Empowering Individuals with Person-Centered Support
Tip Sheet for ICMS Case Managers
Discover key insights on harm reduction, SUD treatment, recovery paths, and LA County’s CENS services. Get the full tip sheet to guide your navigation efforts.
Terminology
The use of any substance, including alcohol, drugs, or other psychoactive substances, for casual, recreational, or experimental purposes.
A clinically diagnosed condition marked by compulsive substance use. It ranges from mild to severe, involving control struggles, negative impacts on wellbeing, and persistence despite known harm. SUD often co-occurs with mental health conditions like depression or anxiety.
A continuum of clinical interventions to help reduce or stop harmful substance use.
Helps participants who use substances to access person-centered information, resources, treatment, or any other support they may need in relation to their substance use.
Community-driven public health strategies (risk reduction, health promotion, and prevention) to empower participants and their families with the choice to live healthy, self-directed, and purpose-filled lives. It can help when someone is not ready for or hasn’t accessed treatment, or if relapse occurs.
Involves continued support after SUD treatment, helping participants navigate recovery and lower the risk of returning to harmful use.
A personal journey to improve health, wellness, and self-direction. Recovery is not just a lack of symptoms. It involves striving to reach one’s full potential. It is rooted in hope and respect. For substance use, recovery can begin at any stage, with or without diagnosis or treatment. It can involve building healthy relationships, securing housing, working, accessing education, addressing mental health/trauma, and reconnecting with a sense of purpose.
Harmful substance use may impact housing stability and increase the risk of eviction.
SUD treatment offers tools, stabilization, and insight that support long-term recovery.
Barriers like stigma, cost, or cultural mismatch may lead people to avoid SUD treatment.
The Relationship Between Harm Reduction, SUD Treatment, and Recovery
Nature: Clinical, time-limited
Goal: Stabilize or stop substance use
Scope: Treating addiction symptoms
Who Delivers: Licensed professionals
Relationship: May start/assist recovery
Nature: Personal, ongoing
Goal: Meaningful life with or without abstinence
Scope: Holistic — health, purpose, connection
Who Delivers: Self-driven, optional support
Relationship: May include/exclude treatment/harm reduction
Nature: Clinical, time-limited
Goal: Stabilize or stop substance use
Scope: Treating addiction symptoms
Who Delivers: Licensed professionals
Relationship: May start/assist recovery
Use CENS to Connect ICMS Participants to LA County’s SUD System of Care
Client Engagement Navigation Services (CENS): Tailored, hands-on, in-person navigation in the SUD system of care.
Confirm universal sharing consent status before CENS referral.
Outreach, Engagement, and Education
- Targeted outreach for referred ICMS participants.
- Participant, Group, and Agency Presentations:
- SUD and Treatment
- Cannabis Risks
- Mental Health and SUD Connection
- Opioid Overdose Prevention
- Healthy Coping
- Syringe Exchange
- Harm Reduction
- Relapse Prevention
Personalized Substance Use Care Navigation
- Ongoing personal support navigating the SUD system of care.
- Screens for SUD and the type/level of substance use care needed.
- Schedules and arranges transportation for SUD treatment.
Tracking Treatment Progress and Collaborating with ICMS
- Provides ICMS with ongoing updates on SUD treatment progress
- Collaborates with ICMS in linking participants to additional resources, health care, and social services.
The multilingual 24/7 Help Line (1-800-854-7771) is a unified entry point for mental health and substance use care in LA County.
RECOVER LA is a publicly accessible mobile platform for communities, providers, and residents to easily explore and connect with local SUD prevention, harm reduction, treatment, and recovery support. This interface includes the Service & Bed Availability Tool (SBAT).
For project-based ICMS, submit CENS referrals to the onsite CENS provider (if applicable), or to the CENS Area Office where the participant is located.
For scattered site ICMS, submit CENS referrals to the CENS Area Office for the SPA where the participant is located.
- ICMS uses the 5×5 and HAI to monitor functioning and needs
- ICMS identifies potentially harmful substance use
- ICMS submits CENS referral
- CENS coordinates with ICMS to complete SUD screening
- CENS coordinates linkage to appropriate type of SUD care
- CENS follows up to ensure meaningful support in the SUD system of care
Check out the Outreach and Engagement tip sheet to learn more about engagement strategies.
| Service Planning Area | CENS Providers
Area Offices are open Monday – Friday, 8:00AM – 5:00PM |
|---|---|
| 1 | Tarzana Treatment Centers
44447 North 10th Street West, Lancaster, CA 93534; Phone: (661) 726-2630 |
| 2 | San Fernando Valley Community Mental Health Center
4515 Hamlin Street Suite 100, Van Nuys, CA 91411; Phone: (818) 285-1900 |
| 3 | Prototypes, A Program of Healthright 360
11227 Valley Boulevard, Suite 100; El Monte, CA 91731; Phone: (626) 444-0705 |
| 4 | Homeless Health Care Los Angeles
2330 Beverly Blvd, Los Angeles, CA 90057; Phone: (213) 744-0724 |
| 5 | Didi Hirsch Mental Health Services
4760 Sepulveda Boulevard Culver City, CA 90230; Phone: (310) 895-2300 |
| 6 | Special Services for Groups – Homeless Outreach Program Integrated Care System
5715 S. Broadway Ave., Los Angeles, CA 90037; Phone: (323) 948-0444 |
| 7 | Los Angeles Centers for Alcohol and Drug Abuse
11015 Bloomfield Ave., Santa Fe Springs, CA 90670; Phone: (562) 273-0462, Toll free: (844) 804-7727 |
| 8 | Behavioral Health Services
15519 Crenshaw Blvd., Gardena, CA 90249; Phone: (310) 973-2272 |
LA County’s Permanent Housing Integrated Services Program (ISP) includes the critical interventions of ICMS, Full Service Partnership (FSP), Housing Support Services Program (HSSP), and CENS to support housing retention and improved health and wellbeing. Each time ICMS coordinates care in collaboration with a CENS navigator, the “ISP Care Coordination” Service should be recorded in the Case Notes in CHAMP.