November 12 2003
KACL Case Management Policy Analysis
Paper
Practice Functions of Case Managers
Development of the Client Service
and Support Plan (Memorandum of Understanding)
Considerations in Advanced Case
Management
Direct Service Roles of Case
Managers
The purpose
of this paper is to review the role of Case Manager within KACL.
At least
since the early 1980s KACL has had “case managers” whether such were called
“case manager”, “key counsellor”, personal planners etc. In the early 2000s the
Provincial government commenced to fund a number of ‘case mangers” which KACL
and its clients have had to contend[1]. The use of the term has caused some confusion
and
For the
purposes of this paper, Case Management is defined as a designated person (or
team who organizes, coordinates, and sustains a network of formal and informal
supports and activities designed to optimize the functioning and well-being of
people served by KACL.[2][3]
Through
activities the case manager seeks to accomplish the following goals
For systems
assessment is the process by which the case manager and the client cooperate in
the collection, analysis, prioritization, and synthesis of information
concerning the identified needs of the client (Hepworth & Larsen 1982)[8][9]. In community living assessment is the process
by which the assists a client, secondary clients and possibly social network to
collect, analyze, prioritize and synthesize information concerning a client’s
dreams desires and aspirations and environment in order to assist the consumer
succeed in achieving them.
The
assessment process attempts to achieve the following:
Systems
need needs and deficiencies to justify their existence. Community living is about pursuing dreams,
desires and aspirations. KACL’s planning
commences with a thorough grounding in the consumer’s dreams, desires and
aspirations. . Since strengths often
follow desires, identification of strengths often suggest leads in determining dreams,
desires and aspirations. However it is dreams, desires and aspirations that
must remain in focus.
The gap
between the dreams, the resources necessary to achieve them and the existing
situation and resources provide the context for the programs of the
Association. The client’s knowledge,
skills and attitudes are the resources that the consumer can use to assist him
or herself to achieve his or her dreams desires and aspirations
Parents, Siblings, other relatives and close friends of the primary
client are people too who have their own dreams, desires and aspirations both
for themselves as well as for the primary client. Sometimes such dreams, desires and aspirations
are in conflict with those of the primary consumer and provide further
obstacles to the primary client. However
such dreams desires and aspirations of secondary clients provide the vision that
can propel the client to growth and development.
So often
assessments concentrate on needs and deficiencies that new KACL staff must be
reminded to focus on wants and resources.
“You musty be realistic” often means “You must accept by limited
perspective of what is possible. A
proper assessment of capacity determines what gap in resources might be
decreased by training, growth and development.
If capacities are lacking than alternative ways must be found to assist
the consumer achieve his dreams
Again the
capacity of the client’s support network provides the assessment as to what might
be accomplished by working with such group to assist the consumer achieve his
dreams, desires and aspirations. If
capacity is severely limited it may be that extensive effort must be spent to
develop it. Marsha Forrest’s comment: The lack of relationships is the only
disability.
The human
service system may have some assets that can be employed to assist the
consumer. Such assets may become
liabilities if they are used to create dependencies. There mere existence of such assets may create
problems. Staff must always be aware of
such dangers to ensure that in total the Association produces and maximize the consumer’s
opportunities.
Autonomous
source of Income
Housing/shelter
Employment/Vocational
Health Care
Social and
Interpersonal
Recreation
and Leisure
Activities
of daily living
1.
preparing
nutritious meals
2.
bathing
3.
dressing
4.
maintain
household
Transportation
Legal
Education
Five
Characteristic:
Intervention directly with client as a means of enhancing skills and
capacities for self-care
Six Direct Service Roles
Six Indirect Service functions (indirectly with systems impinging on
client)
Evaluation of service plan effectiveness and its
impact on client functioning, on social network’s capacity to support client,
and on capacity of human service professional to work with client (and similar
clients
Appendix A
KACL
The goal of
KACL is to ensure that all persons with special needs have the opportunity to
live a meaningful and satisfying lifestyle and interact as an equal in their
community by providing continuing opportunities for personal growth through
education, training, support, advocacy and an informed public.
Appendix B
Issues
Case
Managers Load
Appendix C
Reference
Moxley,
David P (1989) the Practice of Case Management,
Raiff,
Norma Radol and
[1] In general KACL’s experience with such case managers have been negative. Such external case managers have served to add an additional layer of bureaucracy with adding any substantial benefit to KACL’s clients. Case management as imposed by government has generally been regarded as an approach to societal resource management that in the local Kenora context might be better described as a societal resource mismanagement
[2] Moxley 1989, Page 17
[3] A broker model of case manager is about knowing everything – doing nothing.
[4] Client in this case involves both primary client and those who care about his goals and needs being achieved
[5] Moxley 1989, Page 17
[6] The primary client is generally regarded as the individual with the disability or concern served by KACL. The secondary client is the person or person who immediately surrounds the consumer and who plays a significant role in the client’s life and supports. This generally includes parent and siblings but may also include foster parents, life sharers and significant others. Social network in different contexts may include secondary clients and others in the client’s environment such as friends, acquaintances and others who play a less direct role in the client’s life
[7] Moxley 1989
[8] Moxley 1989, Page 26
[9] John McKnight: Only systems need needs – KACL is about community living
[10] Elsewhere knowledge may be referred to as cognitive domain, skills may be referred to as psychomotor domain and attitudes as affective domain.
[JR1]What do we currently call our plans Goals and
Roles?