Senior Care Case Management

The Senior Care Case Management Team, a collaborative effort between Montgomery County Office of Aging and Adult Services and Central Montgomery MH/MR Center, provides services for individuals aged sixty and over who have mental health and/or substance abuse needs and live in Montgomery County. The programs’ goal is to provide emotional and resource support for seniors in need, through relationship building with Senior Adult Activity Centers, subsidized project-based housing providers, and local social service organizations that can assist in providing support to our consumers.


  • Providing outreach to older adults who may be homebound or in need of mental health services.
  • Providing resource connections for seniors.
  • Educating individuals and facilities as to available mental health support services.

Program Goals:

  • To eliminate or postpone the need for long term institutional placement
  • To promote a sense of independence, hope, meaningful life, and well being within the consumers
  • To create an ongoing network of community support services
  • To honor the choices and nurture the dreams of the consumer by looking beyond illness management
  • To advocate for and connect a person to supports.


  • Two Senior Care Case Managers
  • Support from Central’s Senior Outreach Services (SOS Team)
    • Licensed Clinical Social Worker
    • Psychiatrist

Senior Outreach Services (SOS)

In-Home Services Available Through Senior Outreach Services Include:

  • Psychiatric Evaluations
  • Psychosocial Assessments
  • Ongoing Medication Monitoring
  • Intensive Support and Counseling
  • Emergency Intervention
  • Caregiver Support and Training

An Appropriate Referral for Senior Outreach Services is:

A person age 60 or older

  • who is a Medicare recipient (although other insurances may be accepted)
  • lives at home and
  • has a history of serious and persistent mental illness or substance abuse
  • is experiencing an acute emergence of significant mental health issues.

(may be depressed, agitated, irrational…)

  • who may be homebound isolated or frail.
  • who may be suspicious, fearful or unable to seek clinic-based services.

The Mental Health Professionals who make up the S.O.S. Team are:

  • A Board Certified Psychiatrist

 Licensed Clinical Social Worker experienced in the treatment of serious and persistent mental illness and trained in crisis intervention techniques, co-occurring, and in the management of psychiatric emergency situations.

The Treatment Outcomes We Work to Accomplish:

  • Eliminate or postpone the need for long-term institutional placement.
  • Resolve acute episodes with shorter hospital stays or without having to hospitalize at all.
  • Reduce symptoms and behaviors that are troublesome and distressing for both the elderly person and the caretaker.
  • Promote a sense of independence, self-reliance and well-being.
  • Create an ongoing network of community support services.

OASIS Program

OASIS is a partial hospital program tailored to meet the needs of the older adult with behavioral health and co-occurring challenges.  Special focus is placed on both problems arising from the aging process and the wisdom resulting from a multitude of life experiences. The OASIS program aims to implement interventions through various modalities and to maximize and improve an individual’s emotional, behavioral and physical health. In addition, the program works with older adult clients to assist as they develop and restore their resiliency and achieve personal fulfillment. Our goal is to help older adults prevent premature institutionalization by supporting the individual in living as independently as possible within the community.  OASIS utilizes treatment approaches to reduce symptoms and behaviors that are troublesome and distressing for both the individual and the caregiver.  Our program and staff promote a sense of independence, self-reliance and well-being.  We help the individual create an ongoing network of community supports. Our therapeutic groups are designed to meet these goals, increase social interaction and improve the individual’s sense of self-worth and competence.  Additionally, each person is assigned a therapist who develops an individualized plan which is the focus of treatment and is regularly reviewed with the individual.  Each person’s unique treatment plan is also overseen by the OASIS Program psychiatrist, who develops an appropriate medication intervention and maintains a link with involved general medical practitioners. 

Treatment at OASIS is addressed in a 6-hour therapeutic day which may be attended from 1 to 3 days a week (Monday, Wednesday and Friday). Group therapy topics include: Personal recovery issues, Grief and loss, Improving depression, Maintaining sobriety and stability, Exercise for the mind, Reminiscing group, Physical wellness, Wellness through art, Social Skills group, Wellness through music, and more!


Individuals interested in the OASIS program will first complete an intake assessment in our Outpatient facility. Individuals must be at least 60 years of age or older, living in eastern or central Montgomery County, have a history of behavioral health issues/substance abuse or use and experiencing difficulty due to increase in symptoms, have the ability to interact with others and participate in a group therapy environment, ambulatory and able to manage their physical needs with minimal assistance. Call our Outpatient & Intake Services office to schedule your confidential intake appointment today.


Central's Main Office