Posted: November 29th, 2022

Chronic Care Management Plan

Chronic Care Management Plan
________________________________________
People living with a chemical or behavioral addiction often struggle with daily living functions, employment, family, and social relationships. Applying a chronic care management plan can be useful to help a patient manage their chronic disease. Utilize the case below and outline a chronic care management plan for this patient.
Instructions:
1. Review this case scenario
.
2. Use this template Assignment 5.1 Chronic Care Management Plan
to create your chronic care management plan.
3. Be sure to thoroughly address each area (review the grading rubric for more information). You will be graded based on the thoroughness of your responses and the integration of course materials.
4. Support your response with evidence and/or examples from the course materials and/or find additional resources from the UTA Library.
5. Cite any resources using APA format Links to an external site..
Expectations:
Please submit this assignment by 11:59 p.m. (CT) on Friday of Module 5. Submit as a Word document or PDF file only in the format provided.
Grading:
A rubric is provided to explain the criteria for points and how you are graded.

Criteria Ratings Pts
Assessments
view longer description 20 to >17 pts
Exceptional
Identifies 3-4 key assessments relevant to medical diagnoses. Identifies 3 psychosocial concerns.
17 to >13 pts
Proficient
Identified 1-2 key assessments relevant to medical diagnoses. Identifies 2 psychosocial concerns.
13 to >0 pts
Unacceptable
Identifies assessments not relevant to medical diagnoses. Identifies 0-1 psychosocial concern. / 20 pts
Diagnoses
view longer description 10 to >8 pts
Exceptional
Identifies accurate diagnoses specific to patients history and symptoms.
8 to >6 pts
Proficient
Identifies somewhat accurate diagnoses specific to patients history and symptoms.
6 to >0 pts
Unacceptable
Identifies no or inaccurate diagnoses specific to patients history and symptoms. / 10 pts
Interventions & Rationale
view longer description 25 to >22 pts
Exceptional
Identifies 3 independent interventions. Scientific rationale relevant and supported by citations.
22 to >17 pts
Proficient
Identifies 2 independent interventions. Scientific rationale somewhat relevant and supported by citations.
17 to >0 pts
Unacceptable
Identifies 1 independent interventions. Scientific rationale not relevant or supported by citations. / 25 pts
Expected Outcomes
view longer description 10 to >8 pts
Exceptional
Describes relevant outcomes specific to identified interventions.
8 to >6 pts
Proficient
Describes somewhat relevant outcomes specific to identified interventions.
6 to >0 pts
Unacceptable
Describes irrelevant outcomes specific to identified interventions. / 10 pts
Referrals
view longer description 15 to >13 pts
Exceptional
Lists 3 or more appropriate collaborative issues/concerns. Demonstrates excellent understanding of interventions.
13 to >10 pts
Proficient
Lists 2 appropriate collaborative issues/concerns. Demonstrates satisfactory understanding of interventions.
10 to >0 pts
Unacceptable
Lists inappropriate collaborative issues/concerns. Demonstrates unsatisfactory understanding of interventions. / 15 pts
Assessment/Monitoring Plan
view longer description 20 to >17 pts
Exceptional
Follow-up plan is specific and detailed related to interventions and referrals.
17 to >13 pts
Proficient
Follow-up plan is somewhat specific and detailed related to interventions and referrals.
13 to >0 pts
Unacceptable
Follow-up plan is not specific or detailed related to interventions and referrals. / 20 pts
—-
Discussion Board 5.2: Case Scenario
________________________________________
Suzanne has come by the free drop-in counseling clinic where you work to get some information and advice. Suzanne is a 22-year-old single woman who has been living with her boyfriend Jack in Manhattan’s lower east side for the last four years. She and Jack have been heroin addicts for as many years.
When Suzanne was 10 years old, her father, whom she says was a very heavy drinker, left her mom and the kids and never came back. At 14 she started drinking and smoking marijuana. At 16 she had dropped out of high school and at 18 she moved in with Jack. He introduced her to heroin. She reports using about a 1/2 gram of heroin per day just to be able to function and feel comfortable. In order to pay for the heroin and pay the rent on their apartment, Jack doesn’t work, instead, she works the streets at night. She usually drinks four or five beers each night before going out to work. If she can’t score enough heroin, she will try to score either some Valium or Klonopin to “tide me over until I can get some ‘horse’.” She says she has tried cocaine but, “I really didn’t care for the high all that much.” Suzanne tells you that the alcohol and heroin help to calm her nerves and get her through the night.
She and Jack are not having sex all that much. When they do make love, he never wears a condom. He says that’s what makes him different from her John’s. “Which is true because I won’t work without a condom.” Lately she has noticed that her breasts have become swollen and more tender. She also hasn’t had her period in the last 12 weeks. She is pretty sure she is pregnant and knows it’s her boyfriend’s baby. However, she not sure she can stop using dope or work to have the baby even though Jack wants her to keep it. She is really confused at what she should do and is asking for you to help her make some decisions. Her friend who works with her at night told her not to stop using dope if she is pregnant because it’s worse for the baby than to keep using. “I just don’t know what I should do?”
Considerations
As you write your care management plan for Suzanne, consider the following questions.
1. What substance does she seem most addicted to and which pose the greatest danger to withdraw from?
2. What dangers do you see in this case, for Suzanne and for the baby?
3. What treatment options would you offer Suzanne?
4. What referrals would you give her?
5. What legal issues are likely to present themselves if she decides to keep the baby?
—
Assignment 5.1: Chronic Care Management Plan
________________________________________
People living with a chemical or behavioral addiction often struggle with daily living functions, employment, family, and social relationships. People with substance use disorders also have high healthcare utilization and comorbidities but receive poor overall care quality. Applying a chronic care management plan can be useful to help a patient manage their chronic disease.
Instructions:
Review the case scenario in the Canvas Assignment. Using the template below, outline a care management plan for this patient.
Care Management Plan
Assessments: What types of assessments might you want to conduct to gather more information regarding the patient’s past and current situation? These can be medical tests, psychosocial and/or environmental assessments etc.

Clinical Problems: Prioritize a list of clinical (medical/social) problems specific to this patient.

Interventions: What interventions would you recommend for this patient? These can include medical treatments, mental health treatments, psychosocial interventions, etc. that are appropriate for your identified clinical problems. (You can assume the patient is pregnant.) Be sure to cite your selected interventions to ensure they are evidence-based. Do not include assessments/tests or referrals in this section.

Rationale: Provide your rationale for the selected interventions above. Be sure to provide citations to support why your rationale is appropriate for your identified clinical problems and interventions.

Expected Outcomes: If the patient completes the recommended interventions what are the expected outcomes for the patient?

Referrals: What referrals would you recommend for this patient and why? These can include medical specialists, mental health providers, community programs/interventions, etc. What other resources would help this patient?

Assessment/Monitoring Plan: How would you plan to evaluate this patients progress? How often would you follow-up with the patient?

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