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Case Management

Case Management

Case management services are provided to individuals with mental health, substance use, and intellectual/developmental disability needs. Our case managers understand the possible impacts of not only these areas of need, but also how physical health and environmental stressors can affect a person’s overall well-being.  Case managers strive to connect individuals and families to community resources, needed services, and monitor for satisfaction of services and supports.  Case managers also are continually monitoring and assessing for any additional areas of need and supports.



Horizon recognizes that people with intellectual and/or developmental disabilities are best supported to have a good life when they have choice and control about their care and community participation. The role of the case manager is to support the inclusion of all people into their communities, starting at birth with parents and transitioning to adulthood. Horizon case managers listen and look for ways to ensure that people served can have community connections, natural supports, meaningful work, and can live as independently as possible.

Criteria for Admission: intellectual disability – diagnosis/documentation of significant limits in intellectual and adaptive functioning that is completed between the ages of 6 and 18 years of age. Developmental disability - diagnosis/documentation of severe, chronic disability due to a mental and/or physical impairment and resulting in substantial functional limitations, that is completed before 22 years of age.
Virginia has three Waivers for people with intellectual/developmental disabilities which are assessed and managed by Community Services Boards (CSBs). They are:

1. Building Independence Waiver. This waiver is for adults, 18-years and older, who are able to live independently. People with this waiver usually own, lease, or control their own living arrangements, and they don’t need supports all the time.
2. Family and Individual Supports Waiver. People with this waiver may live with their family, friends, or in their own homes. Some people may need supports with some medical and/or behavioral needs. This waiver is available to both children and adults.
3. Community Living Waiver. People with this waiver usually require supports in their homes all the time. This waiver is available to both children and adults.

To find out if you are eligible for one of these Waivers, the first step is to contact your local Community Services Board (CSB), such as Horizon Behavioral Health. Staff will assess whether an individual meets the criteria for the services based on criteria established by the Department of Behavioral Health and Developmental Services (DBHDS). Everyone found eligible for waiver services is added to a waitlist, and it is important to note that not everyone who requests an ID/DD Waiver will be found eligible. A Waiver Slot Committee, made up of community volunteers and DBHDS staff, select recipients from the list of people who have the highest level of need to offer available waivers. Individuals may be on the wait list for years due to the number who need waivers and waivers that are available.
For more information:
Navigating the DD waivers: my life my community

CC Plus Waiver
The former Elderly and/or Disabled with Consumer Directed (EDCD) Waiver and the Assisted Technology (AT) Waivers were combined into one singular waiver which is the Commonwealth Coordinated Care Plus (CCC+) Waiver. The CCC Plus Waiver is for:
-adults 65+ with a medical or nursing need and
-individuals less than 65 years with a disability and a medical or nursing need.
To request CCC Plus Waiver services, contact your local Virginia Department of Social Services (DSS) or your local Virginia Department of Health (VDH).
Studies show that people with a substance use disorder have better treatment outcomes if their other mental health issues are addressed at the same time. But finding and managing treatment can be overwhelming. Horizon’s Case Managers act as a single point of contact to help manage and advocate for clients.

Criteria for Admission: There must be documentation of the presence of a substance related disorder which meets Diagnostic and Statistical Manual of Mental Disorders -5 criteria.
The severity of a mental health disorder can dictate how much care is needed for an individual. Mental health case management can become extremely important when adults or children need multiple services as a part of their behavioral health treatment. A Horizon case manager can act as a single point of contact with health and social services, mobilizing needed resources and finding the best and most appropriate care for the client.

Criteria for Admission: For adults, there must be documentation of the presence of serious mental illness. For children or adolescents there must be documentation of a serious emotional disturbance or a risk of serious emotional disturbance.
This is a service provided to children and their families when the child is at risk of needing residential placement or is in a residential placement due to emotional or behavioral issues. The goal is to maintain the child in his home and transition him back to the community with the natural and professional supports in place to meet the child’s needs. Adult and child mental health case management can continue when the family has completed this program.

Criteria for Admission: Children are referred to this service through the Comprehensive Services Act (CSA).
In some cases, our clients need more intensive adult or child behavioral health treatment due to their vulnerability. If they meet the criteria set forth by the U.S. Department of Justice then they can qualify for enhanced case management.

Criteria for Admission: Per the U.S. Department of Justice Settlement Agreement with the Commonwealth of Virginia, a monthly face to face meeting is required with clients that: a) receive services from a provider with a Conditional or Provisional License, b) have more intensive behavioral or medical needs as defined by the Supports Intensity Scale (SIS), c) have an interruption of service greater than thirty days, d) encounter the crisis system for a serious crisis or, for multiple less serious crises, within a three month period, e) have transitioned from a Training Center within the previous twelve months, f) resides in a congregate setting licensed for five or more individuals, or g) lives in a congregate setting of five or more individuals.