Oct 7, 20195 min read

Case Management Strategies/Models

The Case Management Society of America defines case management as a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote patient safety, quality of care, and cost effective outcomes (https://www.cmsa.org/).

https://www.socialsolutions.com/blog/successful-nonprofit-case-management-components/

Case Management Process:

Intake: Intake is the initial meeting between a case manager and a new client. The case manager uses this time to gather demographic information about the client, identify any immediate needs, and begin to establish trust and build a relationship. This first interaction is helpful for a case manager to determine if a client would benefit from the services your organization offers. If they would, they then move on to assessing the client’s individual needs. If their needs fall outside your organization, the case manager works to identify and refer the client to an outside community resource.

Needs Assessment: The Needs Assessment stage builds on the information collected during the Intake stage, going into greater depth on the client’s individual challenges and goals. During this stage, a case manager’s primary objective is to identify a client’s problems, interests, and risks to success. While every client goes through this stage when they first come to an organization, it’s important to re-assess over time as needs and circumstances often change.

Treatment Service Planning: The Service Planning stage is particularly important to the success or failure of a client. A case manager establishes specific goals and the actions that will be taken to meet those goals. The result of this goal-setting process is a case plan inclusive of outputs and outcomes that will measure a client’s success. A service plan should be both achievable and measurable.

Monitoring and Evaluation: Evaluation is critical to understanding the impact specific programs and services have on a client. Using the output and outcome metrics defined in the previous stages, a case manager should continuously monitor and evaluate a client’s progress. Evaluation and data ensure client success is quantified and qualified rather than simply anecdotal.

https://www.socialsolutions.com/blog/successful-nonprofit-case-management-components/

VIDEO - Welfare Intake Interviews

TOOLS/REFERENCES

PPT - Different Case Management Models https://slideplayer.com/slide/1514719/ PDF - 7 Vignettes https://www.ncbi.nlm.nih.gov/books/NBK138725/pdf/Bookshelf_NBK138725.pdf 1. Intensive/Assertive Case Management (ICM) is a community based package of care, aiming to provide long term care for severely mentally ill people who do not require immediate admission. ICM evolved from two original community models of care, Assertive Community Treatment (ACT) and Case Management (CM), where ICM emphasises the importance of small caseload (less than 20) and high intensity input. A key aspect of this model is that ACT is a team-based approach, characteristically a multi-disciplinary team, including social workers, nurses and psychiatrists, caring exclusively for a defined group of patients (McGrew 1995, Olfson 1990). Team members share responsibility for their clients, so it is common for several members to work together with the same person. Other characteristics of the model are (Stein 1980): -Provide all necessary care themselves, rather than arranging for it to be provided from other settings -Provide care at home or in places of work -Carry low caseloads (usually 10 patients per member) -Practice ‘assertive outreach’, meaning that they persist in attempts to engage uncooperative clients -Place particular emphasis on medication compliance -Provide 24 hour emergency cover PDF - TOOLKIT FOR INTENSIVE CASE MANAGEMENT HOUSING FIRST MODEL https://www.stepstonesforyouth.com/wp-content/uploads/2018/08/Toolkit-for-Intensive-Case-Management-in-Canada-1.pdf Guide/Case Examples - Behavioral Health Services for People Who Are Homeless https://store.samhsa.gov/system/files/sma13-4734.pdf 2. The strengths-based case management model recognizes the value of community services, family, and cross-agency partnerships. It encourages the client to build and nurture informal support networks alongside identifying and accessing formal community services and institutional resources. However, the strengths-based case management model steps away from the perspective that the clinician is the expert on the client’s needs. It encourages the client to take the lead in identifying their own needs, take control over the search for resources and services to address those needs, and view the community as a resource instead of a barrier to success instead. The model focuses on two principles: - Providing support for asserting direct control over clients’ search for resources such as housing and employment -Examining clients’ strengths and assets as the vehicle for resource management. The distinguishing features of this model are: -Practitioners implementing strengths-based case management need to continually emphasize strengths throughout their relationships with people. -The use of assertive outreach -Client-case manager relationship is important -Low caseloads to ensure quality provision of service, with an average case load of 15 -Case manager provides direct services and service coordination -Duration of support is ongoing. PDF - MANUAL - Strength-Based Case Management http://sgdwebsites.com/clients/wHealth/wp-content/uploads/2013/09/wHEALTH-Manual-FINAL.pdf Practice example: Strengths-based approach in assessment https://www.scie.org.uk/care-act-2014/assessment-and-eligibility/practice-examples/strenghts-based-approach-in-assessment.asp 3. The brokerage model is a very brief approach to case management in which case workers attempt to help clients identify their needs and broker supportive services in one or two contacts. This model assumes that a client will voluntarily use needed services once they know they are available, and learn how to access them. This model works best when a client’s biggest challenge is access to services, rather than availability of services. In a brokerage case management model, the case manager/social worker provides very little direct service to the client. Instead, they serve as a link between a client and community resources. The focus is on assessing needs, planning a service strategy, and connecting clients. The essential characteristics of this model are: -The focus of the case manager’s role is on service coordination -No outreach work is undertaken -Contact with service users tends to be office based and less intensive -Average case load is 35 -Duration of support is shorter compared to other models. PRESENTATION - Brokerage Model https://prezi.com/fuui0dstnc0d/the-brokerage-model-of-case-management/ WORKER GUIDE - Case Management Examples http://www.dhs.state.or.us/policy/selfsufficiency/publications/fsm-55-prelim.pdf 4. In a clinical case management model, a clinical care provider serves as the case manager. Frequently, the case manager is a counselor or therapist. This model recognizes that many clients face barriers to services that reach beyond simple questions of access. As a clinician, the case manager in a clinical case management model provides direct counseling for a client’s individual concerns. That might include mental health services, addiction recovery support, or treatment for serious or chronic health conditions. When the case manager is also providing clinical services, they may have unique insight into the client’s needs. That increased level of understanding improves the case manager’s ability to identify needed services and connect the client with formal resources in the form of community service providers. Perhaps more significantly, clinical care providers have a greater ability to encourage the client to connect with informal resources such as family, friends, and peers. That collaboration can increase the client’s willingness and ability to follow through with services. The clinical case manager is also well-positioned to help the client address social, emotional, and mental barriers to services. Its distinguishing features include the following: -The case manager has a therapeutic role and is a role model -Use of outreach -Centrality of client-case manager relationship -Provides direct services and coordination of other services -Average case-load is 10 people -Long-term relationship with clients ARTICLE - Clinical Case Management https://www.researchgate.net/publication/20440985_Clinical_Case_Management_Definition_Principles_Components PDF - Clinical Case Management Vignette http://traumarecoverycenter.org/wp-content/uploads/2017/05/08-Clinical-Case-Management-v1.pdf PDF - RESOURCE - Case Management Practice https://static1.squarespace.com/static/5a837a6932601e630be35696/t/5a8c0f1be4966ba44f7a9383/1519128356101/Case%2BManagement%2Bpaper.pdf