clinical case management: a new service offering in college health cara ludlow, lmsw, caadc michigan...
TRANSCRIPT
Clinical Case Management:
A New Service Offering in College Health
Cara Ludlow, LMSW, CAADCMichigan State University
Jamie Pyo, MS, LPC Penn State Altoona
Learning ObjectivesO Define three roles of Case
Management in college health
O Define three benefits of Case Management to college students
O Identify three improvements in service delivery that have resulted from the implementation of Case Management services within student health care settings
The Complexities of Today’s College
Students
2012 NCHA Survey Results
Percent of Students for Whom Various Issues Were Traumatic/ Very Difficult in the Past Year
2012 NCHA survey results prepared by Larry Hembroff, Ph.D., Director of IPPSR's Office for Survey Research
Percent of Students Feeling Emotionally Challenged
2012 NCHA survey results prepared by Larry Hembroff, Ph.D., Director of IPPSR's Office for Survey Research
Factors Impacting Academic Performance
2012 NCHA survey results prepared by Larry Hembroff, Ph.D., Director of IPPSR's Office for Survey Research
Two Models of Case Management
Michigan State University
Penn State Altoona
Michigan State University
O Big Ten University outside state capital
O 49,343 students from all 83 counties in Michigan, all 50 states in the United States and 130 other countries worldwide
O 37,988 undergraduate
O 11,355 graduate and professional school
O 50% women and 50% men
O 16.6 % students of color; 14.5 % international
O Third largest single-campus residential system in the nation
Fall 2013 statistics: http://www.msu.edu/about/thisismsu/facts.html
MSU Student Health ServicesOlin Student Health Center
Primary Care
O 50,000 visits per yearO 40% of students visit annuallyO 6.2 CFTE PhysiciansO 2.3 CFTE Physician AssistantsO 1.1 CFTE Nurse PractitionerO 9.0 FTE NursingO 6.0 FTE Medical Assistants
Psychiatry
O 5000 visits per yearO 2.5% of students visit annually O 4.0 CFTE PsychiatristsO 1.0 FTE Psychiatric NurseO 2.5 FTE Clinical Social Worker,
Care Manager and Social Work Fellow
MSU Counseling Services
O 10,000 individual visits a year
O 3,000 unique students
O 14 FTE Counselors; Psychologists, Masters of Social Work and Licensed Professional Counselors
O .83 FTE Case Manager
O 4 FTE Pre-Doctoral and Post-Doctoral Students
August 31, 2013 - May 12, 2014
History of Case Management within Student Health
Services and Counseling Center
O In 2008 Michigan State University joined the National College Depression Project
O Added Part Time Case Manager position to follow NCDP participants
O In 2011 grant was completed
O 2012 added full-time Case Manager position
O 2013 added Post-Master of Social Work Fellow
O 2013 MSU Counseling Center added full-time Case Manager
Penn State AltoonaO 4,000 undergraduates
O Rural area
O Commuter campus
O 900 residence hall spaces
O 22% minority students
Penn State AltoonaSheetz Family Health & Wellness Center
Health and Wellness Center Services
Primary CareO 3100 visits per yearO 2 FTE NPO 1 PT Physician
Counseling & Psychological Services (CAPS)O 1650 visits per yearO 80 case management visits per yearO 4 FTE LPCsO 4 hours per month consulting Psychiatrist
Health & Wellness Center (HWC)
O Integrated Health and Counseling services
O Shared EMR
O Weekly Multidisciplinary Team Meetings
O Seamless in-house referrals
History of Case Management at PSU Altoona
O 2008 Penn State Altoona received the GLS Suicide Prevention Grant, allowed for new position (Mental Health Outreach Coordinator)
O MH outreach coordinator assumed case management responsibilities to follow National College Depression Partnership students
O 2009 MH outreach coordinator began meeting with students to provide supportive counseling through case management as a new service
The Role of Case Managersin Student Health
Case Management atPenn State Altoona
O Meet with students individually who are in need of additional educational and/or community mental health resources
O Meet individually with students who don’t meet the criteria for individual counseling, but need support
O Meet with students who are in individual counseling and need additional support
Case Management atPenn State Altoona
O Early Alert Program Coordinator
O First option for students presenting in crisis
O Instruct students in the use of the biofeedbackEASE program
Case Manager Role in Student Health Services at Michigan State UniversityO Provide direct and indirect services to students as part of integrated treatment team
O Monitor high-risk students as part of an interdisciplinary team providing ongoing risk assessment, crisis intervention, safety planning and follow-up with high acuity students
