Assessing need for intensive case management in long-term care

This article presents a brief screening tool to help case managers identify clients in a home- and community-based services (HCBS) program who need mo re intensive social work case management (CM). Using existing data from a c ase management time study (N = 242) and a content analysis of 70 cases in a Medicaid waivers funded HCBS program, this study highlights a number of is sues, such as dementia-related behavior problems, noncompliance with treatm ent, poor informal caregiver health and: mental health, and a conflicted or problematic relationship between client and caregiver, which are useful in predicting need for intensive case management. Kappas for interrater relia bility and t tests for discriminant validity show these items to be reliabl e and valid. This tool will allow for better allocation of CM resources in, terms of case manager time and type of expertise needed to address these i ssues.