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Concept, process, and technique of CASE MANAGEMENT

Nantaporn Ieumwananonthachai Thammasat University August 17, 2011. Concept, process, and technique of CASE MANAGEMENT. History.

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Concept, process, and technique of CASE MANAGEMENT

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  1. NantapornIeumwananonthachai Thammasat University August 17, 2011 Concept, process, and technique ofCASE MANAGEMENT

  2. History • Case management emerged as a separate and professional service in the 1970s, where it was seen as a way to connect clients with multiple needs to an increasingly complex social service delivery system (Turner & TenHoor, 1978). • Throughout its history, case management has focused on the holistic needs of clients, addressing basic needs such as safety, food, and shelter, as well as emotional, medical, and other needs including employment, education, and connection with others in the community (Rapp, 1998)

  3. Case Management • Case management is a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s holistic needs through communication and available resources to promote quality cost-effective outcomes. (Case Management Society of Australia 2009) • Although there are numerous definitions, the common theme is seen as a process for ensuring that clients are provided with whatever service/s they require in a coordinated, effective and efficient manner. (from ADAHPT Case Management Model)

  4. Complex social situation and problems Advancement of Sciences, Technologies, and Medicine Organization mandate is not consistent with responses required Limitation on quality and access of services “Holistic Interdisciplinary” concept CM Limitation of resources and services “Individualized Human Right” concept Globalization and Gap in Economic Development Cross border issues Require intensive coordination

  5. Human Trafficking • The United Nations definition of Human Trafficking is “The recruitment, transportation, transfer, harbouring or receipt of persons, by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation”

  6. Complex social situation and problems Advancement of Sciences, Technologies, and Medicine Organization mandate is not consistent with responses required Limitation on quality and access of services “Holistic Interdisciplinary” concept CM Limitation of resources and services “Individualized Human Right” concept Globalization and Gap in Economic Development Cross border issues Require intensive coordination

  7. CRISIS INTERVENTION • Medical treatment • physical examination and treatment • psycho and emotional support • Legal assistance - law enforcement • Legal advice • Legal support • Investigation and proceedings • Social services • Crisis measures - inc. temporary care • Complete assessment (incl. risk) • Planning

  8. Rehabilitation: Prevention of further harm • Restriction/protection orders • Permanency planning and monitoring • Family support services (economic, mediation, social skills, housing, employment, social services…) • psychological and emotional support • support during and after legal proceedings • advocacy and referral to existing services

  9. Coordination/ Linkages Health Personnel Psychologist Social Worker CM Police Therapist Other Professionals Community workers Families

  10. Case Management definition in work with victims of trafficking • "a collaborative means of helping people who are disadvantaged or devalued in society, to discover their strengths and personal power, pursue their own objectives, and begin to confront the systems that oppress them, in order to redistribute power and thereby improve their life chances and quality of life" (Spindel, 2008, p.15).

  11. The Case Management approach assumes that clients with complex and multiple needs will access services from a range of service providers and the goal is to achieve seamless service delivery. This assumption highlights that the concept of Case Management is based in service provision arrangements that require different responses from within organisations and across organisational boundaries. Case management is described as a boundary spanning strategy to ensure service provision is client rather than organisationally driven. (Case Management Society of Australia 2009)

  12. Components of Case Management Process Termination Identification/ Selection Evaluation Assessment Client Planning Implementation/ Coordination Standards of Practice for Case Management, revised 2010 (USA)

  13. 1. Client Identification and Selection • Focus on identifying clients who would benefit from case management services. Standards of Practice for Case Management, revised 2010 (USA)

  14. 2. Assessment and problem/opportunity identification: • Begin after the completion of the case selection and intake into case management and occurs intermittently, as needed, throughout the case. Standards of Practice for Case Management, revised 2010 (USA)

  15. 3. Development of the Case Management Plan • Establish goals of the intervention and prioritizes the client’s needs, as well as determines the type of services and resources that are available in order to address the established goals or desired outcomes. Standards of Practice for Case Management, revised 2010 (USA)

