Providing Case Management Services Research Articles

Student Support and Retention

Traditional student support services offered by universities are broad and varied; however, many of these fall under either student or academic affairs and are located centrally on campus. Offering a decentralized, college-specific model of student support and retention that partners with both academic and student affairs allows for a holistic, integrated approach to student resources that is easily accessed within a student’s own academic area. UA Little Rock has implemented this innovative model by housing a licensed social worker in each main campus college. These social workers provide case management services ranging from triage of at-risk students to coordination of on-campus and community resources. Each social worker is also able to provide a limited number of small micro-grants as emergency funds. Primary goals of this initiative include increased student use of the case management services, increased faculty referrals, improved student retention, evaluation of interventions, and student satisfaction. Pilot evaluation data indicates that a diverse population of students across multiple disciplines are utilizing these services and that retention rates for students receiving case management services differs based on their presenting issue(s). To support ongoing evaluation of services, there is a need to more clearly standardize data collection without disruption to practice.

What Do Medicaid Members Want From Their Health Plan? Insights From a Qualitative Study to Improve Engagement in Case Management.

Managed care organizations (MCOs) provide case management services to address unmet health and social needs among their members. Few studies have examined factors influencing members' decision to participate in these programs. The purpose of the present study was to describe the life circumstances of Medicaid members offered case management, what they wanted from their MCO, and their perceptions of case management and barriers to participation. Results will inform practice to raise the awareness, engagement, and impact of case management programs. Case management offered through a Midwestern Medicaid MCO. Adult members who had been offered case management services in the 6 months preceding the study were eligible for the study. Fifteen people from each strata were recruited: members who engaged with case management, declined it, or declined it initially but later engaged (N = 45). Participants completed a qualitative interview by phone and a brief health survey online. Across strata, only 22 participants recalled engagement with case management. Members described a variety of life challenges (e.g., chronic health conditions, caregiver responsibilities, and limited finances) and services they desired from their MCO (e.g., stipends for over-the-counter health expenses, improved transportation services, and caregiver assistance). Participants identified direct communication, emotional support, and referrals for resources as benefits of case management.

Impact of community health workers on quality of life in adolescents and young adults with sickle cell disease: The SHIP-HU study.

Health-related quality of life (HRQoL) is an important outcome for patients with sickle cell disease (SCD). It is often poor compared with other chronic medical conditions or measured as a multidomain disease-specific construct. We previously reported outcomes in the Start Healing in Patients with Hydroxyurea (SHIP-HU) randomized controlled trial in adolescents and adults with SCD at six clinical sites. Besides the primary outcomes, we also measured HRQoL as a secondary outcome. Patients in the intervention arm were each assigned community health workers (CHWs) who provided case management services. CHW services were independent of medical management, and medical managers were blinded to the study arm. Patients in the control arm received only standard of care. We hypothesized that having a CHW would improve HRQoL in patients enrolled in SHIP-HU. We did not find significant differences between domains of HRQoL in the two study arms. Possible explanations include selection bias of enrolled versus unenrolled patients, selection bias of sites, medical providers and medical management, enforced blinding, and a lack of cooperation between medical managers and CHWs. The importance of CHWs and HRQoL is nonetheless recognized based on the literature. Future interventions on HRQoL in SCD should consider alternative study designs and multimodal interventions.

Assessment of Veterans Affairs Case Managers Using a Leadership Conceptual Framework.

