January 19, 2023

Chapter 2 brings up issues of diversity and describes the contributions of Mary Richmond. Research a program in your town or city (Atlanta, ga) and identify the population it serves. I

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Chapter 2 brings up issues of diversity and describes the contributions of Mary Richmond. Research a program in your town or city (Atlanta, ga) and identify the population it serves. Imagine implementing this program in another area with a different population (for example, make a program that services inner-city youth work for rural youth or vice versa). Identify changes you would need to make in order to adequately serve the new population.

PPT attached.

classmate example post: I currently live in Atlanta, and I have lived here my entire life. Therefore, I decided to choose a case management program called Supportive Services for Veteran Families (SSVF). SSVF provides homeless and near-homeless veterans and their families an opportunity to find stable housing. According to the website SSVY work together with Veteran families to address personal needs and goals. By empowering Veteran families, the SSVF Program is committed to serving those who served us and advancing housing permanency within the Veteran community. The cost of this program is free. In addition, the SSVF program offers services that include - case management, coordination, and linkage to VA and mainstream benefits (medical, mental health, substance abuse, housing, etc.) financial assistance for initial move-in costs as eligible, and advocacy.
If I could make any changes to this program, I would change the population served. I would use this program to serve a younger population who may be struggling with serve mental illness in rural areas. I feel a program such as this one helps with finding housing in inner cities but neglects more rural areas. I also believe that this program can be of service to those who may not know anything outside of their hometown. I would still offer the same services because I do believe they are vital. Overall, I feel this is a fantastic program. I am interested in learning more about it. I am interested to learn what my classmates feel about the changes I decided to make to this program.

CaseManagement.pdf

Generalist Case Management A Method of Human Service Delivery 5th Edition

Marianne R. Woodside Tricia McClam

CHAPTER 2

Historical Perspectives on Case

Management

Introduction

• Modern-day case management reflects many changes such as:

changing needs of individuals served, financial constraints on the

human service delivery system, increasing number of people

needing services, and the growing emphasis on client

empowerment, evaluation of quality, and service coordination.

• Much of the foundation of case management developed when it was

used to serve people with mental illness who were

deinstitutionalized in the 1970s.

Perspectives on Case Management

• Four perspectives have shaped case management

since the 1970s:

• Case management as a process

• Client involvement

• The role of the case manager

• Utilization review and cost-benefit analysis

Case Management as a Process, Slide 1

• The 1970s brought deinstitutionalization to the mental health

community and changes to case management practice.

• Deinstitutionalization: the movement of large numbers of people

from self-contained institutions to community-based settings

such as halfway houses, family homes, group homes, and

single-residence dwellings.

• During deinstitutionalization, case managers had to help

determine which residents could live outside of an institution,

and then they had to help such clients transition into new

settings. Sam’s case (2.1 & 2.2) illustrates the issues that could

arise during these two tasks.

• An early definition of case management came from the American

Psychiatric Association’s Ad Hoc Committee on the Chronic Mental

Patient. In summary, case managers helped persons with

disabilities access and use resources; case managers played a key

role in service integration.

Case Management as a Process, Slide 2

• The three key elements for success in the case management

process include:

• Responsibility for assessing the client’s problem and developing

a responsive plan.

• Continuity in planning care and implementing the case plan

through aftercare time periods.

• Accountability for tracking and updating the case plan, helping

the client gain independence, and incorporating the client’s

voice during plan-of-care decision-making.

• These elements ensure that a client’s problem is assessed,

appropriate plans are put in place for the duration of treatment, and

the client’s ability to function independently and to assume self-

responsibility are increased.

• Case management provides a focus and oversees the delivery of

services in an orderly fashion.

Client Involvement

• During the 1980s, client involvement came to be emphasized more

strongly.

• A new model of case management was proposed, giving clients a

more active role in their development.

The Role of the Case Manager, Slide 1

• Traditionally, terms such as caseworker and case manager

described the efforts of helpers.

• Today, job titles include service coordinator, liaison worker,

counselor, case coordinator, health-care case manager, and care

coordinator.

• This range of titles reflects the diversity of service delivery today

and the broader range of responsibilities and perception of roles.

The emphasis shifted from the skills of managing someone to

terminology reflecting a more equitable relationship

The Role of the Case Manager, Slide 2

• Changes placed an emphasis on working with other professionals,

coordinating care and other services, and empowering individuals to

use the system to help themselves.

• For the client, the focus became the ability to develop skills needed

to work within the human services network.

• For the case manager, the focus shifted from management to

coordination.

