Continuity of Care Teams (COC)

The Continuity of Care Teams provide critical support to the Department of Behavioral Health. Their efforts are targeted to CBH enrollees who are non-responsive to traditional treatment approaches, who may be heavy users of behavioral health services, and many of whom have medical problems, forensic histories, substance addictions, MRS involvement, DHS involvement, experienced homelessness, and/or suffer with HIV.

The COC Child/Adolescent team and COC Adult team are staffed by a multi-disciplinary team composed of a clinical coordinator, psychiatrist, registered nurse, mental health and drug and alcohol case managers, and behavioral health technicians. The COC teams operate on an intensive, short-term model. Through outreach, the Teams engage consumers through immediate intervention. They assess the person's need for immediate medical and/or behavioral health services, provide short term supportive counseling (if appropriate), work with family and significant others, if needed, and connect the individual with the appropriate treatment and supports.

The COC Teams are an integrated part of the entire Behavioral Health System and ensure coordination between service authorization, case management and continuity of care planning. A weekly clinical meeting, composed of representatives from the Office of Mental Health, CBH, DHS (Child and Adolescent Team meeting) reviews with the COC Teams the consumers who are on the Teams' caseloads. Referrals to the COC are made by CBH.

PMHCC supports the COC Teams by providing fiscal services, informational support and human resource management.