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Integrated Case Management

Integrated Case Management assists people in stabilizing their housing, income, behavioral health, and/or substance use. Integrated Case Management empowers individuals and families to achieve their own goals of economic mobility and self-sufficiency through supportive housing, supported employment, and peer support services, and works to help clients access behavioral health, substance use disorder, and healthcare services directly and efficiently, in order to provide our clients with high-quality and holistic services.

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What is permanent supportive housing?

  • Our wraparound supportive services strategy rests on the concept that housing functions as a whole-person/whole-family healthcare delivery system, encompassing all the social determinants of health. Our ICM program links Care Coordinators, Peer Supports, Behavioral Health Specialists, Supported Employment Specialists, and Healthcare Specialists on a collaborative team supporting client-centered goal achievement.

  • Our services assist people in realizing their goals, up to and including helping clients gain the stability to move on from our services. We intend for supportive housing to function not as the end point of crisis response, but as a platform for access to services and opportunities that promote client-driven progress toward lifelong success. ICM staff help individuals and families take steps to achieve their goals of stabilization, recovery, to increase their income, and move to their own safe permanent housing.

Coordinating Care through Teamwork

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The ICM team comprises professionals from across disciplines who collaborate to provide whole-person care that supports clients’ long-term goals. They meet regularly to coordinate each client’s care, and their combined expertise finds creative ways to help clients overcome the biggest barriers to their stability.

ICM team members meet with clients at their supportive housing apartment to reduce barriers to accessing services. Some clients do not want to go to doctor’s offices because of past traumas. Some clients are not able to meet at a case manager’s office because of mental health challenges. Providing services to clients in their homes increases access, and improves outcomes.

Integrated Case Management Team

Care Coordinator

  • Develops case plan with client, including specific goals

  • Keeps service notes

  • Provides crisis response to prevent return to homelessness

Peer Support Specialist

  • Has lived experience with substance use disorder, behavioral health conditions, and/or homelessness to relate to client
  • Helps clients access service systems, like healthcare, public benefits, and employment

  • Helps clients navigate daily tasks, like shopping and picking up prescriptions

Employment Specialist

  • Helps clients access income benefits

  • Helps clients with job search, applications, and on-the-job support and training

  • Assists client with accessing educational, training, and certification programs

Behavioral Health Specialist

  • Credentialed behavioral health provider

  • Provides mental health and substance use disorder assessments and treatment

  • Refers clients to outside services and coordinates care

  • Provides crisis intervention to support stability

Healthcare Coordinator

  • Engages clients in their own health management

  • Creates follow-up plan for any treatments

  • Coordinates care with ICM team members to address all social determinants of health

Person-Centered Approach

Our person-centered approach honors clients’ dignity by helping them access the services that further their goals. Our work with each client starts by asking them where they want to be. It ends when they achieve their goals. ICM focuses on outcomes that helps individuals and families not just stabilize, but thrive.   

  • ICM supports more than 400 units of supportive housing across the Spokane Community.

  • Reducing Vulnerability:  ICM clients in supportive housing see an 11% reduction in vulnerability index score after their first year in housing, indicating significant whole-person health improvements. 

  • Housing Stabilization:  94% of clients remain stably housed after entering supportive housing

  • Income Growth: 61% of clients that have been residing in housing units for more than a year saw increased income after entering supportive housing; of those clients who exited our program in the last 18 months 38% had stable increased income.

Contact Us

Integrated Case Management

19 W. Pacific Avenue

Spokane, WA

(509) 340-9329