Effective Case Management:Is there such a thing? Kristen Gray Beach MRC, CRC, CPM Kentucky Office of Vocational Rehabilitation
I come to you on what authority? None that I’m aware of.
Case Management is WHAT???? Case management is a professional practice in which the service recipient is a partner, to the greatest extent possible, in assessing needs, defining desired outcomes, obtaining services, treatments and supports, The focus of the partnership is a process that assists Blah Blah Blah Blah Blah blah blah blah Blah Blah Blah Blah Blah blah blah blah
What does this mean for a Rehabilitation Counselor functioning in a State Agency? We collaborate with our consumers, and partners to achieve goals of employment and independence while adhering to policies and procedures of our organization. (While keeping everyone happy)
Currently it means doing all of these things while… • Being short staffed, statewide vacant positions for counselors, assistants and administrators • Learning and adapting to new agency policies and procedures • Figuring out what practical implementation of new major federal legislation looks like Remember we need to keep everyone Happy!! AND YES, THIS IS A LOT TO DEAL WITH!
Referral • appointment letter • appointment reminder call • be somewhat flexible on appointment days and times Helping the potential applicant be prepared starts the collaborative relationship.
Initial Interview & Application Leave time to do everything • progress note • send releases • enter into CMS • do any referrals needed, call for appointments • Notify the applicant of the 60 day and 90 day timelines. ONLY TOUCH THE CASE ONCE Complete any action before putting it away.
Who is the one friend you should take advantage of? OUTLOOK • Outlook reminders to notify you at 30 and 45 day mark. • At the 30 day mark, notify consumers that they need to assist in getting records (this is 15 days earlier than your “dashboard” notifies you. Again remind the applicant of the 60 & 90 day timelines. • Crystal Report “APPLICATION STATUS” • This is the time to consider an extension.
Eligibilities: if you put them off they congregate and multiply! • 60 days is the magic number! If you don’t have an extension, close the case. • Social Security recipients CANNOT be extended. No records or verification of benefits, the case should be closed. (But should be expedited if records come in) • Complete eligibility immediately upon receipt of records. • Enter into CMS Remember ***ONLY TOUCH THE CASE ONCE***
Once eligible make a decision about what comes next and act on it. You have 90 days to develop and implement the IPE.
Notify the consumer of the next action along with the Agreement of Understanding. You may need to contact the consumer via phone or email to discuss or explain the next step. • Discuss with the consumer the 90 day timeline for IPE. This keeps your consumer informed and active.
Monitoring Progress • Programs to which I refer notify me once they receive a referral of initial appointments, if a consumer fails to show, and if they reschedule or make no contact. • If they do not follow through, I make a phone contact as soon as I’m notified. If I do not reach them, I send a letter asking them to contact me. ***OUTLOOK REMINDER OPPORTUNITY***
Keep a working drawer. Cases that need an action by me do not leave this drawer. If I’m awaiting vocational evaluation reports they do not leave the drawer. If I’m waiting on a consumer to contact me about a decision for training, they do not leave the drawer. If I’m waiting on a medical report to come in they ………… These cases greet me every day!
What’s the plan Stan??? • Implemented in 90 days or have an extension. **OUTLOOK OPPORTUNITY** set a reminder for 45 days. Send extension letter at this point if needed. Crystal Report” ACCEPTED STATUS 75 DAYS” • Schedule appointment immediately (if eligible) upon receipt of vocational assessment( this is where building time in your weekly schedule for quick appointments. helps). Remind consumer of 90 day timeline. • Allow time for discussion and career exploration at this appointment. Would be a good time to involve job placement staff to discuss labor market trends, and available jobs in the area.
If you need to reconvene, adhere to a timeline. Don’t leave it open ended. ****OUTLOOK OPPORTUNITY***** • You might need an extension • Remind Consumer of 90 day timeline.
