Understanding Case Management

• Case management is a method of service delivery and a set of roles undertaken by service providers.
• Serves as a link between the client and the service delivery system.
• Case management describes a function designed to arrange and sequence needed services from various providers for a client or their family.
• Case management is an ongoing process: includes assessing wants needs, planning, locating & securing support, monitoring and follow up.
• It helps people identify areas where they need help and connects them to community resources.

Key Components of Case Management

• Advocacy is a key component.
• Coordination is a key component.
• Service Delivery is a key component.
• Contact are key to case management

Systems Theory

• Problems are not solely because of any one individual’s psychological makeup
• Forces working on a person bring them to voluntarily or mandatorily seek help.

Assessment Levels

• Micro Level is personal/interpersonal.
• Mezzo Level covers institutional, organizational, and community concerns.
• Macro Level encompasses social policy, governmental, and cultural issues.

Interventions

• Interventions can be direct where its directly with a client.
• Interventions can be indirect or outreach where its with others on behalf of clients

Case Management Functions

• Outreach & Identification
• Linking Resources
• Assessment of Needs
• Service Planning
• Monitoring & Evaluation

Case Management Models

• There are numerous models including: Generalist, Strengths-Based, Intensive or Rehabilitation
• The goal of using a model is to achieve a balance between individuals' capabilities and the resources available to them

Case Management Process

• Defining the problem
• Developing Hypotheses
• Establishing Goals
• Implementing Service Plans
• Monitoring & Evaluation
• Termination & Follow-Up

Case Management Tasks

• Initial Interviews are a key task
• Psychosocial assessments are a key task
• Documentation is a key task
• Its key to remember that it is a partnership with the client

Confidentiality & Ethics

• Client information should not be shared outside the direct worker-client relationship without express written consent.
• Clients must be informed when a legal mandate requires information sharing with other professionals or agencies without their consent.

Challenges in Case Management

• Managing case loads can be very challenging
• Addressing systematic barriers are also a significant challenge
• Advocating for adequate resources can be very challenging

Case Management Roles

• Direct Personal Support
• Crisis Intervention
• Short-Term Interventions
• Broker/Facilitator
• Enabler/Teacher/Mediator
• Advocate
• Service Coordinator
• Tracking/Follow Up

Direct Personal Support

• Rapport = foundations to helping.
• Dealing with the inability to build rapport.
• Clients who have been “burned”
• Activate a community resource network that will meet client needs.
• Improve connecting skills.

Crisis Intervention

• Provide is done in a Timely Manner.
• A crisis is defined by the client, people around the client, a professional, or someone in the community
• Assess Severity is key part of intervention.
• Interventions range from informing referral source to full-fledged intervention.
• Assess, Set goals, Support, Maintain Contact

Short Term Treatment Intervention

• It is usually defined as methodologies that help people deal with a problem in 1 to 12 sessions.
• Used for mental health, family problems, prevention education that focuses on health or mental health, budgeting, educational tutoring, and employment
• Includes task-centered and solution-focused treatment, the behavioral approach, ego psychology, and cognitive interventions

Broker/Facilitator

• A broker functions as an intermediary between two or more parties in negotiating agreements or bargains

• Brokers provide linkages to social service agencies, governmental or voluntary community organizations, and other concerned people

• Facilitators are responsible for leading or coordinating group work

• Facilitators make processes easier and helps move them forward as well as connecting clients with new helping networks in the community

Enabler/Teacher/Mediator

• Enablers help clients take increasing levels of responsibility for achieving identified and agreed-upon goals, by moving from doing for to doing with, to having clients doing for themselves.
• Teachers offering learning opportunities for clients relating to community resources, mental illness, health, STDs, alcohol, and drugs
• Mediators facilitate disputes between clients, between clients and community services, or between personnel in agencies involved with your clients while remaining neutral

Advocate

• Advocates act on behalf of clients who are unable or unwilling to act on their own behalf to show them care and side with them
• They make referrals or appointments
• Seek and assess community resources
• Make it possible for clients to gather information and access programs

Service Coordinator

• Formal intensive Case Management Programs (ICMs)
• Professionals and agencies may begin looking to you as the central resource person for clients because you have spent time trying to coordinate services on their behalf.

Tracking/Follow Up

• Tracking clients after case management termination
• Requires organization to expend the necessary effort
• Requires time, energy, and money

DeShawn Carter Case Summary

• A 38-year-old single father of two, laid off from his manufacturing job, cannot keep up with bills and childcare
• He has no family nearby and wants to handle his problems as a "real man."
• His 12-year-old son was suspended for fighting and he worries about his stress impacting his kids.
• Assessment is about building on his resilience, dedication and work ethic.
• Supports with job training, financial assistance and fatherhood support groups

Strengths Perspective

• This model focuses on identifying and utilizing strengths rather than focusing on their problems
• In DeShawn’s case, his resilience, dedication to his children, and past work ethic are emphasized.
• Managers help him recognize abilities while linking him to resources that support personal growth and stability.

