Case Management Agency - Policies and Procedures - Virginia State Licensure

Introducing our comprehensive Case Management Agency Policies and Procedures Package designed specifically for Virginia State licensure. We understand the importance of meeting state regulatory requirements while maintaining the highest standards of quality, safety, and individual-centered care. Our meticulously crafted set of policies and procedures is your key to achieving and sustaining compliance while delivering exceptional healthcare services.

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Table of Contents

Introduction
Vision
Mission
Values
Document Control
Statement of Policy
Regulatory Crosswalk
Chapter 1: Governance and Administration
Compliance with Applicable Laws, Regulations and Policies Policy
Governing Body, Organizational Structure and Administrator Policy
Code of Ethics and Conflict of Interest Policy
Advertising and Marketing Integrity Policy
Contracted Services and Business Associates Policy
Chapter 2: Rights of Individuals Receiving Services
Assurance of Rights and Responsibilities Policy
Dignity Policy
Nondiscrimination, Language Access and Effective Communication Policy
Right to Services Policy
Participation in Decision Making, Informed Consent and Right to Refuse Policy
Restrictions on Freedoms of Everyday Life Policy
Capacity Determinations and Authorized Representatives Policy
Advance Directives Policy
Complaint and Grievance Resolution Policy
Abuse, Neglect and Exploitation Prevention and Reporting Policy
Human Rights Program Responsibilities Policy
Research Participation Policy
Chapter 3: Case Management Services
Service Description Policy
Scope of Case Management Services Policy
Medicaid Substance Use Case Management Policy
Funding Sources and Medicaid Coverage Limits Policy
Initial Contacts, Screening, Admission and Referral Policy
Assessment Policy
Individualized Services Plan Policy
ISP Requirements Policy
Reassessments and Quarterly ISP Reviews Policy
Case Management Direct Assessments (Face-to-Face Contacts) Policy
Progress Notes and Service Documentation Policy
Orientation of Individuals and Authorized Representatives Policy
Case Manager Assignment and Choice Policy
Transition of Individuals Among Services Policy
Discharge Policy
Crisis and Emergency Intervention Policy
Documenting Crisis Intervention and Emergency Services Policy
Chapter 4: Health, Medication and Behavior Supports
Health Care Policy
Emergency Medical Information Policy
Medical Equipment Policy
Medication Monitoring Policy
Behavior Interventions and Supports Policy
Prohibited Actions Policy
Seclusion, Restraint and Time Out Prohibition Policy
Chapter 5: Personnel
Provider Staffing Plan, Supervision, Students and Volunteers Policy
Job Descriptions Policy
Qualifications and Credential Verification Policy
Case Manager Knowledge, Skills, Abilities and Core Competencies Policy
Criminal Background Checks and Registry Searches Policy
Provider Statement to Other Licensed Providers Policy
Exclusion Screening Policy
Tuberculosis Screening Policy
Orientation of New Employees, Contractors, Volunteers and Students Policy
Employee Training and Development Policy
First Aid and CPR Certification Policy
Notification of Policy Changes Policy
Employee and Contractor Performance Evaluation Policy
Employee or Contractor Personnel Records Policy
Confidentiality and Security of Personnel Records Policy
Equal Employment Opportunity and Anti-Harassment Policy
Employee Grievance Policy
Employee Conduct, Discipline and Separation Policy
Wage and Hour, Leave and Timekeeping Policy
Drug- and Alcohol-Free Workplace Policy
Chapter 6: Records Management, Confidentiality and Privacy
Records Management Policy
Individual’s Service Record Policy
Retention of Records Policy
Confidentiality of Information Policy
Access to and Correction of Records Policy
HIPAA Privacy, Security and Breach Notification Policy
Substance Use Disorder Records (42 CFR Part 2) Policy
Electronic Records and Signatures Policy
Chapter 7: Infection Prevention and Control
Infection Control Policy
Bloodborne Pathogens Exposure Control Policy
Chapter 8: Safety and Risk Management
Risk Management Policy
Serious Incident Management and Reporting Policy
Root Cause Analysis Policy
Weapons Policy
First Aid Kit Policy
Workplace Violence and Field Safety Policy
Vehicle and Transportation Safety Policy
Chapter 9: Emergency Preparedness
Emergency Preparedness and Response Plan Policy
Chapter 10: Quality Improvement
Quality Improvement Program Policy
Chapter 11: Financial Management
Fiscal Accountability and Internal Controls Policy
Indemnity Coverage Policy
Fee Schedule and Financial Agreements Policy
Funds of Individuals Receiving Services Policy
Billing Integrity and Medicaid Documentation Policy
Compliance Program and Fraud, Waste and Abuse Policy
Anti-Kickback and Referral Practices Policy

List of Annexures

Annexure 01: Client Funds Expenditure and Disbursement Record
Annexure 02: Staff Orientation Checklist (Employees, Contractors, Students and Volunteers)
Annexure 03: Staff Training and Development Record
Annexure 04: Performance Evaluation Form
Annexure 05: Employee Grievance Form
Annexure 06: Office Safety Inspection Checklist
Annexure 07: Emergency Preparedness Drill and Exercise Record
Annexure 08: Emergency and Reporting Contact Numbers
Annexure 09: Initial Contact and Screening Form
Annexure 10: Initial Assessment Form
Annexure 11: Comprehensive Assessment Form
Annexure 12: Individualized Services Plan (ISP)
Annexure 13: Quarterly ISP Review and Reassessment Form
Annexure 14: Case Management Progress Note
Annexure 15: Orientation of Individuals Checklist
Annexure 16: Transfer Summary Form
Annexure 17: Discharge Summary Form
Annexure 18: Crisis Intervention and Emergency Services Documentation Form
Annexure 19: Fall Risk Screening Form
Annexure 20: Emergency Medical Information Form
Annexure 21: Abuse, Neglect and Exploitation Reporting Form
Annexure 22: Face Sheet
Annexure 23: Service Record Checklist
Annexure 24: Authorization to Release or Exchange Information
Annexure 25: Record Review Form
Annexure 26: Behavior Supports Coordination and Monitoring Form
Annexure 27: Rights of Individuals Receiving Services Acknowledgment
Annexure 28: Human Rights Complaint Form
Annexure 29: Complaint and Grievance Log
Annexure 30: Informed Choice and Consent to Case Management Services
Annexure 31: Case Manager Change Request Form
Annexure 32: Face-to-Face Direct Assessment Record
Annexure 33: Serious Incident Report and Quarterly Review Log
Annexure 34: Root Cause Analysis Worksheet
Annexure 35: Criminal History Disclosure Statement
Annexure 36: Background Check and Registry Search Log
Annexure 37: Exclusion Screening Log
Annexure 38: Credential Verification Record
Annexure 39: Supervision Record
Annexure 40: Client Satisfaction Survey
Annexure 41: Quality Improvement Plan Worksheet
Annexure 42: Annual Risk Assessment Review
Annexure 43: Staff Acknowledgment of Policy and Procedure Manual and Policy Changes
Annexure 44: Policy Review Log
Annexure 45: Fee Schedule and Financial Agreement
Annexure 46: Medicaid Substance Use Case Management Monthly Activity Log
Annexure 47: Annual Emergency Preparedness Plan Review