Case Management Changes: What Can You Expect?
Case management may be one of the most-used and least-understood services offered to HIV+ individuals living in the Atlanta area. This year, a task force convened by the Ryan White Title I Metropolitan Planning Council of the Atlanta Eligible Metropolitan Area and comprising AID Atlanta staff members, HIV+ community leaders, other case management agencies and agencies providing medical services decided to sit down and talk case management. The goal of these discussions was to clarify misconceptions about case management, to improve access to case management services to the most needy individuals and to focus case management on the business of promoting healthcare. As a result of these conversations, a Standard of Care for case management services has been created and adopted by the primary funder of case management services in the Atlanta area, the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, to be implemented by March 1, 2004. These standards mark a change in the services that HIV+ individuals can expect from their case manager.
First and foremost, the task force decided to implement a new model of case management services that incorporates the Behavioral Change model. This new model focuses on helping clients to improve their access and adherence in medical care. In the past, the case manager acted primarily as an information center, allowing clients to access the resources they need when a crisis arises. In this new model, the case manager works with the client to avert the crisis in the first place. By teaching the client how to find resources on their own and how to problem-solve, the goal of case management becomes one of self-sufficiency, with the client eventually "graduating" from case management. Each client will be asked to work with the case manager to decide which areas need to be worked on and the best way to achieve goals in those areas.
As case management agencies implement this behavioral change model, many clients currently using case management services may no longer need services. Many clients already have the skills and resources necessary to be self-sufficient, but need help every once in a while finding additional resources. Each client will work with a case manager to determine his/her level of need by working on a "treatment plan." The treatment plan includes an assessment of the each individuals situation, problem areas, personal resources, support network and ability to solve problems with minimal guidance. The information gathered during the treatment plan allows the case manager to "level" each client into one of four levels. Levels 1 and 2 are considered low need, while levels 3 and 4 are considered high need. Although level 1 and 2 individuals will still be given assistance locating additional resources, they will no longer be eligible for long-term case management services. Over the next several months, clients of case management services who fall into these low need levels will be graduating from case management with lists of phone numbers, additional resources to contact for help and information on how to get back into case management services should their situations change. Additionally, clients of any level can access peer counselors at AIDS Survival Project at (404) 874-7926 for assistance in locating community resources.
Finally, since the goal of case management services is to promote access to healthcare, the task force decided to mandate participation in primary care services as a requirement of case management services. In order to be eligible for case management, each individual must attend at least one visit with a medical provider every six months. Clients can register for case management services without a medical provider, but will be required to get into care within the first six months of enrollment in services.
Starting next year, several trainings will be held to ensure that clients of HIV case management agencies and other interested parties have access to information about case management and about other community resources. Keep a lookout at AIDS Survival Project for future training dates. In the meantime, if you have any questions about case management, about your services or about resources, please do not hesitate to contact the Georgia AIDS Information Line at 1-800-551-2728 or an on-call case manager at AID Atlanta at (404) 870-7800.
Amy Richter is Client Services Supervisor at AID Atlanta, Inc.
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This article was provided by AIDS Survival Project. It is a part of the publication Survival News.