Like many US cities, Portland had become a magnet for troubled youth, and had no good answer for how to deal with them. Typically, adolescents with severe behavioral problems were sent to psychiatric hospitals or placed in foster care. This did little to address the many root problems that had gotten the young people into trouble—mental illness, behavioral disturbances, drugs and alcohol, or homelessness.

The Case Management for Youth (CMY) project was designed to address these problems by providing alternatives for those youth with pressing health and social service needs. The program aims to simplify access to services and, ultimately, to connect the youth with local resources to ensure a stable living arrangement and enhance their ability to function in the community.

Who is served?

CMY works with adolescents ages 11 to 17 who have mental health problems. These are high-risk youth who otherwise would "fall between the cracks" of the health and social service system. Their mental health needs limit their functioning and quality of life at home, at school, and in the community.

How does the project work?

CMY operates on a decentralized case management system to coordinate services across many agencies and disciplines. Community sources, including schools, social service agencies, health care providers, and families, refer adolescents to CMY. A six-member, interdisciplinary team screens the referrals. Eligible adolescents are referred to a case manager in participating local agencies.

The case manager meets with the family and youth, then convenes an interdisciplinary, core service team. This team helps the adolescent and family to set individual goals and create a service plan. The case manager helps the adolescent and family develop short- and long-term goals, identifies resources, and coordinates and advocates for services.

Families and teens participate in all aspects of CMY, from developing the program to serving on advisory committees. The result is a program that reflects the needs of those it serves. Parents and teens are invested in the program's success—and their own.

How is the project financed?

Medicaid reimburses CMY through a new category for targeted case management services, which the project negotiated. United Way of Greater Portland contributes in-kind services. Participating agencies and the state's mental health department provided seed money. CMY is negotiating with the state Medicaid agency to develop a capitated rate for mental health services.

Quotes About the Project

Case Management for Youth enables families to care for their children at home—children who in the past would have been placed in a residential treatment facility." — Fran Finnegan, Deputy Director, Bureau of Medical Services, State of Maine

Case Management for Youth's outreach has pulled kids into the formal service system who otherwise would have drifted from shelter to shelter or wandered the streets homeless until they ended up in the state's corrections system or a residential in-patient facility." — Tanya Busch, Executive Director, Case Management for Youth