Case management is more of a function than a position. Textbooks recognize case management as a new paradigm of practice in the human services. It is founded in concepts of social work, however, to be a case manager is not the same as to be a social worker. More on this point later.
A new clientele is driving the case management paradigm, persons presenting with severe and chronic vulnerabilities. Since chronic illnesses are not necessarily curable, the goal of case management is to enable these individuals to live quality life within their communities. The two key strategies in case management are enhancement and prevention. Enhancement includes enrichment programs whereas prevention includes programs to avoid repeat exposure to adverse circumstances.
Case Management Society of America defines case management as, “A collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive needs through communication and available resources, to promote quality, cost effective outcomes."
Case management is community based and involves long term commitment, longitudinal as well as cross-sectional services whose focus is supportive and skill development in direct practice.
The relationship between case manager and client is one of trust and empowering to encourage client’s use of services along a care continuum with the goal of restoring and maintaining a client’s independent functioning to the fullest extent possible.
Intervention objectives are at three levels: client, social support systems, and agency. A key objective is connecting the client to community support systems and assuring services. Case management provides continuing care and client stability at a reasonable albeit impaired level of living. Success is measured by the distance clients are elevated and prevented from completely failing to function. One author notes that clients can sink to a dire and grievous low if not buttressed.
Three kinds of people come through the shelter. Passers-by who needed shelter for the night on their way to some other place. Some people passing through the city can not afford the hotel or Inn, they come to the shelter to ask for a bed for the night.
There are individuals coming into the city to start a new life. These individuals are looking for a long term solution totheir situation. Among them are individuals who have lost everything they owned and have become homeless. Others are victims of family crisis. A significant number among them have experienced conflict with their spouses and were forced to leave.
Finally there are individuals who have a rather complicated story for their homelessness. Mental illness contribues to this category. These individuals may not have any specific plan at all. In fact many of them are holding on to dear life having lost hope.
Start of a day
The day in my office starts with the reading of God's Word -the Bible-, and a prayer for divine help. Thereafter I review the shelter log. I learn about the people who stayed overnight in the shelter and any issues affecting them. I take note of any new people listed and whether or not they want to see me. The general rule is for every new client to see the case manager in the morning. The purpose of the first meeting is to establish contact with the case manager. This is a very important meeting. There are some who prefer not to see the case manager; t hey are entitled to their wishes.
End of a day
Before the day comes to an ends I have reviewed each of the clients coming to stay in the shelter and written instructions for each to follow based on our contact meeting earlier in the day. My day ends when I hand over the pink box containing instructions for the clients and move on with other tasks of the day.
The nature of case management
Maturity, common sense, and conceptual knowledge and skill in case management are required. You are dealing with some personal issues and problems; coworkers have issues of their own, and every client has a set of issues and problems they present to you. No two cases are the same. The complexity of some cases is truly baffling.
Armed with grace however, nothing is too hard because you have an extra set of glasses to see with.
To fully understand my work and how I approach it, it is important to explain what is important to me. My relationship with the LORD Jesus is number one, then my wife and children, and finally, the organization employing my services. My relationship with God is the North of my compass. I am commanded to do to others as I would have them do to me; and to always ask, WWJD? What would Jesus do in this situation? What would He say to this person? How would He handle this matter?
My work is essenstially one of giving hope. I always ask myself, do clients see hope or despair when they deal with me? Do they feel pushed and cornered by things I do?
Concerning shelter monitors working with me; do they see Christ in me? Are my actions consistent with those of a believer in the Lordship of Jesus Christ? Do I make rushed decisions? Do I make emotional decisions? Do I reverse decisions that are wrong or doI insist in my own ways?
Case management is about God and His people. To be a case manager is to work as a hope giver, pointing people to a greater hope. Personal, professional, and organization ethics are important and the law of the state too. The longer one works in this field the more one is exposed to human tragedy, raw pain, and human suffering. It helps to see case management as team work with others in the field and with the LORD Jesus. He said, we shall always have the poor among us. He also said, come to me all you who labor and are heavy laden and I will give you rest (Mat 11:28).
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