Care Review is a time for a person or family to meet with community and agency representatives to their needs and wishes across multiple areas including: mental and physical health, housing, transportation, legal, financial, educational, vocational, social and spiritual needs. The Care Review Team will assist with brainstorming and creating a plan to access resources in the community. Often, the Teams come up with ideas that an individual provider or case manager have not been able to identify or coordinate on their own.

Care Review teams CANNOT:

  • Provide a clinical recommendation for a particular treatment service or level of care (such a recommendation is the product of a Comprehensive Clinical Assessment)
  • Overturn decisions made by Alliance’s Utilization Management Department with regard to the denial or reduction of authorizations of MH/DD/SA services
  • Guarantee a particular MH/DD/SA service will be approved by Alliance’s Utilization Management Department as meeting medical necessity
  • Approve or guarantee housing funds, such as ILI funding
  • Determine eligibility for funding sources like Medicaid or State funding.

Who is on the Care Review Team?

The Care Review team represents different agencies and organizations in the community.  While Care Review Team members represent their organizations, they are expected not to advocate for the interest of their organizations, but rather to focus on the interest of the participant. The members of the team are invited by the Care Review facilitator. Participants are welcome to bring whomever they want.

Typically, members represent:

  • Mental health providers
  • Department of Human Services
  • Department of Social Services
  • Faith-based organizations
  • Peer support groups
  • Public schools (child)
  • Vocational rehab (adults)
  • Departments of Juvenile Justice or Public Safety
  • SSI/SSDI advocate
  • Public Health/healthcare provider
  • Housing agencies
  • Alliance Consumer Affairs Specialist

How long is a Care Review?

Each Care Review is scheduled for one hour. Usually that is enough time for you to share your concerns and to create an Action Plan.

What happens during Care Review?

Everyone will introduce themselves and the team will review the strengths of the participant. The referral source should be prepared to present information about a child or individual’s Crisis Plan, Individualized Education Plan (IEP) if applicable, Person Centered Plan (PCP), Individual Support Plan (ISP) or other treatment plan goals, and other  available evaluations or documentation that can lend itself to productive planning during the Care Review process. Support persons and professionals involved with a child, family or individual should be ready to discuss their function and role in relation to how the child, family and/or individual is being served.

An Action Plan will be developed and reviewed at the conclusion of the meeting. The participant/guardian and anyone the participant wishes will receive a copy of the Action Plan.  By request, copies of any additional resource information will also be given to the participant/guardian and referral source.

What happens after Care Review?

You, your support team, and members of the Care Review Team will work together to follow up on your action plan. A Care Review staff member will follow up with the participant, guardian and referral source about three months after Care Review to check on the progress of the Action Plan.

Alliance does not provide transportation to and from the Care Review. For Youth and Transition Care Reviews, the referral source is required to inform and invite all Child and Family Team members to the Care Review and to incorporate their input into the referral form.

As we work hard to include members from a number of community agencies, please extend the courtesy of notifying us within 24 hours if the participant decides to not attend.

Page last modified: August 26, 2019