Case management should be central to the operation of the interdisciplinary treatment team. Case managers for Native Americans require special skills in advocacy, access of community-based services and systems, and interagency coordination. Case management should also be consumer- and family-driven. Case managers should be accountable for the cost and appropriateness of the services they coordinate.
1. Urban/Suburban and Rural/Reservation:
Case managers working with Native consumers and families should be able to demonstrate their level of cultural competence as a condition of their employment.
2. Urban/Suburban and Rural/Reservation:
Case managers should be knowledgeable about the community, its resources, and natural supports.
3. Urban/Suburban and Rural/Reservation:
Case managers should have access to flexible funds for the provision of wrap-around services.
4. Urban/Suburban and Rural/Reservation:
Case management should be continuous and proportional to the degree of the consumer’s need, level of impairment, and person/family resilience. The case manager should act as a single point of contact and have responsibility across all levels of the system of care.
5. Urban/Suburban and Rural/Reservation:
The Health Plan should define and enforce caseloads for case managers consistent with industry standards, accounting for severity of consumer impairment/case mix and associated cultural stressors. These should enable case managers (especially ethnic minority) to effectively serve consumers and prevent burnout and unacceptable levels of turnover.
6. Urban/Suburban and Rural/Reservation:
Access and advocacy support should be afforded to case managers across the entire system of care including settings such as inpatient facilities.
Recommended Performance Indicators
- Cultural competence requirements commensurate with level of responsibility and supervision provided for case managers who serve Native Americans.
- Cultural competence training for all case managers as part of a credentialing process.
- Community resources and natural supports included in all care plans.
- Use of flexible funding for Native American consumers, comparable to others.
- Sufficient numbers of case managers to support caseload standards for Native American consumers.
- Consumer and case manager involvement in level of care and other treatment decisions.
- Consumer and family satisfaction with selection of services
Benchmark: 90% satisfaction
- Reduction in utilization and lengths of stay for more restrictive levels of care
Benchmark: Comparable to overall community and decreasing over time