Utilization Review and Cost-Benefit Analysis

• One result of the spiraling cost of medical and mental health

services is the growth of the managed-care industry.

• The purpose of managed care is to authorize the type of service

and the length of time care is provided. An emphasis is placed on

the efficient use of resources.

• Case managers, working in managed care, are involved in

utilization review and have the responsibility to authorize and deny

services.

• Case managers are also responsible for cost-benefit analysis, which

focuses on the financial matters of the case, specifically the cost

and efficiency of services.

The History of Case Management

• First used in institutional settings, case management included the

responsibilities of intake, assessment of needs, and assignment of

living space.

A Pioneering Institution

• An early example of such an institution was the Massachusetts

School for Idiotic and Feebleminded Youth, established in 1848.

• The school provided services in case management such as tracking

student progress, providing follow-up services, and managing

information.

• Other practices at this school (aftercare, evaluation of services, and

advances in recordkeeping) contributed to case management as we

know it today.

Early Pioneers, Slide 1

• Early case management took either of two forms: a multiservice center

approach or a coordinated effort of service delivery.

• Jane Addams, Lillian Wald, and Mary Richmond were three early

pioneers who contributed to the development of the emerging case

management process.

Hull House

• Jane Addams founded Hull House in Chicago (1889), committed to

sharing a love of learning.

• As services expanded, the need for effective administration and

recordkeeping increased resulting in the collection of information about

demographics, participation, and attendance.

• Advocacy was also integrated into the work of Hull House.

Early Pioneers, Slide 2

Henry Street Settlement House and Contributions to Case

Management

• Lillian Wald and Mary Brewster established the Henry Street

Settlement House in New York (1895), and created a system for

nursing the sick in their own homes, promoting the dignity and

independence of the patient.

• The work at Henry Street led to two significant innovations: the

designation of the visiting nurse and the development of the Red Cross.

Mary Richmond and Contributions to Case Management

• Mary Richmond was a social reformer who promoted the idea that each

person was a unique individual whose personality, family, and

environment should be respected.

• She believed that professionals should work with clients rather than

“doing things” to them.

Early Pioneers, Slide 3

Mary Richmond (continued)

• Social diagnosis: developed by Richmond, is a systematic way for

helping professionals to gather information and study client problems.

• Richmond established a series of methods for gathering information

about individuals, assessing their needs, and determining treatment.

• She recognized that gathering data is a complex process and urged the

use of different methods for different individuals.

• She also believed in multiple sources of information and warned that

data gathering was an often incomplete process.

Impact of World Wars I and II/The Red Cross

• During the First World War, the American Red Cross—in response to

an increased interest in Mary Richmond’s style of casework—used

casework to address individuals’ problems and their psychological

needs.

• The Home Service Corps helped address the needs of the families of

military personnel (those experiencing problems such as illness and

marital difficulties).

• The Home Service Corps made two important contributions:

1) Extended help was offered to individuals and their families.

2) Volunteers became brokers of services, coordinating

communications and requests between families and agencies.

The Impact of Federal Legislation, Slide 1

Contributions to Case Management: The Older Americans Act of

1965

• Focused on providing services for older individuals in order to

improve their quality of life.

• Contributed to case management by emphasizing the multiplicity of

human needs and recognizing the need to coordinate care.

Contributions to Case Management: Rehabilitation Act of 1973

• This act and its subsequent amendments emphasized client

involvement and satisfaction, consumer choice, and control in

setting goals and objectives.

The Impact of Federal Legislation, Slide 2

Contributions to Case Management: Children with Disabilities,

Education for All Handicapped Children Act of 1975

• Included an explicit case management process to treat the client

as a customer.

• The client was to be involved in identifying the problem, given

complete information about the results of the assessment of

needs, and empowered to help determine the type of services

delivered.

Contributions to Case Management: The Family Support Act of

1988/The Personal Responsibility and Work Opportunity Act

• Mandated that case management be applied to the process of

serving those who were deemed eligible for welfare.

• Case managers became a key component in welfare-to-work

programs by developing the case plan and coordinating services.

The Impact of Managed Care, Slide 1

History of Managed Care

• The emergence of managed care has increased the demand for case

management services and provided new models and definitions of

service delivery.

• Fee-for-service: an early provision of medical care; each patient was

assessed a fee for each health or mental health service provided by a

professional.

• In the 1930s, physicians implemented prepaid group plans or

managed plans for medical services.

• The basic concept of a prepaid plan was to guarantee a defined set of

services for a negotiated fee.

• The prevalence of managed care is now commonly regarded as being

connected to the rising cost and decreasing quality of health care and

mental health care.

