Beofore Sunday

MODULE 2 ASSIGNMENT: ROLES OF A CASE MANAGER

List of 10 components (pages 1-3)

#1: Drug courts integrate alcohol and other drug (AOD) treatment services with justice system

processing. This component highlights the necessity of a multifaceted, collaborative “team” approach

for integrating the delivery of services into the administration of justice and enhancing the justice and

treatment systems’ joint mission of promoting abstinence and law -abiding behavior. It underscores the

need for collaborative goal setting and program monitoring through ongoing communication and

continuous processing of timely and accurate information about each participant’s performance in the

program. It is the case manager who coordinates the flow of drug court information across and within the treatment and justice systems.

#2: Using a non-adversarial approach, prosecution and defense counsel promote public safety while

protecting participants’ due process rights. The case manager assists in keeping these traditionally

adversarial parties focused on the primary purpose of the program: the participant’s moveme nt toward

fulfilling his or her recovery plan. As an advocate for the participant’s recovery, the case manager

supports due process, ethical, and strengths-based treatment, and confidentiality while simultaneously

promoting individual accountability and community safety. It is in this sense that the case manager helps

bridge the traditional gap between the coercive traditions of justice, the protection of the public, the privacy mandates of treatment, and respect for individual rights.

#3: Eligible participants are identified early and promptly placed in the drug court program. The case

manager helps ensure the coordination of this process by “tracking” and facilitating the prompt sharing

among the team of all relevant information arising from the initial referral, eligibility screening, and assessment process.

#4: Drug courts provide access to a continuum of alcohol, drug, and other related treatment and

rehabilitation services. The case manager identifies and monitors each participant’s unique needs for

support and rehabilitation services, coordinates participant access to these services, and ensures linkage

and coordination among the drug court service providers. The case manager works closely with the

clinical treatment provider(s) and community supervision officers to provide ongoing assessment and

communication of the participant’s progress and to coordinate referrals to appropriate ancillary service providers.

#5: Abstinence is monitored by frequent alcohol and other drug testing. The case manager ens ures that

drug test results, whether obtained by probation, treatment, law enforcement, or other court partners, are promptly and accurately recorded and disseminated to the drug court team.

#6: A coordinated strategy governs drug court responses to parti cipants’ compliance. As the central

person responsible for coordinating team information flow, the case manager tracks and monitors the

court’s allocation of sanctions and incentives to each participant to help ensure that subsequent

sanctions, incentives, and interventions are graduated, treatment-relevant, strengths-based, and otherwise consistent with the program’s philosophy.

#7: Ongoing judicial interaction with each participant is essential. As the primary link between the

treatment and justice systems, the case manager serves as the bearer of much participant information and, in this role, can give critical insight and input to the drug court judge.

#8: Monitoring and evaluation measure the achievement of program goals and gauge effectiveness. The

case manager ensures that all relevant information is accurately, promptly, and systematically

documented so that ongoing monitoring of the participants and evaluation of the program can occur.

#9: Continuing interdisciplinary education promotes effective drug court planning, implementation, and

operations. Because the case manager deals daily with clinical and ancillary service providers as well as

justice system partners, he or she is well situated to facilitate interdisciplinary education within the drug

court team. In some jurisdictions, case managers integrate interdisciplinary training into drug court

meetings by periodically enlisting an ancillary service provider or justice system professional to address the team and, if appropriate, participate in the staffing process.

#10: Forging partnerships among drug courts, public agencies, and community -based organizations

increases the availability of treatment services, enhances drug court effectiveness, and generates local

support. While all drug court team members contribute to the formation and maintenance of these

critical partnerships, it is the case manager that sustains ongoing contact with key line staff of the

partnering agencies and organizations. This consistent and direct contact with other commu nity based

service delivery professionals puts the case manager in a position to learn about the policies,

procedures, capacities, strengths, and limitations of existing support service organizations. With this

knowledge base, the case manager is well posi tioned to identify service gaps and community needs, and

offer strategies to facilitate collaboration between the court and the community.

List of Roles for Case Managers

Advocate Counselor

Broker Planner

Coordinator Problem solver

Consultant Recordkeeper

Cost containment

Case Example: Tina S. (pages 14-24)

The assessment process for Tina begins with the initial Intake, which the designated drug court case

manager conducts the day following Tina’s first court hearing. The case manager has limited information

prior to meeting with Tina, but does know that she is Caucasian, 28 years old, and receives Temporary

Aid to Needy Families (TANF). During the interview, the case manager learns from the participant that

she has four children ages 10, 7, 4, and 14 months. The youngest two are in the custody of foster

parents. She has an eighth grade education and is studying for the high school diploma equivalency

exam. Her parents are both deceased, and she has a sister who lives in another state. S he shares with

the case manager that she has few friends who are clean, but she does have a neighbor who does not

use drugs or alcohol and who provides occasional childcare for her. She has used methamphetamine

and marijuana almost daily since she was 16, and began drinking when she was 13. She has been in

residential substance abuse treatment twice in the past 4 years. Tina describes her greatest concerns as

lack of employment and housing. She has held two long-term jobs in the past; for two years she worked

for a fast-food restaurant, and until she quit one month ago, she worked at a local grocery store stocking

shelves. She currently lives in subsidized housing, but is afraid that she may become ineligible due to the

current matter before the court. To augment the information gathered from Tina, the case manager

consults the drug court team and learns from the public defender that the participant has five

outstanding traffic matters that have gone to warrant in another county. The county treatment provider

confirms the prior attempts at residential substance abuse treatment, sharing that the participant

earned a perfect attendance award at the last facility eleven months prior to her latest offense.