O Part of Clinical Review Team in Partnership with MSU Counseling Center
O Part of university-wide Interdisciplinary Behavioral Intervention Team [BIT] which includes MSU Police Department, Department of Student Life [Student Conduct], MSU Counseling Center and Residence Education and Housing services
O Assist and facilitate voluntary and involuntary hospitalizations through admission, discharge planning and follow-up
Case Manager Role in Student Health Services at Michigan State University
O Coordinate referrals to MSU’s Resource Center for Person’s with Disabilities
O Assist students in navigating MSU’s Medical Withdraw process through the University Physician’s Office
O Refer and facilitate services for students with community partners and treatment providers outside of university system
O Provide brief supportive counseling and bridging to long term treatment providers
O Provide follow-up with students to confirm connection and engagement with services
Benefits of Case Management
Benefits of Case Management
O Improved collaboration and integration with students and providers in addressing students health and mental health needs
O Increased monitoring and support of high acuity students
O Provide transitional care and coordination during changes in student status
Benefits of Case Management
O Provide additional model of support aside from traditional counseling
O Identify and seek to resolve barriers
O Helping new and existing students learn about and connect to campus and community services
O Follow-up with students to ensure care was secured
O More efficient use of Psychiatry and Counselor time
O Increase academic performance and retention
Improvements in Service Delivery
Improvements in Service Delivery
O Increased monitoring of high risk students
O Quicker response time in engaging students
O More comprehensive continuum of care between treatment providers
Improvements in Service Delivery
O Increased engagement in treatment and supportive services
O Reduction in missed or no-show appointments
O Improved communication and support between multi-disciplinary staff in health centers, counseling centers and across campus
Student ResponsePenn State Altoona
O 85% of students receiving case management services were satisfied with the service
O 93% of students agreed or strongly agreed that case management provided help with improving emotional health
O 93% of students agreed or strongly agreed that case management helped them stay in school
O 78% of students agreed or strongly agreed that case management helped them maintain academic performance
Challenges in Case Management
Challenges in Case ManagementMichigan State University
O Service providers in two separate buildings on campus
O Different administrative units and separate funding for services
O Documentation across two electronic records systems that do not interface
O Duplication of services between Health Center and MSU Counseling Center
O Increased risk of triangulation between multiple treatment providers
O Historic cultural differences:“Medical Model vs. Developmental Model”
Challenges in Case ManagementPenn State Altoona
O Students and staff lack of knowledge of the role and service, lead to hesitancy at times
O Local students are at times reluctant to try community resources
O Insurance issues
O Lack of availability of psychiatry and at times counseling in the community
Bridging the Gaps
Rami Sean
RamiO Currently 21 year old single femaleO International student from JapanO College of Social Science; Psychology majorO First contact was 2011 fall semester, freshman
yearO Withdrew from first semester and returned home
to JapanO Returned to MSU; three suicide attempts in four
weeks, involuntary suspension from school, and ambivalent about engaging in treatment/services
SeanO 20 year old male student
O Diagnosed with ADHD in 7th grade, prescribed
Adderall 15mg twice daily since then
O First semester, fall 2012 did well
O Second semester, spring 2013 medically withdrew
O Fall 2013 stayed home and completed online
coursework
O Currently attempting third semester
O Living in the residence halls
Questions?
Contact InformationO Cara Luldlow: [email protected] Jamie Pyo: [email protected]
ReferencesO 2012 NCHA Full report available at: O http://www.ippsr.msu.edu/NCHA/NCHA_2012_Repo
rt.pdfO Van Brunt, B., Woodley, E., Gunn, J., Raleigh, MJ,
Reinach Wolf, C. & Sokolow, B. (2012). Case Management in Higher Education. Publication of the National Behavioral Intervention Team Association (NaBITA) and the American College Counseling Association (ACCA).
O Wilson, C., Powell, A., Woodley, E., Nelson-Moss, T.M., Blamey, A., & Thibodeau, T. The History of Case Management in Higher Education. Publication of the Higher Education Case Managers Association (HECMA).