providers in the five states engaged in varying levels of case management in conjunction with providing crisis intervention, counseling services, and/or information and referral. One provider described the broad role of the case manager by saying, families need a relationship with someone who knows a lot about adoption, a lot about the issues of loss and separation, some basic counseling and social worker skills, who can make appropriate referrals.
All of the states used client-tracking systems to assist staff in case management activities. Events that were tracked included incoming referrals, case openings, service use, and case status.
Case management was most formal in Texas, where PAS providers billed the state for reimbursement. Case managers were required to develop service plans that the families and state liaison approved. Providers stipulated what services were needed in the plan and then submitted an authorization form to the state, which served as a basis for reimbursement of those services. Every six months (sooner if residential treatment was provided) a state liaison reviewed the service plan.
|The sophistication of care management systems varied widely, from spreadsheets to a Web-based system.|
In the other four states, program staff documented their activities in spreadsheet or Web-based programs. In Massachusetts, a Web-based case management system was developed that all service providers could access.
PAS providers in four of the five case-study states admitted having had difficulties adjusting to more formal case management requirements, particularly in the early stages of implementation. However, they said that they had come to appreciate the ability to monitor cases and produce service statistics.