Case management in Veterans Affairs (VA) depends on leadership skills such as effective communication, excellent resource management, self-governance, patient advocacy, and a distinctly professional attitude. VA registered nurses (RNs) and social workers (SWs) also provide case management services, a role and service, which is pivotal to veteran satisfaction and effective health care coordination.The leader-follower framework (LF2) was used to assess and compare the responses of RNs, SWs, and case managers (CMs) on the annual VA All Employee Survey (AES) to provide insight regarding VA case management performance, which has influenced veteran satisfaction. VA CMs work in a variety of clinical settings, which, in recent years, includes the use of telehealth modalities because of COVID-19. VA CMs remain flexible working in environments where and when veterans require their services while promoting safe, effective, and equitable health care services. RNs and SWs indicated greater agreement and satisfaction scores in 2019 compared with 2018 on questions related to the leadership element of character and questions regarding mutual respect between VA senior leaders and the respondents. In contrast, RNs and SWs indicated less agreement and satisfaction scores on questions related to the leadership elements of competence, context, communication, personal, interpersonal, team, organizational, and greater burnout in 2019 than in 2018. RN response scores in 2018 and 2019 were greater and burnout scores were less than SWs. Additionally, the one-way analysis of variance indicated no difference for RNs and SWs who were performing the duties of a CM. The responses of RNs indicated greater satisfaction and less burnout than SWs and were consistent whether RNs and SWs were in case management roles or not. These are important findings and concerning trends warranting further discussion and research.

Black Moms Matter: A Qualitative Approach to Understanding Barriers to Service Utilization at a Children's Advocacy Center Following Childhood Abuse.

Black families are significantly less likely to receive evidence-based trauma treatment services; however, little is known about factors impacting engagement, particularly at Children's Advocacy Centers (CACs). The goal of this study is to better understand barriers and facilitators of service utilization for Black caregivers of CAC referred youth. Participants (n = 15) were randomly selected Black maternal caregivers (ages 26-42) recruited from a pool of individuals who were referred to receive CAC services. Black maternal caregivers reported barriers to accessing services at CACs including a lack of assistance and information in the referral and onboarding process, transportation issues, childcare, employment hours, system mistrust, stigma associated with the service system, and outside stressors such as stressors related to parenting. Maternal caregivers also shared suggestions for improving services at CACs including increasing the length, breadth, and clarity of investigations conducted by child protection services and law enforcement (LE) agencies, providing case management services, and having more diverse staff and discussing racial stressors. We conclude by identifying specific barriers to the initiation and engagement in services for Black families, and we provide suggestions for CACs seeking to improve engagement of Black families referred for trauma-related mental health services.

Exploring the Relationships Among Student Outcomes and Case Management Services Delivered by School Social Workers.

PurposeSchool social workers (SSWs) deliver case management (CM) services to connect students to an array of supports that meet their academic and non-academic needs. However, gaps exist in understanding the profiles of students receiving CM services delivered by SSWs, and the relationships between dosage and receipt of CM services and student outcomes.MethodResearchers utilized secondary data from three large middle schools to explore the demographics of students (N = 3,012) receiving CM services and students not receiving CM services. Among students receiving CM services (n = 238), binary and multinomial regression analyses explored relationships among students’ demographic characteristics, dosage of CM services, and non-academic and academic outcomes. Student outcomes were also compared among a demographically matched subsample of 181 students receiving CM services and 181 students not receiving CM services.ResultsStudents receiving CM services were more likely to be at-risk, Hispanic/Latino, and limited English proficiency status than students not receiving CM services. Regression analyses indicated a higher dosage of CM services was associated with higher odds of receiving two or more behavioral referrals and failing 60% or more courses. Moreover, among a demographically matched subsample, students receiving CM services were significantly more likely to have two or more behavioral referrals and fail 60% or more courses than students not receiving CM services.DiscussionOur findings suggest SSWs provide CM services to students with significant academic and behavioral risks. We discuss the implications of our results concerning SSW practice, education, research, and policy.

Community-Based Remediation of Juvenile Competence to Stand Trial: A National Survey

Youth found incompetent to stand trial in U.S. juvenile courts may be ordered to attend Juvenile Competence Remediation Services to assist them in becoming competent to proceed with their case. Representatives from 19 community-based JCRS programs were surveyed about current norms and practices. The results suggest that programs routinely meet some emerging best practices (e.g., dyadic service delivery; developmentally sensitive services), but not others (e.g., providing case management services; services guided by outcome data). The results also reveal a lack of consistency across programs in a variety of areas (e.g., training and experience of providers; educational curricula used by providers).

