APPENDIX E: PROVIDER

APPENDIX E: PROVIDER DELEGATED FUNCTIONS MATRIX INTAKE Allamakee County Access Points REFERRAL FOR CASE MANAGEMENT (if needed) 35 REFERRAL FOR CLINICAL ASSESSMENT (if needed) DEVELOPMENT OF AN INDIVIDUALIZED SERVICE PLAN HELP THE INDIVIDUAL NAVIGATE THE SERVICE SYSTEM Allamakee County CPC Office X X X X Allamakee County Case Management X X X X X Alternative Treatment Associates X X X X X Makee Manor X X X X Mosaic X X X X Northeast Iowa Behavioral Health Center X X X X X TASC, Inc X X X X Iowa Vocational Rehabilitation Services X X X X X INTAKE Bremer County Access Points REFERRAL FOR CASE MANAGEMENT (if needed) REFERRAL FOR CLINICAL ASSESSMENT (if needed) DEVELOPMENT OF AN INDIVIDUALIZED SERVICE PLAN HELP THE INDIVIDUAL NAVIGATE THE SERVICE SYSTEM Bremer County CPC Office X X X X X INTAKE Buchanan County Access Points REFERRAL FOR CASE MANAGEMENT (if needed) REFERRAL FOR CLINICAL ASSESSMENT (if needed) DEVELOPMENT OF AN INDIVIDUALIZED SERVICE PLAN HELP THE INDIVIDUAL NAVIGATE THE SERVICE SYSTEM Buchanan County Community Services Office X X X X X Abbe Center for Community Mental Health X X X X X B & D Services X X X X Full Circle Services X X X X Goodwill Industries X X X X Iowa Vocational Rehabilitation Services X X X X X INTAKE Clayton County Access Points REFERRAL FOR CASE MANAGEMENT (if needed) REFERRAL FOR CLINICAL ASSESSMENT (if needed) DEVELOPMENT OF AN INDIVIDUALIZED SERVICE PLAN HELP THE INDIVIDUAL NAVIGATE THE SERVICE SYSTEM Clayton County CPC X X X X X DHS Case Management X X X X Northeast Iowa Behavioral Health Center X X X Hillcrest Mental Health Center X X X RISE, Ltd X X X Scenic Acres X X X

INTAKE Delaware County Access Points REFERRAL FOR CASE MANAGEMENT (if needed) 36 REFERRAL FOR CLINICAL ASSESSMENT (if needed) DEVELOPMENT OF AN INDIVIDUALIZED SERVICE PLAN HELP THE INDIVIDUAL NAVIGATE THE SERVICE SYSTEM Delaware County Community Services X X X X X Abbe Center for Community Mental Health X X X X X INTAKE Fayette County Access Points REFERRAL FOR CASE MANAGEMENT (if needed) REFERRAL FOR CLINICAL ASSESSMENT (if needed) DEVELOPMENT OF AN INDIVIDUALIZED SERVICE PLAN HELP THE INDIVIDUAL NAVIGATE THE SERVICE SYSTEM Fayette County CPC Office X X X X Abbe Center for Community Mental Health X X X X X Northeast Iowa Behavioral Health Center X X X X X Goodwill Industries X X X X Alternative Living Corp. X X X X Full Circle, Inc X X X X Quality Choices X X X X INTAKE Howard County Access Points REFERRAL FOR CASE MANAGEMENT (if needed) REFERRAL FOR CLINICAL ASSESSMENT (if needed) DEVELOPMENT OF AN INDIVIDUALIZED SERVICE PLAN HELP THE INDIVIDUAL NAVIGATE THE SERVICE SYSTEM Howard County CPC Office X X X X Howard County Case Management X X X X X Northeast Iowa Behavioral Health Center X X X X X Howard Residential Care Facility X X X X Opportunity Homes, Inc X X X X The Spectrum Network X X X X Mental Health Institute-Independence X X X X X Iowa Vocational Rehabilitation Services X X X X X Gilbert A. Alber, PC X X X X X INTAKE Winneshiek County Access Points REFERRAL FOR CASE MANAGEMENT (if needed) REFERRAL FOR CLINICAL ASSESSMENT (if needed) DEVELOPMENT OF AN INDIVIDUALIZED SERVICE PLAN HELP THE INDIVIDUAL NAVIGATE THE SERVICE SYSTEM Winneshiek County CPC Office X X X X DHS Targeted Case Management X X X X X Northeast Iowa Behavioral Health Center X X X X X Gundersen Clinic X X X X X Opportunity Homes, Inc X X X X The Spectrum Network X X X X Wellington Place X X X X Iowa Vocational Rehabilitation Services X X X X X Lighthouse Professional Counseling Services, LLC X X X X X Iowa Vocational Rehabilitation Services X X X X X