Case Management/assistive technology

The most appropriate view of the counselor‐client relationship in terms of case management may be summed up with the term

"co-management," This model emphasizes a team approach with the client playing an active role in processing information and making decisions.

time allocations as a VR counselor

-Intake Interview: 1 hour per interview -Counseling and Planning: 1 to 2 hours per client -Arranging, Coordinating, and Purchasing Services: 30 minutes per client -Placement and Follow-Up Services: 1/2 to 1 hour per month, per client -Monitoring and Problem Solving: 1 hour per day -Business Management: 3+ hours per week; in addition, 15 minutes per client or community service provider contact.

case notes should NOT include:

-Unnecessary personal details that have no bearing on the client's needs or situation -Gossip -"Venting" of your own or others' feelings -Information that may be incriminating of you or your agency...but no lies -Your own personal view on topics such as religion or politics.

leadership theories

1) Trait: The focus of this theory is on the type of person that makes a good leader. Trait theory assumes certain types of people make good leaders and they naturally rise above those who do not make good leaders—they innately possess particular traits suited for leadership. 2) Behavioral: The focus of this theory is on how good leadership acts. They choose behavioral styles best suited to accomplishing the goals they set forth for their followership (e.g. autocratic, democratic, transactional). 3) Contingency: The focus of this theory is on the situational nature of leadership. Leaders depend less on a certain style of leadership than on shifting styles as circumstances dictate a need for change. 4) Power & Influence: The focus of this theory is on the source of leadership's authority. A leader utilizes differing means toward the exercise of power and exerting influence to accomplish goals.

In providing case management services within the state‐federal VR process, counselors typically use the following approach to case management/functions of the rehab counselor:

1. Intake Interviewing - The information collection and dissemination tasks associated with initiating the client into the rehabilitation process 2. Counseling and Rehabilitation Planning - The identification of medical, psychological, and/or vocational evaluations; the processing of information with the client; and the joint determination of the major rehabilitation goal, intermediate goals, and the goal attainment assessment plan. 3. Arranging, Coordinating, and/or Purchasing Rehabilitation Services - Tasks through which the rehabilitation plan is implemented, including services such as training, physical restoration, transportation, and housing. 4. Placement and Follow‐Up - The tasks associated with the employment process (e.g., job development, job analysis, job placement, and follow up after placement in employment or independent living). 5. Monitoring and Problem Solving - Collecting information on client service programs and assisting in solving problems that occur in the process.

Role‐based Case Management:

A case manager may exclusively coordinate or arrange services, or case management may be just one duty in addition to vocational counseling, for example.

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Closed rehabilitated (after 90 days of successful employment)

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Closed unsuccessfully after services began

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Closed unsuccessfully before services began

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Counseling and guidance (if this is the only service being provided)

DAP notes

D=Data - this includes both the subjective and objective information from the SOAP note example. A=Assessment ‐ this is the same as in the SOAP style, and is a summary of your critical thinking about the client's situation. P=Plan - this is also the same as in the SOAP style, and identifies the action steps needed.

stages of vocational planning for VR counselors

Goal setting - Establishing an employment objective, Information processing - Considering all relevant data collected during the evaluation process, Decision making - Selecting a vocational goal to guide development of the rehabilitation program, Planning - Identifying intermediate objectives and rehabilitation services relevant to vocational goal and developing steps of an action plan, and Action and self‐evaluation - Following the action plan while using available data to evaluate process, and making course corrections when necessary.

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Physical and mental restoration (medical services are being provided)

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Plan completed (IPE written, but not initiated

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Plan development (accepted for services, but the IPE is not completed)

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Post employment services (when necessary to maintain a 26 closure)

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Ready for employment (the client is ready for job placement)

SOAP Notes entail a process of recording both subjective and objective information in a sequential manner

S=Subjective information from the client, such as feelings, concerns, problems, goals, plans, and information from others associated with the client. O=Objective and factual data that can be seen, heard, counted, or somehow accounted for in a non‐subjective way. Use words such as "appeared," "seemed," etc. A=Assessment - this is a summary of your critical thinking about the client's situation. It could include issues to address, unhealthy patterns that need to be challenged, the effectiveness of treatment or referrals, and client progress or setbacks. P=Plan - the plan identifies the action steps needed, such as referrals or homework for the client. The date and time of the action steps should be recorded.

