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Table of Contents

3

Introduction

5

Scope and Purpose of the Standards

5

Interpretation of the Standards

5

Application of the Standards

5

Case Management Definition

5

Case Management Concepts

5

Guiding Principles of Case Management

7

Standard One - Case Identification (screening) and Assessment

8

Standard Two - Planning

9

Standard Three - Monitoring

10

Standard Four - Evaluation and Outcomes

11

Diagram One - Case Management Process

12

Diagram Two Standard One - Case Identification (screening) Phase

12

Diagram Three Standard One - Assessing Phase

13

Diagram Four Standard One Stratifying Risk (risk assessment) Phase

13

Diagram Five Standard Two - Planning Phase

14

Diagram Six Standard Two - Implementing (care coordination) Phase

14

Diagram Seven Standard Three - Monitoring Phase

15

Diagram Eight Standard Three - Transitioning (transitional care) Phase

15

Diagram 9 Standard Three - Disengagement and Feedback Phase

16

Diagram Ten Standard Four - Evaluating Phase

16

Self Assessment Framework (SAF)

17

Purpose of the Self Assessment Framework (SAF)

17

Structure of the Self Assessment Framework (SAF)

17

Application of the Self Assessment Framework (SAF)

17

Self Assessment

17

Verified Assessment

17

SAF 1A Standard One - Case Identification and Assessment

18

SAF 1B Standard One - Case Identification and Assessment

18

SAF 1C Standard One - Case Identification and Assessment

19

SAF 1D Standard One - Case Identification and Assessment

20

SAF 1E Standard One - Case Identification and Assessment

20

SAF 1F Standard One - Case Identification and Assessment

21

SAF 1G Standard One - Case Identification and Assessment

21

SAF 1H Standard One - Case Identification and Assessment

22

SAF 1I Standard One - Case Identification and Assessment

22

SAF 2A Standard Two - Planning

23

SAF 2B Standard Two - Planning

24

SAF 2C Standard Two - Planning

24

SAF 2D - Planning

25

SAF 2E Standard Two - Planning

26

SAF 2F Standard Two - Planning

27

SAF 2G Standard Two - Planning

27

SAF 3A Standard Three - Monitoring

28

SAF 3B Standard Three - Monitoring

28

SAF 3C Standard Three - Monitoring

29

SAF 3D Standard Three - Monitoring

30

SAF 3E Standard Three - Monitoring

31

SAF 4A Standard Four - Evaluation and Outcomes

32

SAF 4B Standard Four - Evaluation and Outcomes

33

SAF 4C Standard Four - Evaluation and Outcomes

33

SAF 4D Standard Four - Evaluation and Outcomes

34

SAF 4E Standard Four - Evaluation and Outcomes

34

SAF 4F Standard Four - Evaluation and Outcomes

35

SAF 4G Standard Four - Evaluation and Outcomes

35

SAF 4H Standard Four - Evaluation and Outcomes

36

SAF 4I Standard Four - Evaluation and Outcomes

36

SAF 4J Standard Four - Evaluation and Outcomes

37

SAF 4K Standard Four - Evaluation and Outcomes

37

SAF 4L Standard Four - Evaluation and Outcomes

38

Glossary A - C

39

Glossary C - I

40

Glossary K - R

41

Glossary R - V

42

Notes

43