One of the biggest challenges MCO case managers face isn’t a lack of services—it’s using the right service at the right time. When Community Living Support (CLS) and Individual Transitional Support (ITS) are misunderstood or misapplied, transitions fail, members destabilize, and caseload pressure increases.

CLS is designed for long-term stability. It supports daily living skills, routines, and ongoing independence once a member’s environment is already stable. It is not meant for crises, discharges, or acute transitions.

ITS, on the other hand, is designed for high-risk moments of change—such as hospital discharge, post-crisis return to the community, or major care transitions. ITS is time-limited but highly effective when started early, preventing regression and repeat crises.

Caseload strain increases when these services are used interchangeably. Using CLS during vulnerable transitions can lead to destabilization and emergency follow-ups. Using ITS without transitioning to CLS can result in short-term gains without lasting stability. In both cases, the added coordination and crisis management falls on the case manager.

The most effective approach is sequencing, not swapping:

• ITS stabilizes the transition
• CLS maintains long-term stability
• Peer Support reinforces engagement and prevention

At TruCare Health Services, CLS and ITS are applied intentionally to reduce repeat crises, improve outcomes, and lower long-term caseload intensity. Our focus is not just service delivery—but caseload relief by design.

Because when the right service starts on time, everyone works less—and outcomes improve.

Supporting MCO case managers across Edgecombe, Nash, Pitt, Wake, and Halifax counties.