Section 2: Workflow Timeline

Addressing Your Client’s Needs

Meeting vs. Addressing

As a case manager, you are responsible for addressing your client’s needs, which is different than meeting their needs. For example, in addressing your client’s needs, you would provide resource information for them to make a choice. In meeting your client’s needs, you would encourage them to make contact with the chosen resource. Addressing the need means educating your client with information related to the need, whereas meeting the need means encouraging and empowering them to take steps to meet their needs.

To address your client’s needs, you must:

  • Ensure all needs and interventions are accurately documented on the Family Needs Assessment and Service Plan.
  • Identify which resources exist to address your client’s needs.
  • Identify which resource best addresses your client’s needs.

Resources

As a case manager, you need to be knowledgeable about resources in your coverage area. A list of some commonly used resources is in the Appendix.

  • Develop your own resource guide.
  • Network with other agencies to learn of resources.
  • Understand how to use the Texas Medicaid Provider Procedures Manual (TMPPM).
  • Research the internet for resources related to your client’s needs.

Be prepared at the first visit to provide community resources to your client, parent or guardian. For example, remember how the case manager for Adam provided his mother, Sarah, with some resources on the day of the Comprehensive Visit? The case manager identified the need as “done” during that visit.

Finding Medicaid Providers

Resources for finding medical and behavioral health providers depend on the type of Medicaid the client has and your location.

For Clients Enrolled in Medicaid Fee-for-Service:
Call the Texas Health Steps helpline (1-877-847-8377) for assistance in locating an enrolled provider.

For Clients Enrolled in Medicaid Managed Care:
Each MCO has a unique contractual agreement for medical and behavioral health providers. To access services, call the health plan listed on the Medicaid card.


Advocacy

A case manager should advocate for the client at all levels of service delivery, including:

  • Promoting self-determination and self-advocacy.
  • Facilitating access to needed services while educating the family about resource availability.
  • Recognizing, preventing and eliminating disparities or barriers in accessing service.
  • Advocating for expansion of services.

Steps in the Advocacy Process

  • Define the Problem
    • Be clear and specific.
    • Separate facts from feelings.
    • Realize that complex situations may involve several different problems.
  • Gather Information
    • The type of problem determines the type of information that is needed.
    • Determine whether there are policies, rules or laws that apply.
    • Analyze the information gathered.
  • Plan a Course of Action
    • Develop a plan to resolve the problem.
    • Identify alternative plans.
    • Identify who will help you and what each person’s role will be.
  • Act Assertively
    • Carry out the plan that you developed.
    • Your plan may include one step or several steps.
    • Use assertive communication involving active listening and negotiation.
  • Follow Up
    • Follow up to ensure that each need has been addressed.
    • You may have to repeat steps using a different approach.
    • Document all efforts.

Advocating for School Services

All children receiving special education and related services in Texas are required to have a minimum of one Admission, Review and Dismissal (ARD) meeting per year to:

  • Develop and implement the student’s individual education plan or IEP.
  • Evaluate the need for continued special education services.
  • Review the student’s progress.
  • Plan for new services, as needed.
  • Dismiss the student from special education services, if applicable.

In addition, ARD meetings can be scheduled any time throughout the school year:

  • To obtain approval for a change to the student’s IEP or
  • Whenever a parent or guardian requests a meeting.

As a federal requirement, school districts are required to provide parents prior written notice of the ARD meeting.

  • Prior Written Notice is written notification from the school given to the parent at least five school days in advance of the scheduled meeting. This prior written notice is intended to provide the parent with information to help them participate in the decision-making process with regard to the child.
  • The notice MUST be written in language understandable to the general public and MUST be translated into the parent’s native language or another mode of communication unless it clearly is not feasible to do so.
  • For additional information regarding parental rights go to Texas Education Agency and search for special education family resources.

Your Role as an Advocate

  • Provide information about ARD and/or special education.
  • Attend an ARD meeting to provide advocacy.
  • Assist the client, parent or guardian with understanding their rights.
  • Collaborate with the school.