Critical Case Tracking Committee: Reporting and Tracking System to Identify At-Risk Individuals

NNEDLearn 2014 Participant: Mental Health Providers of Western Queens

Description: The Critical Case Tracking Committee (CCTC) is a multi-level reporting and tracking system designed to identify at-risk and high need recipients and to provide guidance and support in their treatment and care. Specific CCTC functions include:

  • Provide clinical consultations and suggest relevant therapeutic interventions to psychotherapists and supervisors
  • Coordinate care with the agency’s psychiatric staff, care coordination services, and substance abuse services
  • Coordinate special service interventions such as AOT, EMS, and ACT
  • Arrange preventive services and school-based services
  • Review client’s safety and/or “Wrap” plan
  • Engage patient support systems such as family or other caregivers

Population of focus:

  • Severely and persistently mentally ill adults and severely emotionally disturbed children
  • Individuals with high rate of hospitalization and ER usage
  • Forensic population and dually diagnosed population
  • Individuals with a history of poor adherence to prescribed medication
  • Individuals identified to be at-risk via clinical assessment (suicide risk, violence risk, history of public incidents)

Setting: Hospital, mental health clinic

Level of focus: Individual

Background: Licensure and recertification by NY State’s Office of Mental Health (OMH) requires that an agency develop internal systems for tracking high-risk cases. OMH has implemented this policy based on the following factors:

  • Under-utilization of mental health services, such as clinic treatment, care coordination, and crisis intervention by at-risk individuals
  • This lack of engagement in preventive care is a barrier to recovery and increases the likelihood of hospitalization and ER usage
  • Tragic and highly publicized incidents have focused public attention on the need for improved crisis intervention and engagement efforts by the mental health system (Kendra’s Law/AOT)

Results: NY State auditors have recognized and commended the MHPWQ Critical Case Tracking Committee:

  • Reduced rate of hospitalization and ER usage
  • Reduced frequency of decompensation and public incidents
  • Increased utilization of preventive and crisis intervention services
  • Increased integration of clinic treatment (psychotherapy and medication management) with care coordination services


John Lavin, LCSW-R
Mental Health Providers of Western Queens, Inc.