable strategies that will help them manage their difficulties for years to come.
The Wraparound Model
New Jersey CMOs use the Child Family Team Process to implement the Wraparound Model. The team-based planning process known as the Wraparound Approach brings together individuals from various areas of a family’s life to assist families in achieving their objectives and goals.
Characterized by a set of Core Values and Guiding Principles, the Wraparound Model is founded on the following:
The Principles of Wraparound
1. Family Voice and Choice
2. Team Based
3. Natural Supports
4. Collaboration
5. Community Based
6. Culturally Competent
7. Individualized
8. Strength Based
9. Unconditional
10. Outcome Based
An initial CMO plan includes, but is not limited to:
1. Engagement of the youth and family into CMO services
2. Initiate development of Child Family Team including collaboration with Family Support Organizations (FSO)
3. Development of a Family Crisis Plan to stabilize the youth and address the immediate concerns of the youth and family
Continuing CMO services include, but are not limited to:
1. Ongoing assessment of the child and family’s strengths and needs
2. ISP design and implementation
3. Advocacy, referrals, and linking to therapeutic and community-based supports
CMO vs MCO
Though a care management organization can help with medical care management, CMOs are different from Managed Care Organizations.
CMOs are expected to coordinate with NJ FamilyCare Managed Care Organizations (MCOs). If a child is found eligible for NJ FamilyCare, he or she will be assigned to the proper program and will be prompted to choose an NJ FamilyCare Managed Care Organization. Some youth are eligible for specialized programs, which CMOs should be aware of to provide coordination of care.
What is the role of a managed care organization?
MCOs assist families with the coordination of benefits and service referrals for necessary support. CMOs assist the family in requesting an assessment for this service if it is not already in place. Once the service is in place, MCO’s care managers can serve as a resource to the Child Family Team (CFT).
A Collective of Care Management Organizations
To find your local CMO or for a list of care management organizations in New Jersey, NJCMO is here to help. NJCMO is a resource for your family and community and can assist with your questions. Contact us today to learn more.