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June 9, 2015

Case Management: Finding Community Activities


One of the major challenges of being a case manager is helping clients find activities in the community. The lack of funding is often the root of the challenge. Limited waiver funds make it difficult to find day activities once special needs students have aged out and/or graduated from high school. The most common options that I have found seem to be day support programs, pre-vocational programs, supported employment, competitive employment, and volunteering.

Day Support Programs
Day programs offer activities for adults with special needs and mental health challenges. Mental health related programs are often referred to as “Psycho-Social” Day Programs. 


Day programs are focused on socialization and social integration. They also assist with developing independent living skills. Day support programs are often center-based but go out into the community several times per week. There are also some community –based day support programs that spend just about the entire day in the community. Some day programs also prepare clients for the transition to work.  In many states, some form of Medicaid funding is needed to attend day support programs. Home and Community -Based Waiver Funding is one of the primary funding sources for day support services.

Prevocational Programs
Prevocational programs are programs that serve as an instruction to the work world. They are often in sheltered workshops and supervised and assisted by support staff. These workshops often contract with companies to package and produce items. Some of the tasks include assembling boxes as well as cleaning and packaging remote controls. They often earn a “piece rate” for their performance. The money earned is typically not enough to impact SSI or other income based benefits. Funding for this type of program can be obtained from Medicaid waiver or funding from the Department of Rehabilitation Services.  

Supported Employment
Supported employment is a step up from prevocational placement. Supported employment is often an hourly position and there is the potential to earn significantly more than a prevocational program. Employed are monitored, trained and supported by staff who are equipped to work with the special needs population. These positions may be individual jobs positions or work groups also known as enclaves. Medicaid Waiver funding is often the primary funding sources for supported employment services. Local department of rehabilitation services also provide funding for supported employment.

Competitive Employment
Competitive employment provides the opportunity for adults with special needs to work in a normal environment with other employees. These opportunities are often available in retail, grocery, and food service industries. The employee may have a job coach to follow along and just check up on them as needed. A job coach can also assist with any accommodations or other concerns that may occur on the job. These services are also funded by department of rehabilitation services. Competitive employment opportunities often hourly wages at or above minimum wage and could have an impact on SSI benefits. Consult a local Social Security Administration office for more information on any impact that increased wages may have on benefits.  
  
Volunteering
Volunteering is an excellent opportunity to provide socialization and community integration. Many animal shelters, churches, and small agencies welcome volunteers with special needs. The best part about volunteering is that there is little to no cost. Volunteering provides a sense of pride and acceptance in the community.  

It’s important for the case manager to complete a detail assessment of the individual’s needs and desires to determine the appropriate options. The case manager should also provide a list of service providers and allow the family/individual to make an informed decision. 

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