TCM

Definition of Targeted Case Management:

Targeted case management (TCM) is a state plan service defined as assisting eligible Medicaid members in gaining access to needed medical, social, educational and other services. It is not the direct delivery of any referred service. According to state regulations, a case manager’s primary functions are listed as following:

A Targeted Case Manager (TCM) will identify, select, obtain, coordinate and use paid services and natural supports to assist an individual. TCM services can be utilized before funding is accessed and while on the waiting list. Targeted case managers have a responsibility first and foremost to the interests and well-being of individuals accessing services. In other words, a TCM will assist the individual and family in determining their desires, dreams, and needs. Then the TCM will help identify what is available in their community and whether the support will be paid or natural supports. A TCM provides options that help empower people to make their own decisions while understanding the pros and cons of that choice. A TCM will assist with assessing and coordinating the supports and services needed. Targeted case managers have many roles and can provide a variety of tasks to help your service needs be met.

Why do I need a Targeted Case Manager:

A targeted case manager will strive to assist you in reaching your highest level of independence by providing support, guidance and encouragement along the way. The disability system can be confusing and complicated at times. It is a benefit to have a TCM who can act as an advocate, is aware of resources and can assist and guide you through the system..

What To Expect From Your TCM (pdf)Download

What A TCM Needs To Know From You (pdf)Download

Recent Developments in the State of Kansas Regarding TCM & Conflict of Interest:

The Conflict-Free Case Management (CFCM) issue arises from federal regulations under 42 CFR 441.301(c)(1)(vi), requiring clear separation between case management and service provision in HCBS. These rules have been in place since 2014 and are designed to ensure person-centered care by removing financial or organizational incentives that could compromise an individual’s choices. Without this separation, there’s a real or perceived risk that decisions about services could favor the provider’s interests over the individual’s needs. This issue is currently part of the State of Kansas' Corrective Action Plans (CAPs) with the DHHS Centers for Medicare & Medicaid (CMS). CMS recently issued specific guidance to KDHE requiring the state to resolve these conflicts across its HCBS waivers to maintain compliance and continue to secure federal HCBS waiver funding. A copy of the of the letter from CMS to KDHE is below for review which outlines the corrective actions needed from the State of Kansas.

HARVEY-MARION CDDO : Conflict-Free Targeted Case Management Proposal

Outcome:

The establishment of a conflict-free Targeted Case Management (TCM) provider network in the HMCDDO Service Area.

Action Steps:

The HMCDDO Board of Directors engaged with KDADS on 02/24/2025 to alert them about plans to initiate the HMTCM program.
To ensure that all individuals in the HMCDDO Service Area have conflict-free targeted case managers with a target date of 01/01/2026.
Establish Harvey-Marion Targeted Case Management as an agency to provide conflict-free case management services alongside our current conflict-free case management affiliate(s).
Develop strategies and processes with our current TCM affiliate(s), in the HMCDDO service area, to engage in unbiased options counseling, as well as the subsequent process of choosing a new conflict-free TCM provider.
In the fall of 2025, the HMCDDO will contact all individuals/guardians whom have been identified as "conflicted" to let them know that they will need to choose a new TCM provider to come into compliance with the KDADS corrective action plan regarding this issue.

CMS letter to KDHE 12.26.24: Regarding TCM Conflict of Interest (pdf)Download

Targeted case managenment (TCM)