Protect Your Rights - Case Management Info Sheet
PROTECT YOUR RIGHTS
Connecticut’s mental health system provides a wide range of both clinical and non-clinical services to meet the individual needs of the diverse population that it serves. These include everything from acute institutional treatment to psycho-social clubs to employment assistance. The basic goal of all of these services is to empower the person in recovery to become as self-sufficient as possible.
The State is obligated, under federal law, to provide services to persons with disabilities in the most appropriate integrated setting. This goes beyond simply making services available in a non-hospital environment; it means that persons with disabilities should be empowered to interact with non-disabled persons to the fullest extent possible.
Accomplishing these goals, while respecting the rights and preferences of the individual can be quite challenging, particularly when the state’s mental health system lacks adequate funds to meet client needs. The “system” can seem complicated, conflicting, and confusing, and it can often be difficult for consumers to get the information and support that they want.
The case manager plays a key role in trying to make the system meets the needs of individual clients by coordinating services, assisting with communication and advocating for the client. In many ways, the case manager is the glue that holds the service plan together. Unfortunately, sometimes it is not clear to clients just what kind of services they can or should expect from a case manager.
The purpose of this flyer is provide an overview of the types of assistance and activities that DMHAS includes within the scope of case management services. It is intended to summarize broad categories of services and not to cover every possible situation. If there are questions regarding case management services, the reader should contact the Connecticut Legal Rights Project.
FOR PERSONS WITH PSYCHIATRIC DISABILITIES
WHAT ARE CASE MANAGEMENT SERVICES?
The Department of Mental Health and Addiction Services (DMHAS) defines case management services as support services that can be provided in a variety of settings and assist the client in meeting his or her multiple needs. Case management services help clients gain access to treatment services as well as to medical, social, educational, vocational, housing, and other services that are necessary to meet basic human needs.
WHAT IS THE CLIENT’S ROLE IN CASE MANAGEMENT SERVICES?
Case management is supposed to be a client-driven service that involves the client in the development of a plan of appropriate activities to facilitate recovery. The type, intensity, and duration of case management services are directly related to the individual’s level of functioning.
WHAT DOES THE CASE MANAGER DO?
According to DMHAS, the case manager’s primary functions include:
Assessment: Determining an individual’s strengths, needs and preferences;
Planning: Developing a realistic, comprehensive service plan which addresses all aspects of the consumer’s life;
Linking: Referring the client to all appropriate services and supports;
Monitoring: Continually evaluating progress and the appropriateness of services;
Advocacy: Interceding to assure the client, and other clients, are treated equitably;
Crisis prevention & intervention: Identifying and addressing triggers or symptoms of relapse;
Pro-active outreach: Maintaining contact with the client at different community sites.
ARE THERE DIFFERENT LEVELS OF CASE MANAGEMENT?
YES. DMHAS-funded programs offer three levels of case management services which relate the intensity of the services to the individual’s level of functioning:
Level I-Most Intensive Services: Assists clients whose functioning is most severely impaired, typically as part of a multi-disciplinary team which may include medical staff. Support is accessible at all times and there is extensive daily contact. Caseloads average 10 or less.
Level II-Moderate Services: Assists clients experiencing increased stability who are actively pursuing recovery goals. It serves persons who may have recently had a relapse on either a team or individual basis. However, the psychiatrist is usually involved with the case management program. Regular face to face contact and outreach (4-12 contacts per month) is critical, depending on individual need. Support should be accessible at all times. Caseloads average 20-30 persons per case manager.
Level III-Least Intensive Services: Assists clients who have shown evidence of recovery with only remote relapses or hospitalizations. Outreach is conducted on an as needed basis, with most contact by phone or in the office, however, there is ongoing contact with providers. The caseloads range from 40-60 clients. Support may be available at all times.
WHAT ARE THE TYPICAL SERVICES PROVIDED BY A CASE MANAGER?
The case manager can be expected to assist the client in a full range of services that support recovery and self-sufficiency. These apply to all clients, regardless of their functional status, and include, but are not limited to, the following:
Linking Clients to Benefits: Assisting with entitlements and other services;
Housing Assistance: Helping the client obtain and retain appropriate housing;
Employment Assistance: Assisting with job training and employment;
Counseling: Providing support in resolving day to day problems;
Planning: Assisting the client to develop crisis intervention arrangements;
Facilitating Activities: Coordinating or providing transportation needed for services and socialization; accompanying clients to appointments;
Educating: Assuring that the client is trained in independent living skills, such as financial management and parenting skills, necessary to promote self-sufficiency;
Monitoring: Maintaining contacts necessary to determine client status and participation in treatment plan activities;
Providing family education: Working with family and other members of the client’s support group, as appropriate, to help them understand and support the client.
IS A CLIENT REQUIRED TO HAVE CASE MANAGEMENT SERVICES?
Case managers are required to recognize the importance of natural supports for consumers. They should honor the requests of consumers to be discharged from services when consumers have developed and freely participate in support systems that have not been imposed upon them?
WHAT IF THE CASE MANAGEMENT SERVICES ARE NOT SATISFACTORY?
As with any other DMHAS-funded services, a consumer can file a grievance if he or she is not satisfied with the services being provided by a case manager. This may include things like the case manager’s failure to provide one of the activities listed above, or the reduction or elimination of services. (NOTE: The grievance procedure is described in a separate flyer). Call the Connecticut Legal Rights Project for more information.
INDIVIDUALS HAVE THE RIGHT TO ADVOCACY SERVICES
Persons protected by the Bill of Rights have the right to advocacy to assist them in enforcing their rights. These advocates must be allowed to participate in treatment team meetings as well as other meetings and proceedings to enforce the bill of rights.
The information in this flyer is effective as of April 2001