  16. 4. Implementation and coordinationof care activities • Put the case management plan into action through the coordination with service providers, and client and family. • If the client has to be referred, communicate with new provider (CM) and client, and ensure smooth transition. Standards of Practice for Case Management, revised 2010 (USA)

  17. Coordination Divide into 3 phases 1. Beginning 2. Network maintenance 3. Termination (Onopas, 2011)

  18. Referral • Identify objective of the referral, and jointly work with client to select appropriate agency for referral • Communicate with destination agency and new CM, to ensure smooth transition • Prepare necessary document for referral • Prepare client for the transition • If the client has to be transferred to another geographical area, ensure that there is someone to accompany the client if s/he is not capable of travelling by him/herself. • Follow up on the transition, and evaluate client’s satisfaction.

  19. 5. Evaluation of the case management plan and follow-up • Involve the evaluation of the client’s status and goals and the associated outcomes. Standards of Practice for Case Management, revised 2010 (USA)

  20. 6. Termination of the case management process • Bring closure to the care and/or episode of illness. The process focuses on discontinuing case management when the client transitions to the highest level of function, the best possible outcome has been attained, or the needs/desires of the client change. Standards of Practice for Case Management, revised 2010 (USA)

  21. Case Manager Roles of Case Manager • Facilitator (within service system) • Advocator (rights holder) • Educator • Negotiator • Coordinator • Manager (monitor and follow up on outcomes/ and transition)

  22. Case Manager is working with • Client/ Services User (Micro/Direct) • Environment (Macro/Indirect)

  23. Client/service user • Individual, family and relative, group, community: with problems that are complex, chronic, severe, repeated, etc. • Target group: elderly/ child and youth/ female (with all forms of violence), substance abuser, HIV/AIDS or chronic patients, disable (physical/ mental/ intellectual), perpetrator after being released,those at risk of facing repeated problems,etc.

  24. Environment • services system • economic and politic • culture and belief

  25. Case Management is one of the services delivery approach with following goals • enhancing developmental, problem-solving, and coping capacities of clients • linking people with systems that provide them with resources, services, and opportunities • creating and promoting the effective and humane operation of systems that provide resources and services to people • improving the scope and capacity of the delivery system • contributing to the development and improvement of social policy (NASW, 1992) Micro Meso Macro

  26. Principles of Case Management • The service delivery is individualized based on comprehensive assessment that is used to develop a case or service plan • The plan is developed in collaboration with the client and reflects their choices and preferences for the service arrangements being developed • The goal is to empower the client and ensure that they are involved in all aspects of the planning and service arrangement in a dynamic way. (Case Management Society of Australia 2009) • Multiple services are provided to individual in a holistic approach with case manager as main coordination mechanism through multidisciplinary team and case conference

  27. A team or group consisting of representatives from several different professional backgrounds who all have different areas of expertise. (http://society.guardian.co.uk/glossary/p) A group of professionals from diverse disciplines who come together to provide comprehensive assessment and consultation in abuse cases (http://wiki.answers.com/Q/What_is_the_meaning_of_the_term_multidisciplinary_team#ixzz1UzV0oQFy) Multidisciplinary team

  28. Why a multidisciplinary approach? • Deal with complicated problems • Provide diverse and overall aspect on particular issue • Provide opportunity to see from different angles/ professional perspectives • Allocate work among agencies • Reduce duplication of work

  29. Multidisciplinary team meeting A meeting consist of many professionals vs. Case Conference A meeting for a particular case

  30. Multi Disciplinary Case Conference (MDCC) For Child Protection (Abuse) case, • MDCC is a forum by which professionals having a major role in the handling and investigation of a suspected child protection case can share their professional knowledge, information and concern on the child health, development, functioning and his/her parents’/carers’ ability to ensure safety of the child. • Focus on protection and welfare of the child and not prosecution of the abuser. • Analyzes risks and recommends actions to be taken in relation to the welfare planning of the child and his/her family, respecting the statutory obligations of individual members for the case. (from: www.swd.gov.hk/doc/fcw/proc_guidelines/childabuse/Chapter11.pdf)

