February 11, 2016

Case Management: Is 40 Hours Enough?



One of the biggest challenges a case manager faces is time management. There is so much to get done and so little time. In many situations, quality is sacrificed just to get the work done in such tight deadlines. Phone contacts, daily progress notes, scheduling meetings, and addressing the occasional crisis can wipe out an entire day before you know it. Many agencies can’t (or won’t) pay overtime to complete these tasks. So how in the world do you get all of this work done and maintain quality when overtime is not an option?  This is one of the major challenges facing many case management departments, especially in public sector agencies. 

Many case managers and social workers take work home when they know they know it may be against the agency policies. It’s a choice between getting the work done and breaking policy or not getting the work done and face even worse consequences in addition to being further behind on paperwork. A case manager can easily spend an entire work day doing home visits. One crisis can actually take several days to resolve which leaves no time left to actually document what you did. Of course everyone in the human services field has heard the phrase “If it’s not written, it didn’t happen”. It often takes time to recover from handling a crisis but you have to find the time to complete basic tasks required by the agency. These required tasks such as progress notes, quarterly reports, and treatment plans are usually tied to funding and have to be done by specified timelines. There are some solutions that seem pretty simple but can be difficult to implement due to budget constraints and limited staffing. I have listed a few ideas that can help lighten the load. However, these ideas are much easier said than done.
                                                                
Increasing Staff
Hiring new staff can help with reducing the work load of the current case managers. More staff includes not only case managers, but administrative staff as well. Administrative staff can assist with filing and other documentation so that case managers can focus on providing services to their clients.  Increasing staff will also allow the agency to provide services to more consumers and increase revenue. However, the cost of hiring and training staff will have to be taken into account and ultimately absorbed before producing more revenue.

Reduce Caseloads
Increasing case management staff will provide an opportunity to reduce caseloads. High caseloads are probably the second most complained about issue behind excessive paperwork. A manageable caseload would help with getting things done and getting it done with better quality. I can tell you a caseload of 25 beats 35 any day. Most full time case managers in public agencies average well over 30 cases. Again, a major stumbling block with reducing caseload is the cost to bring in new staff to take on cases. New positions often need to be approved by city council or other governing body for the fiscal year.  Another issue is wait lists. Caseloads may be reduced but the relief could be short lived due to the demand for services. In many states, case management is a mandated service to the community. 

Flex/Comp Time
Flex time is often used to offset when workers have to work outside of normal work hours. An example would be an emergency that comes up at 4:45PM and it can’t be resolved until 6:00. The employee would then be able to either come in an hour later or leave or leave and hour earlier the next day or another day in the near future.
Comp time is often considered when there is a significant deviation from the normal work schedule. In some situations such as emergency shelter duty or special projects, comp time is offered in lieu of overtime pay.  Like flex time, comp time can be taken off to make up for the extra work time. The problem with these options is that the case managers often can’t afford to take the time off and get further behind on their work. This is especially the case when comp time that is more than eight hours.

Teleworking
Teleworking  is also an option that can help case managers get work done without the distractions that may come with working in the office setting. Teleworking a couple of days a week can provide an opportunity to dedicate time to completing paperwork.

I have seen each one of these suggestions implemented in an effort to alleviate some of the workload on case managers. The reality is that the nature of the job makes it difficult to complete everything in a normal work week. Taking work home and working a more flexible schedule is the only way to get it done. The old 9 to -5 schedule is too restrictive in this age of increased responsibility and the mobile technology available to help make the job easier.