This document discusses case management and the role of social workers as case managers. It defines case management as assessing a client's needs, arranging services to meet those needs, and advocating for the client. Comprehensive case management involves assessing a wide range of client needs, coordinating services, teaching self-advocacy, and advocating on micro, mezzo, and macro levels. Social workers are well-suited for comprehensive case management due to their focus on environmental factors, client strengths, and advocacy across multiple systems. Benefits of case management include increased access to services, improved compliance, better communication between providers, decreased costs, and support for clients navigating complex systems.

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Making the Case for Social Work Case Management
Case Management Basics
Case management has many different definitions and is called different things including care
coordination and discharge planning. Case management services exist in many different
settings but are most commonly found in medical settings such as hospitals, home health and
hospice agencies; through state funded programs for children and adults with chronic health or
mental health conditions; in schools; and in local community agencies. These services are
provided by a variety of professional and para-professional case managers. Primarily, however,
they are provided by nurses and social workers.
Over the past twenty to thirty years, case management services have evolved extensively. Case
management is a term being used to describe services ranging from the most basic to
comprehensive. Some examples follow:
 Utilization review activities are sometimes described as case management. These
activities may include a review of paid claims or medical payments to determine if the
person is “over-utilizing” insurance coverage. These type services often do not include
any contact with the person or patient.
 Phone and/or online contacts with clients are a type of case management. These types
include disease management models in which a health care professional follows up with
patients to assure proper care and management of conditions such as diabetes or
hypertension.
 Discharge planning services are offered in most hospital settings and are sometimes
referred to as case management. These services are time limited and the focus is
meeting the patient’s needs after being discharged from a hospital setting. Services may
include helping clients obtain health insurance coverage of some type, assuring
medication and medical equipment needs are met and helping families make decisions
surrounding care of loved ones.
 Comprehensive case management services are those in which a case managers assesses
a wide range of potential needs with a family, coordinates services with others involved
with a client’s care and advocates for client needs to be met.
Comprehensive Case Management
Comprehensive case management will be the focus of this document since it is most closely in
line with the philosophy and training of social workers. According to the National Association of
Social Workers (NASW), “…..case management is a method of providing services whereby a
professional social worker assesses the needs of the client and the client’s family, when
appropriate, and arranges, coordinates, monitors, evaluates, and advocates for a package of
multiple services to meet the specific client’s complex needs.”
Comprehensive case managers assess for a wide range of needs of clients and families including:
 Health needs, including mental health issues
 Educational or vocational needs
 Basic needs such as housing and food assistance
 Transportation issues

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 Other issues as defined by families
Comprehensive case managers also assess the strengths of the families they work with including
the role of natural helping networks, personal strengths and accomplishments and other
supports such as supports of a client’s community of faith. This comprehensive case
management may be structured around a certain client population, such as children with health
conditions, but services and assessment of needs are not limited by that structure. Needs are
identified by families and services are individualized to meet those needs. In this way,
comprehensive case managers paint a complex picture of families instead of fitting families into
an established box of available services and anticipated needs.
Comprehensive case management services do include referrals to resources to meet needs but
services go beyond simply giving clients phone numbers and contact information for those
resources. Case managers:
 Coordinate extensively with resources and service providers such as physicians to assure
clients needs are being met
 Advocate for clients needs when problems are encountered
 Advocate for new services when client’s needs cannot be met by currently available
resources
 Advocate for changes in local, state and national policy when needed to address needs
of clients
Comprehensive case management also includes a teaching role. Clients are taught how to
navigate complex systems in such areas as health care and education so clients learn how to
become their own case managers in the future. Comprehensive case managers strive for clients
managing without assistance after services are complete.
Social Workers as Effective Case Managers
Social workers are uniquely qualified to be case managers. Social work roots are grounded in
case management activities such as linking clients to the services they need and advocacy for
the disadvantaged. Social workers come from a system focus in which clients are assessed in
their environment. The consideration of environmental factors and the impact of forces outside
the client as an individual is a fundamental principle of comprehensive case management.
Social workers are trained to intervene at multiple levels to meet client needs, this includes
advocating on community, state and national levels for needed changes. Ultimately, social work
case managers seek to alleviate the complexity and problems in systems that make case
management necessary.
Social work education focuses heavily on strengths based perspectives and social workers use
client strengths in interventions to assure positive client outcomes.
Case Management Benefits
Case management can have many benefits dependent on the quality of services being provided.
Benefits include:

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 Increased access to needed health, educational and other services
 Greater compliance with medical and other appointments
 Improved communication between health care providers
 Increased health insurance coverage for clients with case managers
 Decreased cost associated with some case management programs (primarily due to
hospital admissions)
Case management services can be life changing for clients who are struggling to navigate
sometimes complex and de-humanizing systems. Case managers can give clients:
 Needed support and a person to turn to when in crisis
 Education about the issues faced by clients with chronic health or mental health
conditions
 An advocate when systems do not function optimally
Social workers, due in part to their education, disciplinary philosophy and code of ethics, are
well suited to the case management roles and requirements. They have proven themselves to
be able to operate both independently on behalf of their clients as well as a part of a clinical
team. While nurses and other professionals are able to perform some case management
functions, social workers are able to provide comprehensive services to address the needs of the
whole person in his/her environment to achieve healthy client outcomes.

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References
Gotham, C., Bayliss, D. , Luzinski, C., Stockbridge, E. , Schmidt, M. (2000). A Cost Effective Model
of Community Case Management. The Case Manager, Volume 11, Issue 3, May-June 2000, Pages
75-79.
Moore, S. (1990) A Social Work Practice Model of Case Management: The Case Management
Grid. Social Work, Volume 35, Number 5, September 1990, Pages 444-448
NASW Standards for Social Work Case Management (1992). Retrieved from
http://www.naswdc.org/practice/standards/sw_case_mgmt.asp on April 12, 2010.
Netting, E. (1992) Case Management: Service or Symptom. Social Work, Volume 37, Number 2,
March 1992, Pages 160-164.
Polinsky, Margaret L., Fred, Carol, Ganz, Patricia A. (1991) Quantitative And Qualitative
Assessment Of A Case Management Program For Cancer Patients. Health and Social Work,
Volume 16, Issue 3, August 1991.