Comparing the predictive ability of the Revised Minimum Dataset Mortality Risk Index (MMRI-R) with nurses' predictions of mortality among frail older people: a cohort study.

to establish the accuracy of community nurses' predictions of mortality among older people with multiple long-term conditions, to compare these with a mortality rating index and to assess the incremental value of nurses' predictions to the prognostic tool. a prospective cohort study using questionnaires to gather clinical information about patients case managed by community nurses. Nurses estimated likelihood of mortality for each patient on a 5-point rating scale. The dataset was randomly split into derivation and validation cohorts. Cox proportional hazard models were used to estimate risk equations for the Revised Minimum Dataset Mortality Risk Index (MMRI-R) and nurses' predictions of mortality individually and combined. Measures of discrimination and calibration were calculated and compared within the validation cohort. two NHS Trusts in England providing case-management services by nurses for frail older people with multiple long-term conditions. 867 patients on the caseload of 35 case-management nurses. 433 and 434 patients were assigned to the derivation and validation cohorts, respectively. Patients were followed up for 12 months. 249 patients died (28.72%). In the validation cohort, MMRI-R demonstrated good discrimination (Harrell's c-index 0.71) and nurses' predictions similar discrimination (Harrell's c-index 0.70). There was no evidence of superiority in performance of either method individually (P = 0.83) but the MMRI-R and nurses' predictions together were superior to nurses' predictions alone (P = 0.01). patient mortality is associated with higher MMRI-R scores and nurses' predictions of 12-month mortality. The MMRI-R enhanced nurses' predictions and may improve nurses' confidence in initiating anticipatory care interventions.

Predictors of Mental Health Recovery in Homeless Adults with Mental Illness.

For people with mental illness, experiences of homelessness can complicate mental health recovery processes. This study used longitudinal data from a randomized controlled trial of housing first (HF) to examine predictors of recovery among homeless people with mental illness. Findings showed that health and community predictors were most strongly associated with mental health recovery. Receipt of HF did not have any effect on changes in recovery scores at follow-up. Overall, the findings suggest that interventions aimed at preventing chronic homelessness, strengthening social networks and community involvement, and providing case management services will facilitate mental health recovery.

Suboptimal Retention in Care Among Recently Released Prisoners: Implications for Social Workers in HIV Primary Care.

Certain populations of people living with HIV (PLWH) are at greater risk for falling out of care, including PLWH with a history of incarceration. This is associated with increased risk of morbidity and mortality. In the current retrospective cohort study, we examined patient-level information for 340 PLWH who had transferred HIV care services from prison or from other community-based or private HIV primary care providers to a large urban HIV clinic in the southeastern United States. Results indicated that, compared to those transferring care from another community-based or private medical provider, PLWH transferring care from prison were significantly less likely to be retained in care than PLWH transferring care from other providers, even after controlling for other factors. HIV primary care social workers, who are trained to provide case management services, can help provide PLWH with a coordinated continuum of care that addresses the complex issues faced post-release.

HPV Knowledge and Vaccine Initiation Among Mexican-Born Farmworkers in North Carolina.

The human papilloma virus (HPV) vaccine is an effective but underused cancer prevention tool. This study assessed knowledge of HPV and HPV vaccine initiation among Mexican-born farmworkers in North Carolina. Interviewer-administered questionnaires were conducted with 100 Latino farmworkers and 100 nonfarmworker Latino North Carolina residents in 2015 as part of an ongoing community-based participatory research project. Farmworkers had low levels of knowledge about HPV and the HPV vaccine. They had a similar amount of HPV and HPV vaccine knowledge compared to nonfarmworkers. Farmworkers and nonfarmworkers learned about the HPV vaccine from different sources. Adolescent children of farmworkers and nonfarmworkers had low HPV vaccine initiation. However, for children living in the United States with farmworker parents, vaccine initiation was high. To prevent HPV-related cancers and improve health equity, interventions are needed in order to increase HPV education and vaccine initiation among children of Mexican-born farmworkers and nonfarmworkers. Public health programs should look for partners outside the traditional health care setting to reach underserved populations. Other key strategies include promoting catch-up vaccines, improving patient-provider communication, and providing case management services.