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Services interrupted (normally loss of contact with the client)

rehabilitation-oriented models for mental health

The focus of this model is on the strengths of the individual, rather than the disability, and on the collaborative relationship between the case manager and client.

intensive case management model for mental health

These models emphasize the use of teams to address the client's many needs. It is intense and requires low case loads and "assertive outreach." It emphasizes medication compliance, 24 hour coverage, and daily living supports.

Standard Case Management Models for mental health

This includes the brokerage and clinical case management models. In the brokerage model, case managers act as an advocate and a purchaser or arranger of services for the client. In the clinical model, the case manager has professional training, credentials, skills, etc., to have a therapeutic relationship with the client and provide case management services.

Organization‐based Case Management:

This model focuses on "providing a comprehensive set of services available within a particular organization or agency"

Responsibility‐based Case Management:

This type includes functions to be performed by family, supportive workers, volunteers, or the client. The goal is to transition from human service professionals to non‐professionals.

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Training (when the client is in any form of training)

The private sector primarily serves who?

Workers' Compensation and other insurance claimants

life care planning

a form of medical and catastrophic case management involving the design of a plan of comprehensive and long-term rehab and related services for an individual who has experienced a catastrophic injury or has significant chronic health care needs

Written employability plans in the private sector include:

a vocational objective and the services needed to meet the objective. Because private sector claimants have previous work experience, and because the carriers obligation is restoration of work potential, private sector plans usually first emphasize a return to work on the basis of transferable skills, preferably with the former employer

Individual Employment Plan includes in Public Voc Rehab includes:

a) a vocational objective, (b) all services necessary to accomplish the objective, (c) the party responsible for each service, and (d) the projected date for plan completion

Assistive Technology Act of 2004

any item, piece of equipment or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of children with disabilities. Required states to provide ATs to children and adults with disabilities, as well as guardians

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applicant

the goal of private vr services?

claimants are returned to suitable employment as quickly as possible, with placement on the basis of transferable skills emphasized.

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closed from post employment services

the following should be considered with AT assessment:

consumer's goals, consumers abilities and disabilities, the environment in which it will be used, completion of job and task analysis, etc.

rehabilitation engineering

defined in the 1998 rehab act as the systematic application of engineering sciences to design, develop, adapt, text, evaluate, apply, and distribute technological solutions to problems confronted by individuals with disabilities in functional areas such as mobility, communications, hearing, vision, and cognition, and in activities associated with employment, education, transportation, etc.

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extended evaluation (for eligibility taking longer than 60 days)

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in employment

the goal of public vr services?

maximize the vocational potentials of consumers through training, and is often involved in vocational habilitation

Third parties are involved in service delivery for private or public rehab?

private

After 90 days of successful placement a consumer may be closed as "rehabilitated," and employment services may be provided, as necessary, to maintain the placement. This occurs in which sector?

public

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referral

The purpose of Problem‐Oriented Recording

to identify problem areas, assess those areas, and make a statement about what action is needed to address problem areas. This technique is useful in an interdisciplinary settings, when many different professionals, with different backgrounds, are working on the same problem with an individual.

case notes should include:

your impression of the client's behavior, appearance, and affect; any resolution that takes place; and the reason for the next contact or follow‐up. The format of the contact (whether it was over the phone or in person), should also be recorded, and all participants should be noted

time management principles

• Analyze time allocations • Plan daily - make a "to do" list • Allow for the unexpected • Assess the uncontrollable • Delegate and minimize involvement in routine, repetitive tasks • Consolidate similar tasks • Use prime time for important tasks - "prime time" would be when you are most productive • Avoid procrastination (do the task you want to do least first) • Identify and avoid time wasters

goals of case management

• Enhancing the continuity of care • Providing access to cross‐sectional service delivery that is comprehensive, coordinated, and ongoing • Enhancing accessibility by overcoming administrative barriers • Enhancing accountability by designation of a case manager as the single point of responsibility for assuring the overall effectiveness of the system, and • Enhancing efficiency by increasing the likelihood of consumers receiving timely delivery of appropriate services

principles of case note writing:

• Record notes soon after the event occurs • Be accurate and objective • Use a simple and direct style of writing • Avoid uncommon abbreviations acronyms • Describe what happened • Only include significant information

VR case management process

•Referral •Application •Eligibility Determination •Evaluation and Assessment •Service Planning •Service Delivery •Placement and Follow‐up