Tina and the case manager work together to develop a list of needs to be addressed, related goals, and

objectives. The case manager discusses with Tina a list of services intended to address these needs and

meet her goals. These services include: ƒ Intensive outpatient treatment (indicated by a standardized

substance abuse assessment tool) ƒ High School Equivalency Exam tutoring ƒ Twelve-step recovery

support groups ƒ Drug testing to provide an incentive to remain drug free ƒ Case conferences with a

social worker assigned to child custody cases to coordinate servi ces and court orders ƒ Walk-in warrant

schedule to address traffic matters Plan development includes Tina preparing a daily schedule of

activities. She will outline the times she is available to attend intensive outpatient treatment. She states

she is currently attending diploma equivalency exam tutoring twice weekly. She and the case manager

agree that this can be reduced to once weekly until she completes intensive outpatient treatment.

Childcare is identified as a need and the case manager focuses on locating a treatment facility that

provides this service. Tina and the case manager assess her home environment. The case manager

believes the neighborhood, and specifically the apartment complex, is not conducive to remaining clean

and sober. This is evidenced by the initial police report that stated: (1) the drugs found in her possession

were purchased from a person living in a nearby apartment; and (2) the defendant was found under the

influence of methamphetamine in the apartment of an acquaintance. Tina i s resistant to moving, and

attempts to minimize the risk it may pose. The case manager explores with Tina her reasons for wanting

to stay and agrees to discuss this matter with the drug court team before making a final recommendation to the court.

The case manager learns from Tina that she has been prescribed an asthma medication. Further

discussion reveals that she currently has no primary care physician and uses the local hospital

emergency room when she feels ill, since Medicaid will pay for the visit. The case manager directs her to

obtain a primary care physician, providing the address of a local family clinic. Tina adamantly states that

the clinic will not take her because she receives Medicaid, although she has not actually asked. The case

manager encourages her to make contact and, if she is ultimately unsuccessful, agrees to help her find

another physician. Tina returns three days later to report that the family clinic did in fact accept

Medicaid and not only accepted her as a patient, but also asses sed her asthma/bronchitis and ran some

tests and discovered that she was borderline diabetic. The clinic recommended nutritional assistance.

Tina is rewarded for her actions when the case manager commends her and helps her develop a plan to

implement the newly recommended dietary changes. Two weeks later, Tina returns and reports she is

taking a new asthma medication. Upon inspection, the case manager sees that the prescribing physician

is someone other than the clinic doctor. When asked, Tina states that s he went to the emergency room

because the asthma attack happened over the weekend, though it was not a crisis situation. The case

manager inquires as to why she did not call the clinic doctor, and Tina states that the clinic is not open

on Sundays. The case manager acknowledges this, but tells her that the clinic has an answering service

that would have paged the doctor. Tina was clearly unaware of this process, and benefited from the

case manager’s information.

An unannounced home visit is conducted. Tina is found at home with her youngest children, who she

was able to regain custody of from foster care; her older children were at school. The 4- year-old and 1-

year-old appear clean and well cared for; the apartment is otherwise quite cluttered with clothes and

other belongings. Tina shares with the case manager that a male friend has been staying overnight off

and on and that she is not comfortable with the situation because she believes he may be using drugs.

Tina states that she feels afraid to tell him to leave and at the same time has been afraid to tell anyone

in drug court because of her probation condition not to associate with any known drug user. Tina says

she is relieved that the case manager now knows and asks if there is any way a visit and/or sea rch could

happen when this friend is actually at the house. The case manager and Tina make a plan for a return

visit at a time when the friend will be there. Additionally, the case manager helps Tina work out a

response for the next time someone asks or insists on staying with her. The case manager further

assesses the situation by discussing with Tina other factors that might pose a threat, (e.g., physical or

sexual assault, and child abuse). A case file note is made to return for an unannounced visit with in two weeks.

At a team staff meeting following the unannounced home visit, the case manager shares with the team

that Tina has had a male friend staying periodically at her home, and that Tina believes the individual

may be using drugs. It is further shared that Tina had not been forthcoming with the information for fear

of being found in violation of her probation terms. During the team meeting, the prosecutor argues that

Tina is deserving of a sanction for continuing her association with the individual. The treatment provider

agrees with the prosecutor. The prosecutor suggests Tina may be involved in attempting to manipulate

the team and recommends she spend a weekend in custody. The treatment provider expresses concern

for the lack of disclosure and acce des to the need to sanction but is undecided as to whether Tina

should go into custody. The public defender argues the behavior deserves a response but does not rise

to the level of an infraction requiring custody. The case manager acknowledges to the team that Tina’s

association with the individual is not conducive to her remaining sober and is a violation of program

rules. The case manager further offers that while a sanction may be in order, the period of time in

custody would likely be counterproductive given recent efforts Tina has made in studying for her high

school diploma equivalency exam, orchestrating child care arrangements for her children, and otherwise

making positive progress in the program. The team ultimately agrees on a sanction where Tina will be

required to write a letter to the individual explaining why she can no longer associate with him,

including how their relationship may be damaging to her attempts to remain sober. The case manager

requests that the treatment provider address with Tina the perceived value of continuing in a relationship that clearly appears not to be in her best interest.