Concern over care: Case management changes cause worries among vulnerable adults
Published 10:46 am Friday, February 7, 2014
Ronnie Rosenberger didn’t know about a case manager switch until she sat in a meeting at The Bridge last week. She and others heard Mower County cut case management providers from six to two, which instantly caused concern.
For Rosenberg and other vulnerable adults who use mental health services through Mower County, the switch is frightening.
“It takes a long time for someone to gain that trust and get everything in place,” Rosenberger said.
Yet Rosenberger and up to 200 vulnerable adults in Mower County will soon switch case managers for their mental health needs starting March 1. The changes, according to county officials, are necessary to conform with recommended human service reforms and enhance county services.
“What we were looking at was the quality, and the ability to meet the standards and the ability to produce outcomes,” Mower County Health and Human Services Director Julie Stevermer said.
Up to speed
Vulnerable adults who receive mental health services from the county can have case managers, who coordinate a patient’s needs, from social workers to psychologists, counselors and more. The case manager runs a team for the patient and ensures a treatment schedule is kept by all.
Mower County previously contracted six providers to run its case management services. Yet a February 2013 legislative report recommending human services reforms and a Department of Human Services waiver review of the county last April led county officials to consider several reforms to conform with state mandates and recommended practices.
Among the changes to human services procedures was a new position to process Community Alternative for Disabled Individuals. Another change was to bring case management providers up to protocol. According to Stevermer, case management providers don’t all follow the same procedures, which meant the county needed to re-evaluate providers.
County officials did so in November, when they submitted a request for proposal to meet the new case management guidelines.
Seven providers submitted proposals, and county officials went through several interview phases before deciding on two providers at the end of January. The county asked providers to inform patients about the changes, because providers had the most recent patient contact information.
“We didn’t want some people not getting notified,” Stevermer said.
For Rosenberger and other patients, the notification came too quickly. Rosenberger has used mental health services for the past five years since she moved to Austin, and the switch to a new case manager was incredibly stressful. Now, Rosenberger may not choose another case manager, and she may not be the only one.
“This doesn’t just affect vulnerable adults,” she said. “It affects families, service providers, everyone.”
She decided to speak out because she and others were concerned about the 30-day transition. Patients get 30 days to transition from one case manager to another per state law, according to Stevermer. For Rosenberger, the transition is too soon. Mental health patients often require routine, and a sudden change could be catastrophic during treatment.
“They definitely needed to give us more time to transition,” Rosenberger said.
Stevermer acknowledges the difficulties some patients could have, but said the change is ultimately necessary to help patients get better quality treatment to ultimately heal.
“The end result is to make sure that we have the quality of services,” she said. “We know it’s disruptive … We’re in charge of overseeing those services and making sure that people are getting what they need to get.”
Rosenberger said she and others will attend the Mower County Board of Commissioners meeting next Tuesday, likely with a petition to persuade the board to keep their case managers.