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Selection of Case Management Model and Placement

The Supportive and Comprehensive models of case management provide different levels of service geared to the needs and readiness of the client.

Supportive case managementis designed for clients who need short term service, for those who require continued maintenance support following comprehensive case management, or for those not yet willing to participate in comprehensive case management.

Comprehensive case management is intended for people with multiple, complex needs who require intensive, longer term service.

For case management programs approved to provide both models of service, the ability of clients to shift from one model to another within the same program provides flexibility and enhances continuity of service as client needs evolve.

Standard Criteria

Clients are enrolled in a Supportive or Comprehensive case management program that provides a level of service that meets the needs identified in the Brief Intake/Assessment and in which the client is ready and willing to participate.

Time requirement: At completion of Brief Intake/Assessment.

  1. Case management model most appropriate for client needs is determined
    • Acuity of client needs is ascertained.
    • Case management services are explained.
    • Readiness and interest in case management is assessed.
    • Client is enrolled in model most suited to their needs regardless of agency enrollment needs.
  2. Program capacity is evaluated.
    • Program's service level and staff qualifications and/or expertise meet clients' needs.
    • Program has caseload capacity.
    • Program has capacity to meet clients' cultural and linguistic needs.
  3. Clients are enrolled in Supportive or Comprehensive Case Management within agency.
    • Consent for case management services is obtained where required by initiative.
    • All required forms authorizing the release of HIV confidential information and other protected information are signed by clients as required by applicable law.
  4. For clients at agencies which are not able to provide level or type of case management services necessary:
    • Agency refers the clients to another case management program.
    • Referral to another case management program occurs within 15 days after the determination of appropriate level of care.
    • Referring agency follows up and verifies with client that placement was appropriate and client is receiving services.
  5. Agency has referral arrangements with local case management providers to ensure diverse needs of clients are met.
  6. For agencies providing both Supportive and Comprehensive Case management models of service:
    • Agencies are able to identify which clients receive Supportive or Comprehensive case management at any point in time, and to report total number of clients being served in each model.
    • Policies and Procedures describe the process to move clients between models.

Exceptions

In some circumstances clients with extensive needs may be unwilling to accept or participate in Comprehensive Case Management but will agree to a supportive level of services. In these instances Supportive Case Management may be provided to meet immediate and crisis needs. With a continued cycle of crises, efforts should be made to encourage clients towards engagement in Comprehensive Case Management.

Clients enrolled in an ADHCP automatically receive Comprehensive Case Management services.

Best Practices

Agencies that coordinate with a variety of service providers and hold multiple reciprocal service agreements can best meet diverse client needs.

The most effective agencies are culturally competent and employ staff who culturally and linguistically represent the community served.

When clients are referred for case management services elsewhere, case notes include documentation of follow-up and level of client satisfaction with placement.