Adolescent mental health case management: Provider perspectives

ABSTRACTDue to the inconsistent definitions and varying models of implementation of adolescent mental health case management, the perceptions and experiences of the professionals providing services are invaluable to improving case management and mental health outcomes for adolescents. This qualitative article examines case management as a service for adolescents with mental illness within the context of one Midwestern state. The primary research question was: what are the current experiences of professionals providing case management services to adolescents with mental illness? Through collaboration with community mental health centers, researchers conducted five focus groups with adolescent mental health providers. Focus group participants discussed the challenges they currently experience while providing services to adolescents, and described current case management practices. Participants also provided suggestions for service delivery improvement. Researchers present focus group results and discuss the implications of the results at both a local and national level.

Aetna’s Compassionate Care Program and End-of-Life Decisions

In this article we describe the successes of Aetna's Compassionate Care Program in providing case management services for people with advanced illnesses.

Proyecto Interconexiones : A Pilot Test of a Community-Based Depression Care Program for Latina Violence Survivors

Latina intimate partner violence (IPV) survivors often face great barriers to depression care. We sought to use a community-based participatory research (CBPR) approach to create and evaluate a community-based depression care program for Latina IPV survivors. We created a multifaceted, culturally tailored intervention, based on principles of chronic illness management. A promotora provided case management services and led 12 weekly group sessions. Participants completed surveys at baseline and 6 months and participated in open-ended exit interviews. Ten Spanish-speaking Latina women participated in the intervention. The program had excellent attendance, with 100% of women attending at least 10 group sessions, and high satisfaction. We found a large decrease in depression severity (Patient Health Questionnaire [PHQ]-9, 17.3-7.2; p = .001), as well as improvements in depression self-efficacy, self-esteem, and stress. This study offers promising preliminary data to support the use of community-based approaches to reducing depression disparities in Latina IPV survivors.

The Predictors of Suicidality in Previous Suicide Attempters following Case Management Services

Suicide attempts constitute a serious clinical problem. People who have attempted suicide are at an elevated risk for additional suicide attempts, but there is limited evidence regarding the predictors of suicidality of suicide attempters following case management services. In the present study the indicators of suicidality after case management were examined. A total of 1,056 subjects who had recently attempted suicide were recruited from January 1, 2011, to June 30, 2011. The suicide prevention center of Kaohsiung City in Taiwan provided case management services and followed up on suicide attempt cases for 6months. The salient factors for repeat suicide attempts were estimated using a logistic regression analysis. The results showed that multiple factors, including a "willingness to receive mental health services during a crisis," "social support," "a history of mental disorders," and "a history of suicide," could predict repeat suicide attempts with hazard ratios (0.58, 0.54, 3.84, 1.51) and 95% confidence interval (0.39-0.86, 0.36-0.83, 2.41-6.10, 1.03-2.21). The four factors mentioned above were the most accurate predictors of subsequent suicidality when case management services were utilized after 6months of follow-up. The findings of our study could help clarify future strategies for suicide prevention.

Occupational methamphetamine manufacturing toxin exposure: An exposure example

Purpose To illustrate opportunities for pharmacists as resources for community-based healthcare professionals that may be at-risk for occupational exposure to toxins of illicit methamphetamine (METH) manufacturing while providing case management services to community-based patients. Summary Pharmacists can serve as a resource with education and protocol development for minimizing the hazards of healthcare professionals, including pharmacists, at-risk for exposure to the toxins of METH manufacturing while providing community-based case management. The illicit production of METH requires solvents for extraction and purification and often results in the release of a number of harmful, and potentially deadly, chemicals and gases. For community-based healthcare professionals, risk factors include direct contact and inhalation. Community-based healthcare professionals providing case management services to patients involved in the production of METH are at-risk for exposure. Examples of an occupational exposure and how the pharmacist can serve as a resource to these providers are provided. Conclusions When conducting home- or community-based services, healthcare professionals may inadvertently experience health-related consequences and injuries because of exposure to hazardous wastes created by and used in the production of METH. The pharmacist can provide education and protocol development to help healthcare professionals identify hazards of exposure to the toxins of the manufacturing of METH, identify signs and symptoms of METH use, and identify signs and symptoms of toxin exposure.

