http://www.cfha.net/forum_thread.php?t=70Recent posts in Fran Parker: "A Day in the Life of a Case Manager"http://www.cfha.net/forum_thread.php?t=70#post146pWow This is a ton of work. Veyr impressive. Thank you for sharing this as many out there may not know the complexity and time that goes into comprehensive programs like the one you discuss. Not to open up another lexicon discussion but I know I have been asked about the difference between case managers and care managers. I wonder if this is something you all get as wellphttp://www.cfha.net/forum_thread.php?t=70#post138pFran and Sarahnbsp Im struck by the amount of community and health resource procurement going on.nbsp Is that typical for case management at Marillac Clinicnbsp Do you think a case manager would have a different role in a for-profit setting like described by Dr. Whistlernbsp Possibly more chronic disease managementphttp://www.cfha.net/forum_thread.php?t=70#post133pClinical case management is a core aspect of Marillac Clinics Integrated Care model.nbsp It is provided by a full-time case manager all of our counselors and to a lesser degree by our medical and nursing providers.nbsp These services were recently a titleLink to Case in Point article hrefpagesCase-in-Point-Magazine-July-2009describeda in the national periodical for case managers and innbsp a a titleLink to Marillacs integrated care model hrefpagesMarillac-Clinic-Integrated-Care-Modeldescriptiona of Marillac Clinics integrated care services that was presented to the Advancing Colorados Mental Health Care initiative.ppnbspppThe following is a description of an actual day in the life of our full-time case manager Sarah.ppnbspppSarah starts her Tuesday at 800 am at the weekly mental health providers meeting.nbsp Her participation in the meeting is disrupted when the front desks calls her to help with a patient.nbsp Martha a 58 year old homeless woman has come to the Clinic asking for an early medication refill.ppnbspppBy 10 am Sarah has handled phone calls from two parents calling on behalf of adult children waiting for medications through the Medication Assistance Program MAP.nbsp Shes assisted two patients with the disability application process.nbsp The local mental health center has faxed a discharge plan for a patient who will be coming to Marillac for service and she decides she needs to follow up for additional information.ppnbspppOver the next hour and a half Sarah gets two requests from women needing early medication refills because of travel plans.nbsp Lisa makes her request in person.nbsp Sarah is familiar with Lisas case and provides a brief counseling intervention since her mental health provider is not available.nbsp The other early refill request is made over the phone.nbsp Sarah is familiar with Karen who has no-showed for several medical appointments.nbsp The patient has been told repeatedly she needs to see a medical provider before her prescriptions will be refilled.nbsp Sarah tells both women she will need to check with the medical team and get back to them.ppnbspppThe Clinical Case Manager also answers disability related questions from another patient reassures an asthmatic patient who calls concerned that her Advair will not arrive in time and handles a phone call from a pharmacy provider confused about the pharmacys new contract with Marillac Clinic.nbsp She briefs two of her colleagues a physician assistant and a mental health provider about a patient with auditory hallucinations.nbsp Sarahs scheduled the two providers for a joint appointment with this patient.ppnbspppWhen a medical provider asks Sarah to meet and greet a patient just discharged from an inpatient substance abuse program Sarah goes into the exam room talks with him and reinforces his relapse prevention plan. nbspAfter 25 minutes the two of them decide he currently has enough structure and support in an aftercare program.nbsp Sarah tells him to call her if he needs help.ppnbspppAt 1140 am Sarah finds the Medical Officer of the Day MOD and discusses the two early refill requests.nbsp The MOD approves Lisas request.nbsp However the MOD does not approve Karens request.nbsp Instead the MOD writes a prescription with instructions on how to taper down the patients anti-anxiety medication.nbsp When Karen returns from her trip and keeps an appointment with a medical provider her health status and medication needs can be reassessed.ppnbspppBefore she leaves for lunch Sarah discusses financial assistance programs with a 29 year old patient who needs shoulder and eye surgery.nbsp After lunch she fields another call from the pharmacy and faxes a voucher so the cost of medication for a homeless man will be billed to Marillac.nbsp She listens to voice mail message from a case manager at the local domestic violence shelter whos checking on the status of the agencys request for a psychiatric evaluation of an undocumented person.ppnbspppTheres also a message from a man who needs a psychiatric consultation about potential interactions between his psychiatric and other medications.nbsp Sarah has been working for three months to arrange a consultation with an out of town psychiatrist due to the local shortage of psychiatrists.nbsp She makes several phone calls to arrange an appointment on a day the patient will have transportation.ppnbspppMid-afternoon finds the Clinical Case Manager getting patient updates from several colleagues a volunteer counselor and a staff mental health provider.nbsp She reviews the records on Larry who has two prostheses.nbsp Larry cant afford the approximately 1000year cost of replacement parts.nbsp She calls the prosthetics provider about arranging a payment plan.ppnbspppAt 315 pm a medical provider asks Sarah to meet with a woman whos grieving her mothers recent death.nbsp Sarah spends nearly an hour encouraging the woman to find some balance between meeting her fathers needs and her own self care.ppnbspAs the day draws near to an end Sarah talks to a medical provider about potential resources for Leonor a woman who has a very large kidney stone.nbsp Leonors not a citizen so she isnt eligible for most assistance programs.ppnbspppShe responds to another call from the pharmacy and another patient whos seeking sample medications while waiting for MAP.nbsp After receiving a second phone call from a father about his daughters medication Sarah checks the Medication Outlet and finds the medication has arrived.nbsp She calls the father back with the good news.ppnbspppSarah ends her day noting that it has been kind of slowp