Case management within substance abuse treatment programs in Los Angeles County

Case management has been used to link clients and the service system, but is loosely defined and poorly understood. The aims of this study were to describe the use and purposes of case management within substance abuse treatment programs, and also the structures and processes for providing case management services. A descriptive survey was done, with 50 program directors of 134 treatment programs (with 205 case managers), in Los Angeles County. Results showed that 80% of directors reported they use case management. Half of the programs use case management both before and after discharge, and 72% provide case management to all clients. Case managers' most important roles are to develop treatment plans and prevent relapse during treatment, and 60% of directors indicate the case managers in their programs are also counselors. Case managers perform numerous roles of coordination and advocacy. Eighty percent of case managers follow the care of the client during treatment and 32% of directors reported a case load of 1-10, while 26% reported a case load of 11-20. The professional background of case managers varies from chemical dependence professional to social worker or nurse. Twenty percent of program directors plan to increase case management in the future.