Case Management The New Movement in Behavioral Intervention

Introductions Team & Committee Structures Important Policies & Tools Lessons Learned Best Practices in Case Management Small Group Case Studies Topics

Erica Woodley Tulane University, New Orleans, LA Assistant Dean/Case Manager Jennifer D. Van Norman Colorado State University, Fort Collins, CO Student Case Management & Referral Coordinator Presenters

Team & Committee Structures Tulane (6,000) Colorado State (25,000) Current CM Model(s) Student Affairs Employee (EAP) Student Affairs x2 Employee (EAP) Combined Health & Counseling Developing CM Model(s) Clinical Case Management Committee(s) Behavioral Intervention Team Students at Risk Committee Meeting Student Consultation Team Employee Consultation Team

Tulane Team/Committee Tulane Team/Committee Behavioral Intervention Team Assistant Dean of Students/Case Manager (chair) Mental Health Professional Associate Dean of the Undergraduate College Director of Emergency Preparedness University Police University General Counsel Ad Hoc Members as needed

Tulane Case Management Tulane Case Management Position created Summer 2008 Dual reporting to Vice-President for Students Affairs’ and Provost’s Office Assist in campus wide crisis management and emergency response Provide case management to students identified as high risk Oversee the re-entry process for students on medical leave of absence Assist students in accessing resources or navigating university systems Provide formal referrals to both on and off campus resources Coordinate mandatory medical leave actions Plan and implement faculty and staff training relative to identifying students at risk Chair weekly behavioral intervention team meetings Maintain records of students at risk Serve as contact point for external constituents on behalf of the Vice- President and Provost’s offices (parents, hospital administrators, community partners)

CSU Student Consultation Team CSU Student Consultation Team This committee is convened when an incident involving a student occurs that could potentially cause harm to the student, other students, staff, faculty or the community. The team recommends and initiates responses that provide for the well-being, safety, and respect of those involved. Student Consultation Team: Dean of Students (chair) Student Case Management & Referral Coordinator General Counsel Office Associate Executive Director of Health/Counseling Director of Residence Life Director of Conflict Resolution (Judicial Affairs) Associate Director of Women’s Programs CSU Police Detective EAP Manager Ad Hoc Members as needed

 Hired Fall 2007  Reports to Dean of Students  Works with students in “crisis”  Develop/maintain relationships with campus and community resources  Hospital Liaison (Medical & Mental Health)  Connect students to campus resources  Coordinate transitions from CSU to external community providers  Assist students and families with internal procedures (withdrawal, appeals, etc.) CSU Case Management CSU Case Management

 Medical Withdrawal Policy  Voluntary  Involuntary  Readmission Policy  Mandated Assessment Policy  Interim Suspension Policy  Threat Assessment Tool Important Policies and Tools

Tulane Process of Care Tulane Process of Care Student enters the POC (TUPD or NOPD report, medical transport, concerned faculty or staff member) First point of contact within 24 hours Immediate intervention or support services offered as appropriate Second follow-up within 72 hours Student discussed at Behavioral Intervention Team if appropriate Plan formulated by BIT Assistant Dean of Students follows up to ensure plan followed

Student Identified by faculty, staff, student, community or family member and contacts the Division of Student Affairs Dean of Students Behavior of student is NOT perceived as a direct threat or disruptive to others Behavior of student IS perceived as a direct threat or disruptive to others Information Gathering/Referral from/to collateral agencies/programs on campus that may include: Other faculty/staff/students Resources for Disabled Students Conflict Resolution and Student Conduct Services Student Case Management & Referral Office of Women’s Programs and Studies University Housing CSU Police Department Student Consultation Team: Dean of Students General Counsel Office Associate Executive Director of HHS/UCC (Health/Counseling) Director of Residence Life Director of CRSCS (Judicial Affairs) Associate Director of Women’s Programs CSU Police Detective Student Case Management & Referral Coordinator Student Plan from recommendations of all involved that may include: Conflict Resolution and Student Conduct Services Ongoing case management Parent/Guardian involvement University Withdrawal Alternative living arrangements Referral to campus or community resources No action Other Colorado State University

“If you build it, they will come.” Not building it does not mean that issues aren’t present. Lessons Learned Tulane Colorado State Total Cases 08/ /10 to date Known MH Hospitalizations 08/ /10 to date - 11 Total Cases 07/ / /10 to date Known MH Hospitalizations 07/ / /10 to date - 53

Lessons Learned The success of a case manager can be largely dependent upon who you hire  Dynamic  Establishes Rapport  Listens & Hears  Independent  Recognizes the real issues  Able to discern “need to know”  Ability to recognize, track, and follow a Student of Concern

Lessons Learned Support of upper level administration is critical The BIT must be ACTION based

Lessons Learned The first year is largely about learning policies, creating consistency among policies, and identifying gaps in current policies

You must teach an old dog new tricks Lessons Learned  Educating Staff/Faculty  Resistive Staff/Faculty  Policy Changes  Academic Integrity & Money vs. Student & University Best Interests

Expanding Boundaries or Stepping on Toes? Lessons Learned

Recognize the limits of what a case manager can and CANNOT do Once a case manager “fixes” a situation, there is a tendency to refer ALL difficult students that others do not want to deal with.

FERPA - HIPPA Lessons Learned  Releases of Information (ROI’s)  Communicating with other University Officials  Communicating with Family - Need to problem solve with parents  A Case Manager cannot “un-know” information  Clinical Degree – Help or Hindrance?

Certain areas are best outsourced  Psychological Assessments  Long Term Therapy  Community Provider List is vital  Functional Safety Net  Mobile Assessment Team Lessons Learned

Best Practices Community  Network with community mental health providers  Send introduction letters with information on services as well as signed ROI to providers seeing students followed by case management  Arrange meetings with administrators of local hospitals; inundate them with business cards and other written materials to give staff and students  Maintain referral database  Take Donuts (make them your friend & collaborate) Campus  Establish visibility within university  Marketing case management both on and off campus is vital  Provide current and accessible web presence  Meet regularly with campus counseling center and other university departments

Best Practices Professional  Annual Case Manager Roundtable  Case Managers in Higher Education Google Group/List Serv

Case Studies Small Group case studies  What are the problems?  What is ideal?  What is realistic?  How did CSU or Tulane handle it?