304-256-7100
Serving Fayette, Monroe, Raleigh, and Summers Counties of West Virginia
Care Coordination Services


Care Coordination services are used to develop a community support system for adults with serious mental illness and co-occurring mental illness and/or substance abuse and/or developmental disabilities who are at risk of hospitalization. Care Coordination has been a major expansion to the medical and clinical services offered by FMRS. The service is offered to individuals who have been hospitalized or are at risk of hospitalization. A main objective of Care Coordination is to have the supports in place to allow consumers who have been in treatment facilities on a frequent basis to remain in the community and to avoid future involuntary placement in a treatment facility. 

The main responsibility of the Care Coordinator is to establish a therapeutic relationship with consumers which will allow for monitoring symptoms and compliance with treatment. During this process, the Care Coordinator offers practical help and supports needed to help consumers obtain the necessities of daily living. This could include medical/dental health care, legal/advocacy services, financial support including representative payee services, housing and transportation. Depending on the needs of the consumer, the visits could occur in the home or at the center. Care Coordination has drastically reduced the number of repeat admissions to the local hospital as well as to state mental health facilities.
 
It is the belief of FMRS that recidivism previously occurred because of the lack of support available to individuals in the community. Non-compliance with medication regime is often a cause of an individual returning to the hospital. By providing the necessary supports, including medication monitoring, we have seen that recidivism has decreased. We also believe that Care Coordination with medication compliance monitoring has been an effective tool for consumers with treatment compliance orders (treatment compliance orders are part of a pilot program and only available in Raleigh County). The addition of care coordination to our service delivery system has greatly improved the quality of services offered by FMRS. This program has allowed us to provide comprehensive, community based treatment for individuals with severe and persistent mental illnesses. 

Please address any questions to Denita Walker, Program Director, at 304-256-7100.

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