Amara Osei Case Summary

• A 25-year-old immigrant from Ghana, who works long hours as a home health aide
• She has postpartum depression, feels isolated, and has frequent crying spells and is working full pay as her employer has been withholding wages
• Solution is to educate Amara about her rights and refer her to workers' rights advocacy and to a culturally competent therapist who specializes in perinatal mental health

Broker/Generalist

• The model focuses on assessing client needs, linking to appropriate resources, and ensuring necessary services
• In Amara's case, the manager connects her with legal assistance for wage disputes, childcare support, and mental health services and without direct therapy.

Elijah Moore Case Summary

• A 52-year-old Army veteran experiencing homelessness with chronic back pain, PTSD, and alcohol use
• He avoids shelters; distrusts people and was recently hospitalized for pneumonia because of his health and living conditions
• He is skeptical but agrees to talk and is tired of sleeping in abandoned buildings but doesn’t know where to start
• Its key to building trust, client-centered, setting small goals and you connect him to a Veterans Affairs program that provides housing vouchers and medical care

Assertive Community Treatment

• A structured, team-based approach used with mental illness, substance use disorders, and housing instability. needs, mental
• Elijah benefits from services (housing assistance, medical care, and peer support) being provided consistently with close follow-up.

Sofia Ramirez Case Summary

• A 17-year-old high school junior, in and out of foster care since 10.
• She lives in a group home and skips school, not seeing the point, feeling in control by shoplifting.
• Solution is to coordinate services, connect with a mentor, and collaborate with school staff and mental health professionals to create a plan for her education, well-being, and stability.

Cultural Competence

• Should improve with the evolving climate
• Its an ethical responsibility

Thoughtless vs Thoughtful Competence

• Recognize is a tendency to categorize, and look for exceptions
• Evaluate scripts
• Check Attributions and Perceptions, allow for differences

Individualistic vs. Collectivistic Cultures

• Individualistic cultures emphasize individual goals.
• Collectivistic cultures emphasize group goals and members look out for each other in exchange for loyalty
• Individualistic Cultures tend to apply their value standards to everybody (universalistic)
• Collectivistic Cultures tend to apply different value standards to members of their in-groups and to members of out-groups

Sean’s Case

• Identify emotions, main concern
• How serious that problem is
• Identify any case concerns

What is a Social History?

• A description and history of the presenting problem
• Background Information
• Impressions & Recommendations
• Baseline for plan and progress
• Provides direction

Description & History of the Presenting Problem

• No more than 2 or 3 paragraphs
• Section name may vary depending on the agency (Background Information, Presenting Problem, etc.)

Writing the 1st Sentence

• This leads into impressions and recommendations.
• Paint a mental picture quickly

Question to ask about the Presenting Problem

• Can you tell me a little bit about what brought you here today?
• Can you tell me what happened?
• Can you describe this problem for me?
• Could you give me some idea of what's been going on lately

Clients appraisal

• Could you give me some thoughts on how you see the problem?,
• Give me some ideas you have for how you feel we could best help.
• Start with the 1st sentence of your presenting problem

Robert's Case

• A description and history of the presenting problem.
• Background information on the person's life.
• The worker's impressions and recommendation.

The Work Setting

• Include Auspices Non-profit, For-Profit, Government
• Include Problems, Services, Treatment Goals, Client Populations and Modalities
• The goal is to prevent, ameliorate, or resolve health, mental health, social, or environmental problems that affect individuals, families, specific groups, or communities

Agency Roles

• Managers
• Clinicians
• Case Manager
• Administrator

Types of Organization

• Mutual Benefit, Created by groups hoping to provide services for their own membership: Church, Unions, Civil Clubs
• Government or Public, Estalblished and funded by the general public to perform services that benefit all people: VA, DFCS, HUD, etc.
• Service, Established as nongovernmental, non-profit, voluntary social agencies: 5013c Business or Entrpreneurial, For-profit, private, non-agency based practice: LLC, sole proprietorship

Public vs Private

• Public org social welfare is usually government funded
• Public org missions are described by legal codes and government regulations such as, Social Security Administration, public schools
• Private org Can receive government funding but is independent of government control such as Private org hospitals, nonprofits like United Way

Host Challenges

• Low position in organization
• Value conflicts
• Burnout
• Surrender of professional allegiance
• Feeling unwelcomed

Special Populations

• Developmental Disabilities
• Healthcare & Chronic Illness
• Mental Health & Chronic Mental Illness
• Addictions
• Child Welfare
• Geriatrics
• Criminal Justice
• HIV/AIDS
• The Homeless
• The Military Veterans

Work Environment is made of

• Manager/Supervisor with Style and Gender
• Part-Time & Temporary Personnel
• Volunteers
• Physical Environment
• Culture and Climate
• Use of Teams
• Formal Communication
• Informal Communication
• Informal Environment
• Agency's Workforce
• Staffing Patterns
• Staff Morale

Burnout

• It is the result of Poor morale, Large caseloads , Long Hours and Difficult client situations