Medical case management (MCM) is a range of client-centered services that link clients with health care, psychosocial, and other services to ensure:

• Timely, coordinated access to medically appropriate levels of health and support services

• Ongoing assessment of the client′s needs

• Continuity of care

The purpose and goals of medical case management are to:

• Assist the client with accessing needed services

• Maintain the client in on-going medical care and treatment

• Increase the client′s adherence to the care plan (i.e., medication regimen) through counseling

• Empower clients to remain as independent as possible

• Improve service and client health outcomes

• Control costs while ensuring that client needs are properly addressed

• Coordinate services across funding streams

• Reduce service duplication across providers

• Use available funds and services in the most efficient and effective manner

Ryan White Program Medical Case Management Training is designed for Ryan White Program medical case management supervisors, medical case managers, outreach workers and peer educators.

Scheduled Trainings:

• April 10 and April 12, 2012   |  TOPICS: HIV and Cholesterol; Virology Portal Overview; Food Stamps and Unemployment Benefits, Legal Services Assistance Service Definition Review  The same training will be offered on each date.

• March 13 and March 15, 2012   |  TOPICS: HIV and the Aging Population; 2011 Ryan White Program Client Satisfaction Survey: Stigma Data; Ryan White Program Updates  The same training will be offered on each date.

• February 14 and February 16, 2012   |  TOPICS: Communicating a Clear Path Forward: Understanding the Challenges of Health Literacy; Borinquen Health Vare Center TOPWA and Behavioral Health Services; Revised CHA/POC  The same training will be offered on each date.

• January 10 and January 12, 2012   |  TOPICS: The Life of the Third Gender: Transgender Competency 101; The Village South Substance Abuse Treatment- Ryan White Program Overview  The same training will be offered on each date.

• November 15 and November 17, 2011   |  TOPICS: Side Effects in HIV Therapy; Beyond the Diagnosis; ADAP Enrollment Function Update  The same training will be offered on each date.

• October 11 and October 13, 2011   |  TOPICS: HIV Co-Morbidities; Dental Services Provided by Borinquen Health Care Center; WILLOW Program; SDIS Program Updates  The same training will be offered on each date.

• September 13 and September 15, 2011   |  TOPICS: New HIV Single Tablet Treatment-Complera;HOPWA Survey; SSI/SSDI Disabilty and Non-Disability, Related Issues and Appeals  The same training will be offered on each date.

• August 9 and August 11, 2011   |  TOPICS: Janssen (formerly Tibotec) Portal Updates; Substance Abuse; Jackson Health System Cash & Credit; Pastoral Care Service  The same training will be offered on each date.

• July 12 and July 12, 2011   |  TOPICS: HIV/AIDS Treatment Strategies; Copays and Deductibles; Tropism Access Program (TAP); Oral Health Services and Referral Process; ECHPP HIV Plan Update  The same training will be offered on each date.

• June 15 and June 16, 2011   |  TOPICS: Hepatitis C; HIV Inflamation; Health Literacy Survey; Legal Services Follow-Up; Follow up Module in SDIS  The same training will be offered on each date.

The goals of medical case management training are to:

• Provide detailed and hands on training on various components of medical case management duties (e.g., eligibility screening, documentation, etc.)

• Ensure compliance with the medical case management standards and service guidelines

• Prepare medical case managers and medical case management supervisors for the annual Proficiency Exam

• Advise of medical and pharmaceutical updates

• Provide updates on relevant program changes

• Educate on alternate funding sources

Sessions are conducted by CQI Quality Management Coordinators, health care providers - including doctors, nurses and pharmacists - and other professionals familiar with the distinct challenges faced by Ryan White Program service providers in Miami-Dade County.

All sessions are free and open to the public; attendance is mandatory for Ryan White Program medical case management personnel.

For more information, contact Sandra Sergi, Quality Management Coordinator/Trainer.

The purpose of record reviews is to determine whether program requirements are being met, whether the services provided are appropriate and whether services meet current accepted standards of practice. This page includes medical case management record review results. These results, as well as medical, oral health, psychosocial and substance abuse record reviews are found on the Record Reviews and Reports page.

• 2004-2005 Ryan White Title I Case Management Record Review

• Ryan White Title I Case Management Record Review 2003

The Continuous Quality Improvement Program offers monthly on-site technical assistance at all Miami-Dade County Ryan White Program agencies. Technical assistance visits are part of a continuous quality improvement process designed to identify and resolve problems and weaknesses, both agency-specific and system-wide. The goal of the visits is to prevent the development of chronic problems. Along with regularly conducted system-wide record reviews, and the submission of quarterly record reviews by each provider agency, the visits allow CQI staff to systematically focus on quality improvement areas (e.g., the financial assessment and eligibility determination).

Technical assistance site visits aim to ensure:

• Compliance with medical case management standards

• Identification of areas requiring improvement

• Recognition of agency strengths

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number H89HA00005, CFDA #93.914 - HIV Emergency Relief Project Grants, for $26,483,857, of which 0% was financed with nongovernmental sources.  This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.