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June 26, 2015

When Should I Get a Case Manager?

Many of my posts come directly from questions I receive every day from parents who have a special needs child, family member, or friend who is in need of support services. One of the questions have been getting recently is “When should I get a case manager?” I’ve heard parents say they have been told that their child didn’t need a case manager until they graduate from high school. Of course, this couldn’t be further from the truth. Some feel that they should get case management soon after an official diagnosis. I tend to agree with the latter. Obtaining support early is critical to getting the adequate care. This is especially true in cash strapped states where mental health and developmental services are limited.
Early intervention services may play a significant role in improving child development. In addition, the case manager can link the family to therapy services and resources outside of the school setting. I would suggest case management services or some kind of service coordination for any child diagnosed with autism or developmental delay. Case management services can also come in the form of private agencies that can also provide linkage to community resources. There are also many private advocacy agencies that can also help assist with finding services.

Mental health case management services are also critical in the early stages of life. Children diagnosed with Oppositional Defiant Disorder, Attention Deficit Hyperactivity Disorder (ADHD), or Depression need case management services to be linked to the appropriate counseling and/or medication management services.

Intellectual disability case management usually provides case management services for individuals who are age six and older in most states. An updated psychological evaluation is needed to determine the level of intellectual disability. Depending on the level of disability and need, active case management may be needed to provide linkage to community resources. Parents usually feel that they can manage the situation while the child is young and in school most of the day. However, becoming familiar with the disability system early can make the transition easier when the child is an adult and needs residential and/or day support services. My suggestion is to request case management services as early as possible. In relatively stable situations, the case manager may only be monitoring for several years while the child is in school. It may not seem necessary at the time but those last 2-3 years of school can creep up fast and having a case manager already in place is critical to the transition to adult services.


Benefits of Case Management Services
The benefits of getting case management services established early provides an opportunity to get linked to services and benefits earlier in life. Early intervention has proven to help in the overall development and opens the door for more services. A case manager can provide additional resources in addition to resources available through the school system. Case management can also assist with placement on wait lists for services. Depending on the state, early placement can be critical to getting adult services in place at the appropriate time.


In my work as a case manager I have seen people come in their 40’s and 50’s who have never had any services after high school. I find this difficult to believe that someone could go through school from age 5 to 22 in some cases and never get referred for case management or at least be informed of services that may be available beyond school. Unfortunately, we only see these individuals when a parent or primary caregiver dies or is no longer able to provide adequate care. There is usually some sort of crisis situation that brings them into our services in this situation. This makes it extremely difficult to address a major crisis when the individual has never been in the system. Services may be delayed due to the amount of documentation required to open a new case. Limited service history also makes it more difficult to complete social history information and develop thorough assessments.


My final recommendation is to seek case management services as early as possible. Even if the need is not urgent right now, having case management services in place can make the transition to adult services much easier. Case management services implemented early can ensure placement on statewide waiting lists for services that may be needed later in life such as housing, vocational services, day support, etc. Case management services can also help with obtaining other benefits such as Medicaid and SSI as well as other unknown or unexplored resources. Why wait until a crisis to seek help? Prevention by setting up services early can go a long way in ensuring the best outcomes in the future.

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