Developmental Services - Case Management Manual
Case Management Standards
Developmental Services adheres to a set of Case Management Standards that are very closely based upon the National Association of Social Workers (NASW) Standards approved by the NASW Board of Directors in June of 1992. The interested reader is referred to http://www.naswdc.org.
Following is a presentation of the 10 standards. In some cases the standards have been modified slightly to be best apply to the consumers we serve. Along with each standard are a brief discussion and a list of some of the relevant policies and procedures to be found in this manual.
Standard 1. The Case Manager shall meet the standard set forth in the job description of a Case Manager with the Department of Health and Human Services (DHHS) or the standards set forth in the certification for Community Case Management.
Standard 2. The Case Manager shall use his or her professional skills and competence to serve the consumer, whose interests are of primary concern.
Case Managers have two sorts of ethical obligations. The first is to resolve all scheduling and procedural conflicts by giving preeminent consideration to the concerns of consumers and their families. While the convenience of a Case Manager is a legitimate concern, during the workday it is secondary to the convenience of the consumer. The second obligation is to be sensitive to the possibility that the Department or Agency may make a policy decision for its own convenience rather than for the direct interest of consumers. If a Case Manager strongly feels that the Department or Agency is doing so, then the Case Manager has an obligation to raise the issue, first to the immediate supervisor; if this action does not provide resolution, the issue must be raised to successive levels of supervision and to the Disability Rights Center. As professionals, Case Managers are obligated to hold both themselves and the Department to the highest possible ethical standards.
- Consumer/Case Manager Relationship
- Client Rights
- The Rights of Maine Citizens with Intellectual Disabilities/Autism
Standard 3. The Case Manager shall ensure that consumers are involved in all phases of case management practice to the greatest extent possible.
The primary vehicle for assuring that consumers achieve this autonomy is the Person Centered Plan. However, some consumers elect not to have a Plan, and the Case Manager has the same obligations in these cases.
- Personal Planning Process/Protocol PCP
- Mission Statement
Standard 4. The Case Manager shall ensure the consumer's right to privacy and ensure appropriate confidentiality when information about the consumer is released to others. Case Managers are reminded that even in cases where a particular consumer appears to be unconcerned or uninterested in issues of privacy and confidentiality, Case Managers are still obligated to adhere to a high standard.
- Release of information
- HIPAA (http://www.maine.gov/dhhs/bh/HIPAA/Index.html)
Standard 5. The Case Manager shall intervene at the consumer level to provide and/or coordinate the delivery of direct services to consumers and their families.
Developmental Services in the State of Maine are highly integrated with community resources. For this reason, the particular shape of case management services will differ greatly from one consumer to the next. In some instances, the Case Manager may be virtually the only liaison for the consumer and her family, while in other cases, a consumer may be receiving a wide variety of services and supports from a network of community providers. Accordingly the Case Manager may be operating as a direct Social Worker in one case, as a service coordinator in another, and as a quality assurance monitor in another. In all likelihood, a given Case Manager will have the whole spectrum of types of cases, and will need to develop skills in a variety of areas. Standard 5 speaks primarily to the direct service category, while Standards 6 and 8 address coordination and quality assurance. In addition to possessing good interpersonal and communication skills, a Case Manager needs to develop, through education or experience, an understanding of interpersonal and family dynamics and a good background in the nature and needs of various disabilities. This is particularly true since many of the consumers whom we serve have secondary diagnoses related to mental health, substance abuse, or physical disabilities. Further, some consumers have children, with whom they may need assistance. Others may be involved in difficult family situations. This manual cannot comprehensively identify all the areas in which a Case Manager may be called upon to act, but it is nonetheless an expectation of the Department that Case Managers will strive to expand their skill base across this entire spectrum of topics.
- Referral and Intake
- Personal Planning Process
- Developmental Services Policies
Standard 6. The Case Manager shall intervene at the service systems level to support existing case management services and to expand the supply of and improve access to needed services.
Case Managers are expected to become progressively more knowledgeable about resources available to consumers throughout their service areas. These resources include residential agencies and providers, respite providers, vocational services, professional and therapeutic services, and the full range of community resources as available to consumers as they are to all other community members. It is expected that Case Managers will take every opportunity to share any information that they gather with all of their colleagues, in order to strengthen the service coordination and delivery system for the system as a whole.
- Medical Services
- Ancillary Services
Standard 7. The Case Manager shall be knowledgeable about resource availability, service costs, and budgetary parameters and be fiscally responsible in carrying out all case management functions and activities.
- Family Support Program
- Financial Procedures
- Case Management Billing
- Waiver and ICF/IID Classification Requirements
Standard 8. The Case Manager shall participate in evaluative and quality assurance activities designed to monitor the appropriateness and effectiveness of both the service delivery system in which case management operates as well as the case manager's own case management services, and to otherwise ensure full professional accountability.
- Quality Improvement Activities
- Grievance and Appeal
Standard 9. The Case Manager shall carry a reasonable caseload that allows him to effectively plan, provide, and evaluate case management tasks related to consumer and system interventions.
- Caseload Ratio
- Co-Case Management
Standard 10. The Case Manager shall treat colleagues with courtesy and respect, and strive to enhance interprofessional, intraprofessional, and interagency cooperation on behalf of the consumer.