Suicide, an Urgent Health Issue in Korea

Suicide, an Urgent Health Issue in Korea

Searching for the Social Work Practice from the Strengths Perspective in the ‘Integrated Case Management’ Services for Children in Poverty

Increasingly many social service settings are implementing ‘integrated case management.’ Especially child welfare is an leading arena where started providing case management services based on family centered and community-based approach in early 2000. The case management services are expanded in other arenas including people with disabilities, families in poverty, and the elderly. While there is yet to be a consensus on what is meant by ‘case management’ in Korea, characteristics of case management is unclear, although the system is known to be taking strengths-perspective and client-centered approach. These issues raise a question regarding what exactly this newly developing system is heading towards in terms of its underlying emphasis on child and family-centered, strengths perspective, and ‘integrated,’; and expects for social workers do both in the service system and in the process of providing mass-services for the children and their family. Thus, this study briefly reviewed theoretical foundation for the children in poverty: social environment where the children and family resides, changes in family functioning and relationships for children and necessary shift of perspectives for the social work practice; and reconceptualization of children as the service user. Then taking the two projects as example, this study outlined the characteristic of the case management services, contents of the services, and role of the case manager, I. e. social worker in the two representative projects, the ‘We Start’ and the ‘Dream Start.’ Then this study examined and discussed characteristics of their perspectives in the two projects, their views of the family and their functioning, the level of strengths perspective, roles of the case manager. Finally this study suggested complementary components for better case management practice for the children in poverty from the strengths perspective.

Enhancing Residential Treatment for Drug Court Participants

In this study, the authors describe and evaluate the impact of increased access to residential treatment added to traditional drug court services in Orange County, California, with a goal of increasing program retention, successful completion, and graduation rates for a high-risk drug offender population participating in drug court between January 2004 and March 2005. Data were gathered from various sources, including the drug court management information system (MIS) and probation records, and the health care agency that provided case management services to drug court participants. The results suggest that increasing the drug court's capacity to adapt treatment for participants in need of a higher level of care was related to positive outcomes. Limitations of this study include the design that is susceptible to uncontrolled influences of extraneous variables such as changes in policy. This research encourages further examination of these variables in alternate settings to determine the extent to which these strong but preliminary results are generalizable.

Delphi-research exploring essential components and preconditions for case management in people with dementia

BackgroundCase management programmes for home-dwelling people with dementia and their informal carers exist in multiple forms and shapes. The aim of this research was to identify the essential components of case management for people with dementia as well as the preconditions for an effective delivery of case management services.MethodThe method used to carry out the research was a modified four-phase Delphi design. First, a list of potentially essential components and preconditions for the provision of case management was drawn up on the basis of a literature review and a subsequent focus group interview. The list was then validated by experts in a first Delphi survey round, following which the researchers translated the list items into 75 statements. In the second Delphi survey, the experts rated the statements; in the third Delphi round, they rated 18 statements on which no consensus had been reached in the second round.ResultsThe experts were able to build consensus on 61 of the 75 statements. Essential components of case management for people with dementia are: information, support and counselling, coordination of the care provided and, to a lesser extent, practical help. A patient-centred approach was found to be one of the key aspects of providing case management services. Essential preconditions are: vision, care relationship, structured methodology, integration of case management into the health care chain, and the case manager's level of training and expertise.ConclusionsWe recommend that, based on the essential components and preconditions referred to above, quality criteria be developed for the provision of case management for people with dementia. Furthermore, we suggest the conduct of additional research to assess the effectiveness of case management in people with dementia.