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 CenterUTMB Referred 357Referred 800 Contacted 298Contacted 600 Appt Made 114Appt Made 113 Appt Kept 102Appt. Kept 104

7. Case Management Services Other Referrals: –Jesse Tree47 –Recovery Ctr.10 –Rx.173 –Social Problems143 –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?