Case Management Services

1. Case Management Services A Snapshot in Time November 18, 2004

2. Case Management Services • What is Case Management? • Addressing the needs of our patients • Social Services • Subsistence Issues • Access to Assistance Programs • Other Individual Needs

3. Case Management Services • Current Status: • A Loosely coordinated group of social service functions partly funded by 4C’s and partly from the recently ended CAP grant. • Two staff members, one who directs activities and supervises other programs and one Case Manager.

4. Case Management Services • Case Management Supervisor Jean Chipman, LSW • Supervise Patient Assistance Program • Supervise Case Manager • Perform Case Management duties

5. Case Management Services Case Manager, Alice Trevino • Approximately two-thirds of the Case Manager’s time is spent with chronic disease patient referrals from Mainland Center Hospital and UTMB. • One-third assisting 4C’s patients with social needs and problems.

6. Case Management Services • ER referrals Feb-July 2004 • Mainland Center UTMB • Referred 357 Referred 800 • Contacted 298 Contacted 600 • Appt Made 114 Appt Made 113 • Appt Kept 102 Appt. Kept 104

7. Case Management Services • Other Referrals: • Jesse Tree 47 • Recovery Ctr. 10 • Rx. 173 • Social Problems 143 • Diabetic DNKA follow ups: 72

8. Case Management Services Current 4C’s activities • 79 4C’s patients seen on a recurring basis • 148 Episodic interventions • 19 referrals to other social service agencies

9. Case Management Services • Budget Figures: • Total Budget: $91230 • CAP Funding: 36039 (40%) • 4C’s Funding: 55191 (60%) (Funding includes salaries for 2 FTE’s, benefits, operating supplies, and travel)

10. Case Management Services • Future Goals of Program • Seek shared funding to cover two-thirds of Case Manager time devoted to dealing with hospital referrals. • Develop direct Provider to Case Manager referrals to address social needs of 4C’s patients.

11. Case Management Services • Future Goals of Program (Cont’d) • Provide onsite Case Management support for dealing with patient acute social problems. • Use Case Management as liaison between 4C’s and other Social Services Organizations. • Utilize Case Managers to identify and facilitate enrollment of 4C’s patients in Medicare, Medicaid and other third party programs where eligible.

12. Case Management Services • Future Goals of Program (Cont’d) • Coordinate with support services to assist patients in navigating the 4C’s system. • Develop detailed data capture system to identify needs and activities that most benefit patients. • Focus on the Priority Populations as identified in the 4C’s Competitive Renewal Grant Application

13. Priority Populations in 4C’s Grant • Underserved Seniors • Women seeking family planning • Counseling for mental health conditions & substance abuse • Prenatal and pediatric care • Managing chronic conditions • Preventing communicable diseases • Homeless • Uninsured small business employees • Persons needing acute care • Dental care for children

14. Case Management Services Questions?