The Impact of Managed Care, Slide 2

Defining Managed Care

• Managed care: an organized structure that uses prepayment rather

than fee-for-service payment.

• It can designate the array of different payment plans, such as

prepayment and negotiated discounts.

• Policies restrict clients’ access to providers such as physicians and

other health professionals.

Models of Managed Care, Slide 1

• Pharmacy benefits management (PBM) : focuses on controlling

prescription costs through negotiations, use of generic treatments,

and mail delivery of prescriptions. Managers review drug benefits and

determine payments.

• HMO (health maintenance organization): a generic term covering a

wide range of organizational structures; combines delivery and

financing into one system.

• HMOs provide health care or assure health care delivery in a

geographic area, have an agreed-upon set of health maintenance

and treatment services, and involve groups of voluntary enrollees.

Models of Managed Care, Slide 2

• PPO (preferred provider organization): plan that falls between the

traditional HMO and the standard indemnity health insurance plan.

• PPOs have established contracts with designated (preferred)

medical providers. Clients receive better benefits when care is

received from a preferred provider.

• POS (point-of-service): allows for more flexibility than HMO or PPO

plans provide.

• Coverage is reduced for out-of-plan providers and clients pay

higher premiums, deductibles, and pay a higher percentage of

medical fees.

Models of Managed Care, Slide 3

• Health Savings Account : high-deductible but lower-premium health

care plans that were developed in 2003.

• Employers and employees make tax-free contributions, up to

$2,500, to a savings plan that can be used for qualified medical

expenses

• Employees decide what qualified services they want to purchase

• Unspent funds in the plan roll over to the next year

• Health Reimbursement Arrangements: similar to health savings

account, without the cap on employer contributions.

• Plans Offered Under the Health Care Exchanges: these plans are

mandated by the Affordable Care Act and provide a set of minimum

services while covering varying percentages of medical costs, at

either 60, 70, 80 or 90%.

Managed Care: Summary

• Managed care has emerged as a response to the fact that employers,

governments, payers, clients, and providers are all seeking ways of

containing health care costs.

• All managed-care plans emphasize management of medical cases,

review and control of utilization, and incentives for restrictions on

providers and clients to reduce costs and maintain quality.

• Clear advantages and disadvantages of these plans have emerged.

• Case managers play a critical role in management of care.

Organizations have developed to establish standards for case

management in these settings, such as the Case Management

Society of America.

• In response to professional and client frustrations, several advocacy

efforts have evolved.

Professionalization of Case Management and

Expanding Responsibilities • The professionalization of case management within human service

delivery includes a national certification offered by several

professional organizations and states.

• The Human Services Board-Certified Practitioner requires

demonstrated competence in case management, professional

practice, and ethics and requires several practitioner

competencies that are related to case management.

• The National Association of Social Workers (NASW) offers a

credential for case managers with a bachelor’s of social work

degree.

• As the care environment continues to shift, the case managers’

responsibilities and accountability through certification will increase.

References

Ozarin, L. (1978). The pros and cons of case management. In J. Talbott (Ed.),

The chronic mental patient (pp. 165–170). Washington, DC: American

Psychiatric Association.

Slide 1: Generalist Case Management A Method of Human Service Delivery 5th Edition
Slide 2: CHAPTER 2
Slide 3: Introduction
Slide 4: Perspectives on Case Management
Slide 5: Case Management as a Process, Slide 1
Slide 6: Case Management as a Process, Slide 2
Slide 7: Client Involvement
Slide 8: The Role of the Case Manager, Slide 1
Slide 9: The Role of the Case Manager, Slide 2
Slide 10: Utilization Review and Cost-Benefit Analysis
Slide 11: The History of Case Management
Slide 12: Early Pioneers, Slide 1
Slide 13: Early Pioneers, Slide 2
Slide 14: Early Pioneers, Slide 3
Slide 15: Impact of World Wars I and II/The Red Cross
Slide 16: The Impact of Federal Legislation, Slide 1
Slide 17: The Impact of Federal Legislation, Slide 2
Slide 18: The Impact of Managed Care, Slide 1
Slide 19: The Impact of Managed Care, Slide 2
Slide 20: Models of Managed Care, Slide 1
Slide 21: Models of Managed Care, Slide 2
Slide 22: Models of Managed Care, Slide 3
Slide 23: Managed Care: Summary
Slide 24: Professionalization of Case Management and Expanding Responsibilities
Slide 25: References

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Chapter 2 brings up issues of diversity and describes the contributions of Mary Richmond. Research a program in your town or city (Atlanta, ga) and identify the population it serves. I

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