Intensity of need of the individual (high, medium, or low) is now required to be documented and reviewed every 90 days. The definitions of levels do not align with realistic time expectations at each level. The population we serve often have needs which are fluid and fluctuate between the three levels frequently. The additional documentation every 90 days seems like an administrative task which is not clinically relevant.
Caseload Maximums: The CMs already adjust their supports naturally based on the individual's needs, having to add in the complexity of increased assessments and caseload limit monitoring is just more work. This restrictive monitoring the size of caseloads based on extremely fluid intensity of need designation is a significant challenge/barrier to service. The agency would have to continually move individuals between caseloads to manage maximums, which is not good or clinically appropriate care. Further, we cover 1400 square miles in our planning district and typically try to geographically assign caseloads to maximize efficiencies and time available to provide services. This may not be feasible with the caseload maximums leading to increased cost, increased administrative burden, increased transitions between providers for individuals, and less time available to provide quality services.
The requirement for a minimum of two hours per individual per month across each provider’s caseload is unrealistic and restricts our ability to provide continuity of care or effectively operationalize Case Management programming. Again, will lead increased administrative burden to manage caseloads and arbitrary transitions in care between different case managers contrary to best care.
