Implementation of Case Management with Dcf Committed Adolescent Females

Implementation of Case Management with DCF Committed Adolescent Females

1. Introduction

        Case management is a fundamental, universal tool used by human service providers to help clients achieve goals and attain acceptable levels of functionality within their communities. Typical target populations and their settings include: children of the welfare system, the elderly and their families, health care settings, the chronically ill, the mentally challenged in the community, developmentally disabled persons and their families, people with physical disabilities in independent living arrangements.  The essential elements of case management require linking a consumer to a service system and organizing the various system components in order to achieve a successful outcome by 1.) Client intake 2.) Assessment of needs 3.) Goal setting 4.) Service planning 5.) Service coordinating and linking 6.) Monitoring ( and continuous evaluation of the client, of the service delivery and of available resources) 7.) Advocacy.  

The goal of case management in human services is to resolve the client’s problems in the most effective was possible within the constraints of the service program.  The case manager’s goal is service provision for the client, not management of the system or its resources. A case manager coordinates mental health, social work, education, health, vocational, transportation, advocacy, respite care and recreational services as needed.  The case manager makes sure that the changing needs of the client are met.  To be an effective social worker it is important to know what case management model and strategies have the probability to work the best for particular clients in order to be able to carry out successful case management.

1. Client Population

The target population at Noank Group Homes is Department of Children and Families committed adolescent females, these clients have often been removed from their families on the basis of neglect and/or abuse.  Although Noank Group Homes only services a specific population it provides a cross sectional, community based style of case management.  Due the business being a non- profit organization it relies heavily on the support of other community providers.   Rothman points out that by using community resources that are close to the client it can make for the “optimal learning environment.”  By utilizing services close to the home it allows the client familiarity and convenience.  Rothman also suggests that the practitioner providing these types of services “has to offer availability that is open ended and around the clock.” The clients at Noank receive comprehensive case management services; clients live within the facility and staff members on are on site twenty four hours a day to address the needs of their clients. Before the client gains access to the agency they are already familiar with the case manager – client relationship.  Potential clients of Noank Group Homes have either a Parole Officer or a DCF worker (these two positions essentially serve as case managers for their organizations).

1. Application of Schematic Model

1. Access to Agency

In order for a client to gain access to Noank Baptist Group Homes a formal report called Child Adolescent Needs & Strengths (CANS) needs to be filed by the child’s Parole Officer or DCF worker. The CANS information will be sent to ValueOptions (a subcontracted Administrative Service Organization) for review and a determination of the appropriate level of care for the client. A CANS decision support tool and algorithm, developed specifically for Connecticut's therapeutic service system, will be created as the means by which a child’s eligibility for this care level is assessed. The CANS will also serve to guide the goal and treatment development process for each child who is subsequently admitted into this care type (DCF, 2007).  When it has been determined that a Therapeutic Group Home is an ideal for the client a member of DCF central office will contact the Director of Residential Services to verify there is occupancy at one of the homes. During this process the central office will forward the CANS information along with client history to the Director of Residential Services for review.  The Director of Residential Services will evaluate the information with the Executive Director and the Assistant Director of Residential Services before accepting the client. If the client is appears to meet the criteria of admission the administrative staff will schedule a pre-placement visit and an intake interview with the client and their worker.

II. INTAKE

Before the initial intake process commences each potential client is afforded the opportunity to spend a weekend at the facility they will be living in.  This gives the client an opportunity to acquaint themselves with the program and allow them to meet future housemates.  After the pre- placement visit, the client and the worker will discuss if the client would like to enter the program. Once the child agrees to accept admission into the program the official intake process can begin.

        At the interview the client will be told informed of the services that are available to them and will be given detailed information once they have been matched with a specific program.  From that point the intake team will go over the information given to the agency from the worker (CANS, medical, therapeutic and personal history).  This will give the worker, the agency and the client the opportunities to clarify and any inconsistent details.  According to the Virginia Department of Health Division of Disease Prevention’s case management standards the initial meeting may should include gathering information on areas such as availability of support systems, familial concerns or supports, mental health status, and use of addictive substances. This process is parallel to the practice guidelines stated by Rothman “establish criteria, clarification of roles and information needed to complete assessment of needs. The client and worker will meet with the therapist and the nurse to sign “permission to treat” forms.  These forms will allow the agency to proceed to the next step of assessment.

III.ASSESSMENT

According to the main objective of the assessment process the manager tries to indentify the contributing factors of the clients’ present problems.  At the group home the Clinician serves as the therapeutic case manager, addressing emotional and behavioral problems; the registered nurse serves as the medical case manager to address current medical conditions.  As noted above, the CANS tool is proposed to be used as the instrument to support eligibility determination for therapeutic levels of foster care. DCF suggests the use of the CANS as the ongoing assessment tool, implemented at six month intervals, to evaluate the progress of children in therapeutic programs. Other DCF behavioral health programs (e.g., care coordination) use the Ohio Scales and the Behavioral Emotional Rating Scales (BERS) as their routine assessment tools.  The case manager should also assess barriers that restrict the client’s ability to access or