Goal Service Plan

Treatment or Goal Service Plan
CLIENT Belinda Well
# WellsB1996
Next of Kin Eva Langloris (aunt)
Initial plan
Updated plan
Date 1/21/15
Review Date 6/21/15
Developed with Kevin May Eligiblity Worker
Level of case management Case Manger for Planned Parenthood
Case Manager Kevin May
Provisional DX: Axis I 311 (Depressive Disorder)
Axis II
Axis III
Axis IV 659.40(current pregnancy poor care)
Scondary diagnosis: Axis I
GOAL(S)

Axis IV
Axis II

TYPE

STRENGTH/NEED

INCOME/FINANCIAL
SITUATION

STRENGTH/
NEED

Utilize or apply for appropriate, available, and necessary entitlements

HOUSING/LIVING
ARRANGEMENT

STRENGTH/
NEED

Find living arrangements that Secure ancillary public and are either government private benefits or grants to supported or
independent assist with housing.

VOCATIONAL

STRENGTH/
NEED

Obtain job coaching skills or Express a desire for wanting Unemplyment offices assitance with job placement to work
Job coaching to gain entry level work technial/trade school

EDUCATIONAL

STRENGTH/
NEED

TRANSPORTATION

STRENGTH/
NEED

Assist with getting to help ensure she is linked to appointments and remainting proper transporation compliant with her health providers for appts. needs

Mediciad transporation private medicaid services through her health benefits.

MEDICAL

STRENGTH/
NEED

Accept the reality of current pregnancy and take responsibility for her health

WIC appts, OB-GYN appts.,
DSS appts,

Explore the idea getting her
GED certificate

COMMENTS

REFERRAL

help obtain identification and DMV, ID cards, Picture ID, documents needed for
Tribal Offices financial needs

HUD housing
Section 8 housing
Housing authority

Explore her options as well Local community college as avennues to get her GED online GED certificantes avaialbe in her area

she will make and keep all scheudled appointments as scheduled by her doctor

From SUMMERS. Fundamentals of Case Management Practice, 4E. © 2012 Wadsworth, a part of Cengage Learning, Inc.
Reproduced by permission. www.cengage.com/permissions

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TYPE

STRENGTH/NEED

ACTIVITIES OF DAILY
LIVING

STRENGTH/
NEED

Learn basic skills for
Assess her functioning
Local Clinics maintaining a clean, sanitary ablities to care for self as well PCP living space for herself/baby as baby famiy support

LEGAL

STRENGTH/
NEED

Obtain competent, caring legal representation for self and that of her children

RECREATION & LEISURE
TIME

STRENGTH/
NEED

MENTAL HEALTH

STRENGTH/
NEED

SUBSTANCE ABUSE

STRENGTH/
NEED

FAMILY RELATIONSHIPS

STRENGTH/
NEED

SOCIAL SUPPORTS

STRENGTH/
NEED

OTHER

STRENGTH/
NEED

Latera Davis
Case Manager Signature

1/21/15
Date

GOAL(S)

COMMENTS

REFERRAL

Assist the client in making
Refer to attorney if need be, decisions about the need for legal aide, Advocate legal assitance

N/A

Recognize, accept, and cope Complete psychological
Behavoral health, PCP, with feelings of depression.
testing to assess the level of psychtirist, depression and treatments

N/A

Rebuild important family relationships Describe the history of family Family counseling relationships individual counseling parenting classes

N/A

N/A

Latera Davis
Supervisor’s Signature

1/21/15
Date

From SUMMERS. Fundamentals of Case Management Practice, 4E. © 2012 Wadsworth, a part of Cengage Learning, Inc.
Reproduced by permission. www.cengage.com/permissions
2