If you are able to develop the plan leave time to do everything • IPE note • CMS entries • Referrals for services. Remember…. **ONLY TOUCH THE CASE ONCE**
PLAN STATUS IS NOT NEVER NEVERLAND…… • Initiated services usually generate reports that keep us informed of the person’s forward movement toward reaching their goal. • At minimum there must be an annual review. This is where touching each case by filing or running a case list regularly will remind you of who you haven’t seen.
Handling Detours to Never Land • This is up to you. Since we’ve gotten this far, my approach is to try to get them back in our doors, figure out why they didn’t move on and salvage the work that has been accomplished. • If not I make three attempts at contact the final one being notification of case closure by a specific date if there has been no contact. • Consider doing a Wage Check
!!Crystal Reports Can Help • Run case list every 2 weeks at minimum**OUTLOOK OPPORTUNITY** • Helps make sure consumers are in the correct status, and can help you know where your focus should be in prioritizing your work.
NOT SURE WHERE TO START? 60 days, 90 days, progress notes, annual reviews, closures, vendors, consumers,eligibilities,medical records,psychologicals, vocational evaluations, case reviews, authorizations, applications, initial interviews, referralspotentially eligible students, PreEts, WIOA, 60 days, 90 days, progress notes, annual reviews, closures, vendors, consumers,eligibilities,medical records,psychologicals, vocational evaluations, case reviews, authorizations, applications, initial interviews, referralspotentially eligible students, PreEts, WIOA, 60 days, 90 days, progress notes, annual reviews, closures, vendors, consumers,eligibilities,medical records,psychologicals, vocational evaluations, case reviews, authorizations, applications, initial interviews, referralspotentially eligible students, PreEts, WIOA, 60 days, 90 days, progress notes, annual reviews, closures, vendors, consumers,eligibilities,medical records,psychologicals, vocational evaluations, case reviews, authorizations, applications, initial interviews, referralspotentially eligible students, PreEts, WIOA, 60 days, 90 days, progress notes, annual
You might try this… • Take a first look at those in IPE Implemented status, do they need authorizations for services or other contact from the counselor to keep moving forward? • Then move to those who are eligible who need to have IPE’s written • Next comes those who are applicants who are waiting on eligibility determination • Potentially eligible • New referrals
Crystal Report “Annual Periodic Review” to remind you of annual reviews due by month • No contact at the time of annual review, send a letter or make a call the same day. • Set aside time each month for annual reviews If you haven’t had contact at the time of the annual review send a letter, or make a call the same day. **OUTLOOK OPPORTUNITY**
Kristen’s Top 7 • Do your own filing. By filing you touch nearly every case. Filing an authorization in Mr. Jones case might remind you that you haven’t heard from Mrs. Jensen and need to follow up. • Answer the phone when it rings, other than when you are with consumers or during your P.U. time. This will prevent playing the game of phone tag. • Use a phone log when checking messages, check or highlight when you’ve completed action required on your part.
P. U. Time- PLANNED UNAVAILABILITY Two hours per week when you don’t answer your phone, check email, schedule consumers, see drop by consumers, chat about the latest episode of Game of Thrones, The UK Wildcats, the latest fashion trends or your love hate relationship with WIOA. DO CASEWORK- things that get lovingly ignored because of the above. Do the work that is the evidence of all of your hard work.
Quarterly closeout- Get bills, reports, cancel authorizations that have expired or the consumer didn’t follow through with the service. • Look at cases that you can close successful before your interim review. ***OUTLOOK OPPORTUNITY***
Let’s hear from you …. • Tricks of the trade, what you have found that works well • Questions, comments, tear drops, aggravations, love stories…..
All that being said….. Never choose paper over people!!! It’s a necessary evil of the job we love.
Thank You for your Attention Kristen Gray Beach MRC, CRC, CPM 333 Waller Ave. Ste. 180 Lexington, KY 40504 Phone: 859-246-2185 Fax: 859-246-2545 KristenG.Beach@ky.gov