Making an Impact – Contracted Case Management

JFS Favicon

In the Making an Impact series, clients and services are featured to expand awareness of the wide array of help available at JFS and to ensure donors understand the lives they touch and the difference they make throughout the community. Client names have been changed to protect their confidentiality.

JFS currently has three contracts with outside entities to provide case management or care coordination services to adults who qualify for medical assistance from the state. Two of those contracts are with local health plans – UCare and Medica – to provide care coordination to individuals over the age of 65 enrolled in the health plan’s Medicaid insurance program. The third contract is with Ramsey County to provide case management to individuals over the age of 18 enrolled in Medicaid who also have a qualifying disability and who are receiving services and support through some of the Medicaid disability waiver programs. Learn more about waiver programs here. Contracted Case Management is led by Director Jill Grover.

The role of a case manager (CM) or care coordinator (CC) is to meet with these individuals to help understand their strengths and abilities as well as understand where they might be in need of more help in order to live independently and safely in their homes. Does the client have a physical disability that prevents them from being able to safely take a shower on their own? Does a developmental disability make it challenging for the client to manage their own finances and pay their bills? Does the person experience depression or anxiety that prevents them from accessing the help they need?

Once the CM/CC has met with the client and has an understanding of the challenges, they can assist with setting up services in the person’s home or community including a personal care attendant (PCA) to help with dressing, bathing, grooming and more; homemaking services to help with cleaning and maintaining the home; meal delivery; adult day centers to provide a recreational outlet and decrease isolation; supported employment services to assist individuals with keeping employment in the community; independent living skills (ILS) including learning how to pay bills, set up medical appointments, and many other tasks to successfully live independently.

Our CMs and CCs are in regular contact with their clients to monitor their successes in achieving the goals they set and adjust the various services and supports as needed. They collaborate with the various state agencies in managing the costs of these services for each individual to ensure that funds are being spent appropriately and responsibly.

The JFS team is exceptional in many ways. They have backgrounds and advanced degrees in nursing and social work. More than 30 percent hold master’s level degrees in social work, while an additional 10 percent are currently working towards advanced degrees. Staff excellence has allowed JFS to win these contracts year after year for more than a decade.

CMs and CCs come with backgrounds in a variety of areas including pharmacology and speech pathology. Our staff members have advanced experience in and knowledge of health and human services, averaging 11 years of experience in the field. Many team members have extensive expertise in the areas of dementia and other mental health issues that impact older adults.

The diversity of the team enables care that honors each client’s unique heritage. Staff can communicate with clients in a variety of languages including Russian, Hebrew, Ukrainian, Hmong, French, and Somali and offer them extensive knowledge of their culture. Next week a new Spanish-speaking team member will be on-board to help us overcome the language barrier with even more clients.

JFS Contracted Care Management teams earned a combined 96 percent compliance score for care plan protocols in 2018 audits. Additional comments provided by auditors included praise for the team’s attentiveness to their client’s social, emotional, and spiritual goals in ways that truly captured what was most important to the client; and noting that it was apparent that the team consistently went above and beyond by following up at multiple points during the year, exceeding contract requirements.

Client evaluations also demonstrate the quality of care provided. Responding to a recent client satisfaction survey, 99.3 percent indicated they would highly recommend or recommend JFS. When asked if their JFS case manager was respectful of their background and values, 96 percent gave the highest possible positive response.

Two of the three teams will undergo audits by their respective contractor again this spring. Team scores and outcomes will be shared after the audits are complete.