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Caseload size

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Joined: 24 Oct 2005
Posts: 12

PostPosted: Fri Sep 22, 2006 10:57 am    Post subject: Caseload size Reply with quote

I've been talking to IPMG case managers across the state and in my own area of the state. Most I have spoken to have said they have case loads of 55 or so. One had 60 and another had 70! The underlying factor in these large caseloads is wanting, or needing, the money. (Serving clients effectively is dead last in this equation.) Case management has been reduced to an "entry level" position. In the past it was a "professional level" position--experienced and educated social services people could earn a decent living on the reimbursement rate. If you think that the rate was too high remember that taxes, social security, and paying for our own health insurance came out of that. Now IPMG's average pay for one client per month is $58. Do the math. Case managers have to work at least twice as many cases to get the same amount of money they used to get. That means work days well over 8 hours. The burnout rate will be unbelievable. In fact, in our area, several case managers have ALREADY quit. The shame of it is that Adrienna Shields, a former case manager who now works for the state overseeing all of this, told the case managers at a meeting that "anyone taking on a case load of over 50 clients" must get it approved from her. Her implication at the time (at least how most of us interpreted it) was that she was against case loads over 50 and would limit caseload size. Well, that isn't happening. Adrienna, as a former case manager herself, knows it is not feasible or possible to serve 50, 60, or 70 clients and do a good job. Where is the conscience of the state in this matter? Where is the oversight?
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Joined: 22 Oct 2005
Posts: 45

PostPosted: Sun Sep 24, 2006 9:26 pm    Post subject: Reply with quote

My child's case manager has a case load of 50. I don't know how anyone can get to know that many clients well enough to do as good a job as I know the case managers want to do.

I'm curious--what are all of you seeing as far as case loads?
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Joined: 24 Oct 2005
Posts: 12

PostPosted: Tue Oct 10, 2006 12:09 pm    Post subject: Caseloads and other news Reply with quote

Here is the latest information I've heard from my former clients. Most of them STILL have not chosen permanent case managers. Several guardians tell me that they have called and called the main IPMG office number they were given to interview case managers, and they never get a return call. The choice list in this area has been revised numerous times. This is because several of the case managers on the list have quit already. I'm hearing reports of higher and higher caseload size--now over 60 and 70 for several case managers in this area. Adreinne Shields and the state seem not to be putting limits on caseload size, because they just keep growing.

The most disturbing news I've heard involves reports of how the "annuals" are being held. More and more annuals are becoming overdue in this chaos. One case manager was told to do a TELEPHONE annual with her new client and do a very short person-centered plan over the phone with the guardian. Then she was instructed to fax this little tiny PCP to the case manager responsible for the ISP and that case manager would write the ISP based on the phone interview and the faxed PCP. Basically, neither of these people had actually met the client or guardian in person. In another case, the annual case manager (who is actually a designee, so how can she be allowed to write ISPs?) visited a client for 45 minutes and contrived an ISP with three generic outcomes--activities of daily living, community, and domestic. She never reviewed the old ISP strategies or their progress or asked for any person-centered information that would help her write individualized outcomes for the client. She stated there would be no need for any individualized health and safety goals. She left after 45 minutes. She never spoke to the client during the meeting. She asked for no input from the team on ISP outcomes or strategies. The other (regular) case manager who was present at the meeting never spoke at all.

How is any of this an improved system? How is any of this helping the indivuduals on the waiver to achieve a better, more enriched, life?
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Joined: 10 Oct 2006
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PostPosted: Tue Oct 10, 2006 12:30 pm    Post subject: Reply with quote

I'm hearing things like this, too. My brother's former case manager sent the new agency all of the paperwork and goals and plans, yet the new case manager doesn't have access to any of this. She is basically starting from scratch. Plus she says she can't even get into the computer now to see my brother's information.
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