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 more intensive social work case management (CM). Using existing data from a case management time study (N = 242) and a content analysis of 70 cases in a Medicaid waiver-funded HCBS program, this study highlights a number of issues, such as dementia-related behavior problems, noncompliance with treatment, 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 reliability and t tests for discriminant validity show these items to be reliable 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 issues.