Six Steps a CMO Takes to Assist Youth and Families
In New Jersey, CMOs use the Wraparound Approach to provide comprehensive care for youth with complex needs. A CMO brings together all individuals involved in a youth’s care, including family members, mental health/behavioral health providers, school personnel, natural supports, and community resources. This care team works together to develop an individual care plan for each youth.
The CMO plan is designed to structure coordination and communication across the care team so that each youth receives the most appropriate care possible. This type of care coordination has been shown to improve health outcomes and reduce healthcare costs.
Here are the steps a CMO takes to help a youth and their family:
Step 1. Youth is assigned a Care Manager
When youth is referred to their local CMO, they are assigned a Care Manager who will act as the main point of contact. Every child is unique and has different needs. That is why the Care Manager begins by listening carefully, hearing the youth and family’s story, and acknowledging their strengths before helping them identify areas that may need to be addressed.
Step 2. A crisis plan is developed
One of the first things a Care Manager completes with the child and family is a crisis plan. The crisis plan is a document that details what to do and how to respond when a crisis occurs with the child and family. It identifies factors that contribute to crises; describes strategies for coping with them; and lists community resources that may be accessed for additional support.
Step 3. Build a Child-Family Team
The Care Manager will work with youth and their families to help create a Child-Family Team. This team includes both formal (for example, a therapist, probation officer, or teacher) and natural (for example, other family members, neighbors, friends) supports. The Child-Family Team is involved in all of the decision making.
Step 4. Create an individual service plan
The Child-Family Team meets on a regular basis to develop an individual service plan (ISP). The ISP focuses on a variety of life domains, including mental health, safety, family, education, vocation, legal issues, financial problems, housing difficulties, and other relevant topics.
The youth’s/family’s long-term goals are identified, including the family vision, their strengths, and their needs. The ISP outlines specific methods for how to meet those needs. It also serves as a way for the youth/family to access services and resources.
Step 5. Ongoing Contact
The Child-Family Team will continue to meet regularly to evaluate the success of the ISP and modify it as needed. Throughout the youth’s time with the CMO, the Care Manager will keep in touch with the youth and their family, as well as other team members. Contact may include face-to-face meetings at home with the family, trips to youth’s school, or phone conversations with a service provider from the Child-Family Team.
Step 6. Transition
From the initial stages of engagement, Care Managers are focused on transition planning with youth and their family. Although transitions occur throughout the process, a Transition may take place when a family has reached their long-term goal(s) and/or a youth’s behavior has stabilized and no longer requires the support of the CMO.
To help with this, the care team works with youth and their family to develop a transition plan. The transition plan includes information about the resources and services that youth may need after they leave CMO care.