CMSA Today - Issue 7, 2017 - 22

P O S T E R P R E S E N TAT I O N

THE CASE MANAGEMENT MODEL ACT:

Change is the law of life. And those who look only to the past or present ar

P R O F E S S I O N A L C A S E M A N AG E R S T R A
PRESENTERS:

What is Case Management?

Objectives:
* Define the Case Management Model Act and the
impact on the health care system.
* Describe key components of a quality case
management program outlined in the Case
Management Model Act.

Patricia
Noonan RN,
MBA, CCM,
Chair,
CMSA Public
Policy
Committee

* Discuss the importance of professional case managers
advancing the Case Management Model Act into
health policy at the local, state and federal levels.

Background of the CM Model Act
CMSA launched the CM Model Act in 2009 setting forth important
standards for case management services.
CM Model Act established the key elements of a comprehensive case
management program that public policymakers can reference and
use for legislative and regulatory initiatives geared towards reducing
health care costs, improving care coordination, transitions of care,
enhancing quality and promoting better clinical outcomes.

Chriss Wheeler
RN, MSN, CCM,
Vice-Chair,
CMSA Public
Policy
Committee

CM Model Act includes definition of case management, staff
qualifications, functions, scope of services, payment of services,
program requirements, training, quality management, anti-fraud
& consumer protections, complaints, regulatory oversight and
implementation.
CMSA Case Management Model Act, 2009

Case management is a collaborative process of assessment, planning, facilitation, care
coordination, evaluation, and advocacy for options and services to meet an individual's
and family's comprehensive health needs through communication and available
resources to promote patient safety, quality of care, and cost effective outcomes.
CMSA Standards of Practice for Case Management, 2016

Who Are Professional Case Managers?

Case managers are recognized experts and vital participants in the care coordination team
who empower people to understand and access quality, safe, and efficient health care se
What are the Qualifications for Professional Case Managers?
Current active and unrestricted licensure or certification in a health or human services dis
professional to conduct an assessment independently as permitted within the scope of pr
or
In the case of an individual who practices in a state that does not require licensure or cer
must have a baccalaureate or graduate degree in social work or another health or human
promotes the physical, psychosocial, and/or vocational well-being of the persons being s
CMSA Standards of Practice for Case Management, 2016

Key Components of a Quality CM Program
* Short Title
* Definitions
* Staff Qualifications
* Case Management Functions
* Authorized Scope of Service
* Payment of Services

* Other Program Requirements
* Training
* Quality Management
* Antifraud & Consumer Protections
* Complaints
* Regulatory Oversight & Implementation

CMSA Case Management Model Act, 2009

Key Components of a Quality Case Management Program

How Can You Become a Public Policy Cham

*
*
*
*
*
*
*

* Promote client self-management
* Facilitate self-advocacy,
education and anticipatory guidance
* Promote use of evidence-based care
* Optimal client safety
* Promote client behavior change
* Link with community resources
* Enhance transitions of care
* Maintain professional competencies

*
*
*
*

CMSA Case Management Model Act, 2009

*
*

Population identification process
Client-centered collaborative approach
Advocacy and self-determination
Comprehensive holistic approach
Cultural competence & diversity
Collaborative multidisciplinary team
Measurement for quality and quality
improvement
* Informed choice, consent and decision
making

Professional Case Management Guiding Principles

*
*
*

Membership in your professional organization
Involvement in local CMSA Chapter Public Policy Committee
Be a Liaison for the your chapter
Communicate with leaders/legislators at the
organizational, community, state, and federal level
Lead and mentor others
Support CMSA Public Policy initiatives
Utilize the CMSA Public Policy resources at
www.cmsa.org/policymakers
Join us in DC for the CMSA Hill Day event
You can make a difference for the healthcare consumer and our profess

www.cmsa.org/policymakers
PUPLIC POLICY 2017 _ 509.indd 1

22

CMSA TODAY

Issue 7 * 2017 * DIGITAL


http://www.cmsa.org/policymakers http://www.cmsa.org/policymakers

Table of Contents for the Digital Edition of CMSA Today - Issue 7, 2017

President's Letter
Association News
CMSA Corporate Partners
Care Transitions: Remember the Basics
Leveraging Family Caregivers, Clinical Protocols and Technology to Improve Person-Centered Care
Development and Implementation of Relational Building in the Virtual Work Environment
Patient and Provider Satisfaction
The Case Management Model Act: Professional Case Managers Transforming Health Care
Index of Advertisers
CMSA Today - Issue 7, 2017 - Intro
CMSA Today - Issue 7, 2017 - cover1
CMSA Today - Issue 7, 2017 - cover2
CMSA Today - Issue 7, 2017 - 3
CMSA Today - Issue 7, 2017 - 4
CMSA Today - Issue 7, 2017 - 5
CMSA Today - Issue 7, 2017 - President's Letter
CMSA Today - Issue 7, 2017 - 7
CMSA Today - Issue 7, 2017 - Association News
CMSA Today - Issue 7, 2017 - 9
CMSA Today - Issue 7, 2017 - CMSA Corporate Partners
CMSA Today - Issue 7, 2017 - 11
CMSA Today - Issue 7, 2017 - Care Transitions: Remember the Basics
CMSA Today - Issue 7, 2017 - 13
CMSA Today - Issue 7, 2017 - 14
CMSA Today - Issue 7, 2017 - Leveraging Family Caregivers, Clinical Protocols and Technology to Improve Person-Centered Care
CMSA Today - Issue 7, 2017 - 16
CMSA Today - Issue 7, 2017 - 17
CMSA Today - Issue 7, 2017 - Development and Implementation of Relational Building in the Virtual Work Environment
CMSA Today - Issue 7, 2017 - 19
CMSA Today - Issue 7, 2017 - Patient and Provider Satisfaction
CMSA Today - Issue 7, 2017 - 21
CMSA Today - Issue 7, 2017 - The Case Management Model Act: Professional Case Managers Transforming Health Care
CMSA Today - Issue 7, 2017 - 23
CMSA Today - Issue 7, 2017 - 24
CMSA Today - Issue 7, 2017 - 25
CMSA Today - Issue 7, 2017 - 26
CMSA Today - Issue 7, 2017 - 27
CMSA Today - Issue 7, 2017 - 28
CMSA Today - Issue 7, 2017 - 29
CMSA Today - Issue 7, 2017 - Index of Advertisers
CMSA Today - Issue 7, 2017 - cover3
CMSA Today - Issue 7, 2017 - cover4
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