  31. Objectives of case conference • Discussion of the clients history • Identification of the clients multi-disciplinary needs • Identification of outcomes to be achieved by members of the team providing services to client • Identification of tasks to be undertaken to achieve outcomes and allocation of tasks to team members • Assessment of success or otherwise of previously identified outcomes (adapted from http://www.gpageelong. com.au/Our-Services/Medicare/case-conferencing.html)

  32. Tools for CM • Bio Psycho Social Assessment • Strength Based Assessment • Life Plan • Contract Plan (Task Plan) • Case Conference/ Multidisciplinary Team meeting • Resources mapping for coordination and referral

  33. Samples of roles of CM for Trafficking victim (US) • In addition to serving as a single point of contact, a central case manager can assess a client's need for services and support; identify, obtain, and coordinate those services for the client; coordinate and manage communications across systems; and serve as a liaison for the client. Other functions of the case manager include: translating for the victim or obtaining translation services; accompanying clients to appointments; assisting/teaching clients to access public transportation; and in some cases, teaching clients basic life skills. Sometimes this includes teaching clients how to use kitchen appliances or how to make a phone call. • Offering reassurance and comfort to clients often occupies much of a case manager's time, but it is essential in building trust and rapport with the client. In fact, many providers and law enforcement representatives note that the case mangers are often the first and sometimes the only person a victim trusts. From: Case Management and the Victim of Human Trafficking: A Critical Service for Client Success By: Heather J. Clawson and Nicole Dutch , June 2008

  34. Ingredients for Effective CM in Human Trafficking • Establishing a hopeful relationship with the client; • Assessing client strengths and needs; • Developing, in partnership with the client, a service plan to achieve desired outcomes; • Locating, linking, and following up with needed services and support; • Monitoring, coordinating, and adjusting services and supports to achieve desired outcomes; • Providing crisis prevention and intervention services and support; and • Advocating for the client. Extracted from the NACM Web site,http://www.yournacm.com/definition.html

  35. Benefits of case management in human trafficking cases • Victim: helping the victim move toward self-sufficiency, through educating victims of their rights, helping them understand and navigate through criminal justice, immigration, and human service systems, identifying and making appropriate referrals, assisting victims in accessing services, advocating on behalf of the victim to other providers and agencies, and providing moral and emotional support. • Law Enforcement: helping stabilize the victim to assist in the investigation by providing services and support that are beyond the means and expertise of law enforcement. • Prosecutor: Case Manager as source of stability for the victim, helping translates victim into a more consistent and credible witness. From: Case Management and the Victim of Human Trafficking: A Critical Service for Client Success By: Heather J. Clawson and Nicole Dutch , June 2008

  36. Challenges and Limitations of CM in Human Trafficking cases • Resources limitation – staff : client ratio vs demanding tasks • Availability of services - accessing certain services can be a challenge in many communities • Length of services eligibility – inconsistent with client’s needs and time require to go through process • Access to information - issues of confidentiality are often identified as barriers to keeping clients informed about their legal case, or medical diagnoses or results • Staff burnout and turnover – demanding work vs low pay From: Case Management and the Victim of Human Trafficking: A Critical Service for Client Success By: Heather J. Clawson and Nicole Dutch , June 2008

  37. Samples of roles of CM for Trafficking victim (Thailand) • Human Trafficking Act: assign competent official who partially function as case manager for victim of human trafficking (crisis intervention, safety, legal aspect), while coordinate with MSDHS for other social services. • In Thailand, social workers usually act as Case Manager, who look after client and family holistically through need assessment, and services provision (management, coordination, monitor, evaluation, and advocacy) in order to ensure best interest of client.

  38. The effectiveness of any case management program depends upon the availability of high-quality treatment and support services in a given community, the structure and coordination of the service system, and on the ability of an individual or family to pay for care either through private insurance or (more often) through public benefit and entitlement programs. From: Case Management and the Victim of Human Trafficking: A Critical Service for Client Success By: Heather J. Clawson and Nicole Dutch , June 2008

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