Monitoring services is yet another key case management duty. The monitoring phase is usually the final phase of the case management process that occurs after you have made the referral (linkage) and coordinated services that are now in place. The monitoring phase, in my opinion, is the easiest (or less difficult) aspects of case management. Monitoring is basically ensuring that services are delivered as specified on the treatment plan and that the client is satisfied with all services. Case managers also monitor for safety and are mandated to report any suspected abuse or neglect. Although case management services may differ slightly depending on the program and state, a monthly contact of some kind is usually required to monitor services (and bill Medicaid of course). There are several methods case managers use to monitor client services and overall progress on treatment goals.
Phone Call: The
basic phone call remains the primary form of contact. Based on my personal caseload,
I would say that about 60% of my monthly contacts are by phone, 30% face to
face contact, and about 10% other (email, text, fax, etc.). Again, this is
based solely on my personal experience.
Face to Face Visits: The
face to face contact is the second most frequent form of contact behind the
phone call. However, constant
revisions in regulations have resulted in an increased emphasis on face to face contact. The face to face contact is probably
the most effective form of monitoring services. Case managers can directly
observe clients at home, work, or day programs and make more accurate
assessments on their progress. Case managers can also observe any physical
changes from the last visit such as grooming, health changes, weight gain/loss,
or signs of illness. The unannounced visit is really the best type of visit if
you want to get the most accurate assessment of client services. However, high
caseloads make it difficult to just “pop in” without verifying that the client
is at the program. Unannounced group home visits are also difficult with
caseloads that can range from 25 to over 50 clients. Time is at a premium and most case managers
cannot afford a wasted visit.
Email: Email is slowly becoming a more accepted
form of contact. The security of email remains a major concern its usage as a
primary form of contact. Emails between the same agency is usually acceptable
but is not recommended outside of the agency unless it is a secured type of
email that requires a separate user name and password.
Letter: Letters
or other written forms of contact are often used as a last resort when other
attempts were unsuccessful. Some case managers send out letters as a courtesy when
there is going to a change in case manager so there client and family can be
informed. Letters are used the least of all forms of contact largely due to postage costs and the time it takes to
deliver the information. It’s much faster to send an email or fax when you want
to send a letter or other form of written communication.
Contact with Family
Case managers are in regular contact with family to ensure
that services are received as agreed on the treatment plan. This is
particularly important if the client is receiving ongoing services in the home
such as skilled nursing or personal attendant care. It’s also important to follow up after other
services have been provided in the home such as environmental modification
(ramps, railings, etc.) or assistive technology (specialized beds, IPads, etc.)
to ensure complete satisfaction.
Contact with Providers
Regular contact with providers is another way that case
managers monitor services. Case managers receive regular updates on progress
and can address any concerns that may arise.
Case managers often monitor progress in day support and vocational
programs through contact with the service provider or the employer. Case
managers also maintain regular contact with residential providers to ensure
that the client is happy with his home and address any concerns or needs.
Reviewing
Documentation
Another form of monitoring services is the reviewing of
provider reports and other documentation. This form of service monitoring is
often forgotten because it doesn’t involve direct contact with the client,
family, or providers. Case managers routinely review quarterly reports,
treatment plans, and incident reports to monitor progress and address any
concerns.
