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Case Manager is a general term used for a human services professional who helps an individual gain the skills needed to survive in day-to-day living. The Goal of case management is to promote and support independence and self-sufficiency. It requires the consent and active participation of the client in decision making, and supports the client's right to privacy, confidentiality, self-determination, dignity and respect, non-discrimination, compassionate non-judgmental care, a culturally competent provider and quality case management services.

Case management is a multi-step process to insure timely access to services that encompass the whole person: physical, mental, emotional, psychological, social, and all other aspects of every individual.

Case management may include the following processes: '''Intake, Assessment of needs, Service planning, Service plan implementation, Service coordination, Monitoring and follow up, reassessment, Case conferencing, crisis intervention, and case closure. ''' Case Management activities are diverse, and include negotiation and advocacy, consultation with providers, navigation through the service system, psycho-social support, supportive counseling and general client education.

Case Managers use different models to provide human services. Some of these are Supportive Case Management, and Comprehensive Case Management models.

Supportive Case Management is designed to meet immediate health and psychosocial needs of the client as a short term service. Supportive case managers serve as a means of assisting an individual at his/her level of readiness in order to restore or sustain client stability and to establish as supportive relationship that can lead to enrollment in more comprehensive case management services if needed. They encourage client to seek more comprehensive services. Supportive case management can be viewed as triage for the psychosocial needs of the client.

Comprehensive case management is a proactive case management model intended to serve persons living with multiple complex psychosocial and/or health-related needs and their families/close support systems. This is designed to serve individuals who may require a longer time investment and who agree to an intensive level of care management service provision.

Comprehensive case manager is the bridge between the individual's needs and the services providers, such as employment assistance, psychosocial counseling, medical referrals, housing, financial services, transportation issues, addiction treatment programs, and any other needs as identified in the assessment.

Comprehensive case managers conduct an assessment, design a treatment plan, and reassess the plan when needed. This kind of management can be provided by a single case manager or by a team of case managers.

A comprehensive case manager conducting an assessment of the person as a whole, will be able to identify problems and the strengths to address them, within the person. Through networking and collaboration, case managers are constantly learning and gaining information about other agencies and services that can assist their clients. A way of gaining new contacts is to seek information via social media and websites, pamphlets,brochures, community service events, radio commercials, business cards, and word-of-mouth referrals, to name a few.

Case Managers may be differentiated by the model they follow. Case Management models include Brokerage, Clinical case management, Strength model, Rehabilitation model, and High Intensity case management.

The Brokerage Model is a generic model that has been applied in many different fields within the human services. In this model, the case manager functions as an intermediary between the client, the agency, and other referred agencies as needed. His or her focus is on the brokerage of service.

Clinical case management addresses the maintenance of a person’s physical and social environment, with the goals of facilitating his or her physical survival, personal growth, community participation, and recovery from or adaptation to mental illness. It focuses on the long term treatment and helping relationship between the client, the family, and significant others and their collaboration.

Clinical case managers consult with family members and other services, expand social networks, advocate for the client and the system, may offer counseling, social skills training, crisis intervention and monitor progress.

The Strengths based model focuses on strengths that the client already possesses, such as previous work experience, coping skills, peer support, etc. This model encourages productivity and self-esteem, as well as including the client’s input to the extent possible.

The rehabilitative model focuses on helping the clients find success and satisfaction in the social environment with the least amount of intrusion by clinical professionals. It places emphasis on assessing skills deficits and plans for remediation, so that the client can prolong community stays and be more likely to promote the attainment of the client’s goals.

High Intensity Case Management models share an emphasis on a high intensity of service. These programs are always reserved for people with severe or persistent mental illness, homelessness and substance abuse. The ratio of service is of 1 case manager per 10 clients. In contrast, the broker case manager operates with about 30 to 40 clients, while the clinical, strengths base and rehabilitation models may have a ratio of 1 to 20.

After determining the client's needs, the case manager links the need to a service provided within the agency. When the agency is unable to meet the client's needs, a there is a referral process. Case managers must have ample knowledge of community resources. It is advantageous to provide the client with the name of a person to contact within the referred agency. Case managers should also try provide the client guidance on what to expect when they contact the referred agency.

Community Resources:

CPSA, the Community Partnership of Southern Arizona provides a community resource guide for services. Mission statement: Ensure individuals and families receive accessible, high-quality healthcare that is member and family-driven, recovery oriented, respectful of cultural differences and foster hope and self-determination. Services provided by CPSA: Prevention services, such as Substance Abuse Prevention, Suicide Prevention, including treatment and recovery support. Treatment services include rehabilitation, medical, crisis intervention, inpatient, residential services and Behavioral health day programs. Training services include mental health first aid, provider training and live training webinars. Target populations are Children, Adults and Families in Pima County. [1]

SAMHC, the Southern Arizona Mental Health Center provides crisis care and related behavioral health services. Walk-in crisis center. Mobile Acute Services (MAC), National Suicide Prevention Lifeline, SMI determination, Emergency Involuntary Hospitalization, Off-Site enrollment Services, CPS Urgent Response Unit, Peer Support Services/ Recovery Support Specialists, and Outpatient Services @ Elante. SAMHC provides crisis behavioral health services to the entire community, regardless of ability to pay, insurance status, or age. [2]

Case managers are responsible for keeping appropriate records and documentation of their clients progress and changes, communication with client, medications, and all other information pertaining to the treatment plan and implementation.

During the referral process, it is extremely important to match the needs of the client to the services offered by the referred agency. Case managers explain what services are provided by each agency they are referred to.

Part of the documentation may include a referral letter with a reason why the client is being referred to an outside agency. Examples are, when sending a client to a psychiatrist for medication monitoring, the psychiatrist name, and the reason for the referral (medication monitoring) will be included in the letter.

A target day may also be included in the treatment plan as well as on the documentation. Target date is the desired date when the client would meet a goal within the treatment plan. Target dates may be adjusted if necessary.

Record keeping must include time frames, progress reports, phone calls, office visits, home visits, team meetings, client observations, treatment plan modifications, referrals, time and length of meetings, and everything that is of relevance to the helping relationship. If it is not recorded, it did not happen.

Documentation of the helping process is factual, clear, and concise. It is also comprehensive as to record any changes in behavior, mood, or mental status that must be reported to a management team, of such is the case.