Case Management Services assist individuals and their families with gaining timely access to services and supports that are essential to meeting their basic needs.  These services include, but are not limited to, medical, psychiatirc, nutritional, social, educational, vocational, employment, housing, economic, transportation, leisure and recreational, legal, advocacy, and any other supports that individuals need to function in a community setting. 

Case management is an intervention which assures that service systems and community supports are maximally responsive to the specific, multiple, and changing needs of individual consumers and families.  It provides a mechanism to facilitate an individual’s progress within service systems, enhance the individual’s potential and quality of life, and assure comprehensive and quality care.

The Case Management recipient is a partner, to the greatest extent possible, in assessing needs; obtaining services, treatments, and supports; and in preventing and managing crisis. The individual and the practitioner plan, coordinate, monitor, adjust, and advocate for services and supports directed toward the achievement of the individual’s personal goals for community living.

Case management services are available to individuals 18 years or older who meet the criteria of serious mental illness as defined along the following three dimensions: (a) diagnosis (b) level of disability and (c) duration of the illness.

A) Diagnosis-  There is a major mental disorder such as schizophrenic, major affective disorder, paranoid, organic or other psychotic disorder, personality disorder, or other disorder that may lead to a chronic disability.

B) Level of Disability- Severe, Recurrent Disability Resulting from Mental Illness- The disability results in functional limitations in major life activities. Individuals typically meet at least two of the following criteria, on a continuing or intermittent basis:

C)Duration: Individuals are expected to require services for an extended duration or their treatment history meets at least one of the following criteria:

Psychosocial Rehabilitation (PSR) is a set of service interventions designed to work holistically to improve an individual’s functioning, the management of his/her illness, and to facilitate recovery.  Specific areas of intervention addressed by the PSR field include:  daily living skills; social network and supports; finances and benefits; housing; education; employment; legal status; transportation; and advocacy.

PSR interventions occur concurrently with necessary clinical treatments. The goal is to accomplish and support the fullest possible integration of the individual as an active and productive member of his or her family, community and/or culture. 

These services are also available in Rural areas. Please see Rural Services.

Persons must be eighteen years of age or older, have a serious and persistent mental illness, a willingness and desire for such services, and the ability to function within consumer/staff ratios established by PSR organizational structures.

Individual must have had a history of at least one psychiatric hospitalization and demonstrate a clinical necessity for the service arising from a condition due to mental, behavioral, or emotional illness which results in significant functional impairments in major life activities.

Individual must meet two of the following criteria on a continuous or intermitent basis:
1.	Has difficulty in establishing or maintaining normal interpersonal relationships to such a degree that they are at risk of hospitalization or homelessness
2.	Requires help in basic living skills such as maintaining personal hygiene, preparing food, maintaining adequate nutrition, or managing finances, to such a degree that health or safety is jeopardized
3.	Exhibits such inappropriate behavior that repeated interventions by the mental health, social services, or judicial system are necessary
4.	Exhibits difficulty in cognitive ability such that he/she is unable to recognize personal danger or to recognize significantly inappropriate social behavior

PACT provides needed treatment, rehabilitation, and support services to identified consumers with severe and persistent mental illness. The self contained clinical PACT team provides services on a long term care basis with continuity of caregivers over time and minimally refers consumer to outside service providers. The emphasize of the program is on outreach, relationship building, and individualization of services.

Individuals who have severe symptoms and impairments that are not effectively remedied by available treatments or who, because of reasons related to their mental illness, resist or avoid involvement with mental health services. These individuals have a severe and persistent mental illness which seriously impairs their functioning in community living. Priority is given to people with schizophrenia, other psychotic disorders (e.g. schizoaffective disorder), or bipolar disorder because these illnesses more often cause long-term psychiatric disability.

Individuals 18 years of age or over, both male and female, with serious mental illnesses. Individuals must have had a history of at least one psychiatric hospitalization and demonstrate a clinical need for the services arising from a condition due to mental, behavior, or emotional illness which results in significant impairments in major life activities. 

PACSS is a joint service project of Region Ten Community Services Board and On Our Own-Charlottesville, Inc. The overall service effort is designed to provide specialized and intensive outreach to the streets and shelters to identify and engage difficult-to-serve persons experiencing serious mental illnesses. In addition, the project provides the agency’s specialized outreach and engagement of homeless persons experiencing serious mental illnesses through the PATH program (Programs Assisting in the Transition from Homelessness).

Services provided include

A residential apartment and day program for people dually diagnosed with a substance use disorder and serious mental illness who need intensive training and supports to maintain a home within the community.

Adults 18 years and older who have both a serious mental illness,including a psychotic component, and a substance/dependence disorder. Individuals must have a history of a least one psychiatric hospitalization and demonstrate a clinical need for the service arising from a condition due to mental, behavior, or emotional illness that results in a significant functional impairment in major life activities.