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May 1, 2016

Case Management: The Annual Meeting



The annual meeting is often a required component of case management. Most treatment plans are only valid for one year and are required to be renewed annually to continue services (and funding). Most  Intellectual Disability (ID) waiver services  also require authorization on an annual basis. The annual meeting is a great time to get the entire support team together and review progress and discuss any changes that  need to be made. The support team often consists of the parents/family/guardians as well as residential, day support/vocational, and therapeutic consultation providers (if applicable). The annual meeting can last anywhere from 1-3 hours depending on how many providers are involved and the type of issues that need to be addressed.  I outlined the order of a typical annual meeting for ID and Mental Health case management services.

Annual Documentation
While not the most exciting part of the meeting, signing annual  documentation  is an important part of maintaining accurate records. It’s also the most time consuming portion of the meeting. After the meeting (and sometimes before the meeting) even more  assessments require and annual update. The primary forms of documentation signed annually are:
Meeting Signature Page- Everyone in attendance signs this page. It verifies that a meeting was held and that the support team was present. It also verifies that the person receiving services was present and a part of the planning process.
Release of Information Authorizations- Release of information forms or consent forms are signed to allow the case manager to communicate information to other providers. These forms are important because the information exchanged often contains sensitive medical and personal material and is protected under  HIPPA laws.
Provider Choice Forms- This form ensures that the clients are able to make informed decisions. They verify that they were given a choice in service and service provider.
Program Rules (If Applicable) - Some service programs require a form to be signed each year so that they are aware of what behaviors are acceptable and what behaviors may lead to suspension or discharge from the program.       
Consent for Photos/Videos (If Applicable) - Some service providers may post pictures and videos on their websites and/or social media pages. It’s important to have this form signed to ensure privacy.

Review of Human Rights
Review of the human rights is an important part of the annual meeting. The case manager ensures that the client and/or authorized representative or guardian understand their rights and are provided a hard copy for their records. The general list of human rights includes:
1 - Right to be notified of their human rights. This is required on an annual basis but can (and should) be provided anytime it is requested.
2 – Right to treatment regardless of race, sex, religion, or ability to pay.
3 – Right to confidentiality. Information cannot be disclosed to other service providers without permission in the form of a signed consent form. There are some exceptions in emergency situations.
4 – Right to Consent.  Some treatments may not be administered unless informed consent is provided. This usually involves serious medical procedures and not typically applicable to case management services.
5 – Right to dignity. Everyone has to the right to be treated with respect. This also includes being protected from abuse and exploitation.
6 – Right to least restrictive treatment. Restriction of freedom is always the last resort with the exception of emergency situations. The goal is always to find alternatives that integrate the individual into his or community as much as possible.
7 – Right to be compensated for work.
8 – Legal Rights. Individuals retain the basic rights of any other citizen such as the right to vote, get married, etc.
9 – Right to Appeals and Hearings. Individuals have the right to appeal any decisions that impact their services and benefits.
10 – Right to receive assistance from local and regional human rights advocate. In situations that cannot be resolved at the agency level, a regional advocate may be called to intervene and assist with resolving the complaint.

Health and Safety
Part of the meeting involves discussing any changes in health status and medications. Updated information on the last physical and dental appointments is also obtained at this time. A copy of the most recent physical is often obtained at or soon after the meeting as well as an updated list of medications.  

Review Goals and Objectives
The review of the treatment plan goals and objectives, in my opinion, is the most important part of the meeting. After all, the review and renewal of the plan is the reason for the meeting. Each goal is discussed as a team and removed or adjusted. Most goals that include monitoring of health and safety are usually required and are never removed. New goals are added if the client wants to achieve something new or additional service needs are identified.


Progress/Lack of Progress
Goals that have been achieved are often changed or adjusted. For example, a client who has a goal of obtaining employment may have that goal adjusted to maintaining his/her employment. On the other hand, goals may be deleted if they have been on the plan for several years and there has been no progress. It’s a good chance that particular goal is unrealistic and should be adjusted to something more attainable.

Satisfaction with Services
Of course last but not least, the case manager wants to ensure that the individual, family, and/or legal guardian is satisfied with all services. There should be at a minimum a proposed plan to address any unresolved issues moving forward for the upcoming plan year.


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