What is Care Management?
Tailored Care Management (also known as TCM or just Care Management) began in December of 2022 and is designed for people who receive Medicaid and have an intellectual or developmental disability, severe and persistent mental illness, traumatic brain injury, or substance use disorder.
A care manager can help coordinate your home and community-based services, as well as any medical services you might need. They can connect you to local community resources, all of which can improve your health and quality of life. The service is optional for most eligible individuals, and you will want to decide if it’s right for you.
Care management services are available for people who are receiving Medicaid and have an intellectual or developmental disability, severe and persistent mental illness, substance use disorder, or a traumatic brain injury.
A care manager can help coordinate your home and community-based services, as well as any medical services you might need. They can connect you to local community resources, all of which can improve your health and quality of life. The service is optional for most eligible individuals, and you will want to decide if it’s right for you. Here are some resources that may help you explore care management to see if it’s right for you now – or later.
Resources
Video Library
Care Management Overview
Melinda Plue, Director of Advocacy and Chapter Development for The Arc of North Carolina, reviews the details of care management.
Why You Need Care Management
Lisa Poteat, Deputy Director of The Arc of North Carolina, talks about the importance of care management and why you should learn more about this service .
Care Management Family Stories (English)
This video features three parents currently using care management services. Each parent talks about how care management is helping their child.
Care Management Family Stories (Spanish)
This video features three parents currently using care management services. Each parent talks about how care management is helping their child.
Este video presenta a tres padres que actualmente utilizan servicios de administración de cuidados. Cada padre habla sobre cómo la gestión de la atención está ayudando a su hijo.
Care Management FAQs
Tailored Care Management is designed for people who receive Medicaid and have been diagnosed with
· an intellectual and/or developmental disability, or
· severe and persistent mental illness, or
· traumatic brain injury, or
· substance use disorder.
If you are on the NC Innovations Waiver, you are required to select an entity to provide this service or continue receiving Care Coordination from your LME/MCO. For all others, the service is optional.
There are over 70 certified care management providers who are community-based and available across NC. The Arc of NC is one of these. The LME/MCOs are also providing care management at this time. Eventually, the majority of care management will be provided by the community-based providers.
You may not be able to change the person who is serving as your care manager, but if there is a problem you should talk with their supervisor about that. If you want to change the organization that provides your care management, you will complete a change form and submit that to your LME/MCO. Your care management provider or your LME/MCO can help you with that form.
You will need to submit an "opt out" form to your LME/MCO saying that do not wish to have tailored care management at this time. You can also change your mind at any time. Care management providers and the LME/MCOs can help you with this form.
Contact your LME/MCO and let them know you want to receive care management. At that point, you will also choose the care management agency you want.
If you did not act on the letter(s) you received from NC DHHS with instructions on selecting a CMA (care management agency), it is likely that you were assigned to one automatically. Find out from your LME/MCO if that is the case, and know you can make new decisions given that information- keep the assigned CMA, change to another one, or (in some cases) decline the service altogether.