Case Manager

NATURE OF WORK:
Case Management services establish, along with the person, a life-long, person-centered, goal-oriented process for coordinating the supports (both natural and paid), range of services, instruction and assistance needed by persons with developmental disabilities. It is designed to ensure accessibility, accountability and continuity of support and services. This service also ensures that the maximum potential and productivity of a person is utilized in making meaningful choices with regard to their life and their inclusion in the community. All IDDW services purchased, however, must be within their annual individualized budget.

Once the person/legal representative has chosen a Case Management provider from the available IDDW providers, the agency assigns a Case Manager to the person. The person/legal representative may request the assignment of a specific Case Manager (CM) and when possible the agency honors the request. The person/legal representative may choose to transfer to a different CM provider at any time and for any reason.

The Case Manager must inform the person or their legal representative of all licensed IDDW agency providers who serve the region where the person resides. This is to ensure the person, or their legal representative, have a free choice of providers.

WORK ENVIRONMENT: (In-Doors 70% Out-doors 30 %)

WORK PACE: Self-paced, requiring the ability to make decisions quickly and accurately in an oftentimes fast-paced, demanding work environment.

ESSENTIAL DUTIES:

• Use clear communication skills, including people first language with clients and other professionals.
• Assist the person and/or legal representative with re-determination of financial eligibility as required at the DHHR office in the county where the person lives.
• Begin the discharge process and provide linkage to services appropriate to the level of need when a person is found to be ineligible for IDDW Services during annual eligibility or financial redetermination.
• Provide oral and written information about the IDDW provider agencys rights and grievance procedures for persons served by the agency or provide linkage to other agencies rights and grievance procedures.
• Assist with procurement of all services that are appropriate and necessary for each person within and beyond the scope of the IDDW Program including annual medical and other evaluations as applicable to the person.
• Act as an advocate for the person. The IDDW Program must not be substituted for entitlement programs funded under other Federal public laws such as Special Education under P.L.99-457 or 101-476 and rehabilitation services as stipulated under Section 110 of the Rehabilitation Act of 1973. (Public schools can currently bill for specific medical services under their own Medicaid provider numbers). Therefore, it is necessary for the Case Manager to advocate with these systems to obtain the required and appropriate services.
• Provide education, linkage and referral to community resources,
• Promote a valuable and meaningful social role for the person in the community while recognizing the persons unique cultural and personal value system.
• Interface with the UMC on behalf of the person in regard to the assessment process, purchase of services and budget process. Activities may include linkage, negotiation of
• services, submission of information, coordination of choice of appropriate assessment respondents on behalf of the person, education and coordination of the most appropriate assessment setting that best meets the persons needs.
• Communicate with other service providers on the IDT to allow for continuity of services and payment of services.
• Coordinate necessary evaluations to be utilized as a basis of need and recommendation for services in the development of the IPP.
• Notify IDT persons at least 30 days in advance of meeting.
• Support the person as necessary to convene and conduct IDT meetings.
• Documenting that all services, both paid and unpaid, from any and all programs also be documented on the IPP.
• Providing schedules of all programs used by the person to ensure that times and tasks do not overlap or duplicate.
• Coordinate the development of IPPs at least annually. The IPP must be reviewed and approved by the IDT at least every 90 days unless otherwise specified in the plan, but shall not exceed 180 days.
• Access the necessary resources detailed in the IPP, make referrals to qualified service providers and resources, and monitor that service providers implement the instructional, behavioral and service objectives of the IPP.
• Disseminate copies of all IPPs to the IDT persons and Participant-Directed service Option providers (if applicable) within 14 days of the IDT meeting.
• Upload the ISP, the Demographic/cover sheet and signature page into the UMCs web portal within 14 days of the IDT meeting. NOTE: No services will be prior authorized until the current IPP is loaded into the web portal.
• Upload into the UMCs web portal any additional documentation requested by BMS or the UMC.
• Disseminate copies of the budget sheet from the IDDW CareConnection website, once finalized.
• Monitor to ensure that the persons health and safety needs are addressed.
• Comply with reporting requirements of the WV IMS for persons on their caseload.
• Personally meet monthly with the person and their paid or natural supports that are present with the person the time of the visit at the persons residence to verify that services are being delivered in a safe environment, in accordance with the IPP and appropriately documented. The purpose of these visits is to determine progress toward obtaining services and resources, assess achievement of training objectives, and identification of unmet needs. The visit is documented on the Case Manager Home/Day Visit Form (WV-BMS-IDD-03).
• Provide planning and coordination before, during and after crises, including notifying the UMC if a person is admitted to a crisis site or state institution.
• Process Freedom of Choice forms (WV-BMS-IDD-2) in the UMCs web portal within two business days any time a person requests a change of Service Delivery Models.
• Coordinate Transfer/Discharge meetings to ensure the linkage to a new service provider or service delivery model and access to services when transferring services from one provider agency to another or to another type of service delivery model. Coordination efforts must continue until the transfer of services is finalized.
• Travel as necessary to complete Case Management activities related to the IPP.
• Provide information and assistance regarding participant-directed services during annual IPP meetings and upon request by the person or legal representative.
• Inform the person of their rights at least annually.
• Attend and participate in the annual functional assessment for eligibility conducted by UMC.
• Present persons proposed restrictive measures to the IDDW provider agencys Human Rights Committee (HRC) if no other professional is presenting the same information.
• Monitor any restrictive measures approved by the HRC to ensure the measures are implemented properly and reviewed at least annually by the HRC and by the IDT at every IDT meeting.
• Attend and contribute to Futures Planning sessions, including PATHs and MAPs.
• Link clients with necessary resources and services.
• Completes and submits documentation as required by Valley, Medicaid, Waiver and any other licensing agencies. Employee ensures that documentation (such as Progress Notes, SALs, Timesheets, Task Analysis Forms, Behavior Tracking Forms, DD Forms, etc.) are completed accurately and timely and will reflect services the client(s) has received as appropriate.
• Attends all mandated trainings related to profession and enhances knowledge and/or skills which includes Essential Learning Trainings.
• Adhere to Valleys Standards of Conduct and Compliance and follows ethical guidelines of their profession.
• Staff participates in group or individual supervision with his/her supervisor. It is expected that clinical staff will seek supervision/consultation at both scheduled and unscheduled times. For employees whose license requires specific supervision, an employee will meet the requirements of clinical supervision based on licensure definitions.
• Meets productivity standards of the I/DD Division.
• Promotes appropriate community interactions by handling public interactions in a professional and competent manner. Returns telephone calls and requests for information in a timely manner, promotes a positive image of the agency and maintains a good rapport with agency contacts.
• Serve on committees as assigned.
• OTHER DUTIES AS ASSIGNED.

• Ability to perform Essential Duties as outlined below.
• BA/BS in Human Service Field or a BA/BS in a non-human service field with one year experience in I/DD
• Ability to comply with all of Valleys Policies and procedures.
• Ability to comply with Clients Rights.
• Ability to comply with Valleys and Division departmental safety procedures.
• Ability to read, write and speak the English language.
• Valid Drivers License
• Current CPR/First Aid Certificate or ability to be trained.