We are all in the business of advancing our communities and doing it by means of targeting the most underserved populations who are dealing with challenges we will never truly know. We provide a variety of services addressing food insecurity, financial assistance, mental health, education and workforce, advocacy, and connection to resources that are too many to name. The case manager sits right in the middle dealing with all of this, doing a job that is rewarding but never truly appreciated fully. There is so much demand; both in numbers and in need, that dealing with the day to day is extremely difficult in terms of providing a pathway to stability. So, it begs the question, what type of stability are we talking about, and what type of stability are we actually executing towards. Who are we able to get to stability and keep them there? I have spoken with many of you through webinars or meetings about thinking through the extremely poor, poor, and less poor; and who we are actually helping to get to stability. Those in the extremely poor to poor category are exceedingly difficult to help. And so many case managers have told me that they are helping to manage an immediate need, but when you extend the timeframe beyond that initial need, they have not had the time, money, or resources to even think through (yet alone execute) what is needed beyond that in terms of services and programs, their intensity, duration, frequency, and needed touchpoints from a relationship management standpoint to move their clients to longer term stability.
When I was in the investment advisement industry, we saw this all the time with a different type of client, those trying to manage their wealth. Sounds like apples to oranges, right? The concept is the same. People would come to with us with an immediate need, and yes we would help them with that need like life insurance or an annuity, etc. But it was not until we took a more comprehensive look at their overall situation to better understand how that life insurance or annuity fits into an overall wealth management plan trying to achieve their goals towards retirement, college planning for kids, or succession planning. It was here where we uncovered so many things, and identified so many areas to consider; tax ramifications, estate regulations and planning, risk tolerance, other assets, needs and goals, past behaviors and tendencies, and so many other factors that considered their overall protection, savings, and growth elements of their life and financial situation.
I see great parallels here with the work case managers face, and an interesting exercise I ask them to think through is; what would you do for a client if all you had was that one client to serve. Yes, this is unrealistic, but it gets this conversation going around what the ideal situation could be, and you could always work backwards from there. So for those clients you are dealing with who come to you through your intake channels for a specific need like job placement, food, financial assistance, mental health, etc.; what can case management look like that moves the client towards long term stability in a more comprehensive way. I think we have to understand that needs based or transaction based case management is hard work and truly needed, but there is a difference in this and case management that moves a client to stability and keeps them there.
Over the years I have noticed that making this distinction is critical because most have not thought this through. But once you do, it gives you a guiding light on what “could be”, and yes, we all understand that this may not be for every client, and every client may not need this level of support. However, it could help us understand what may be needed for the extremely poor and poor populations that we serve; and maybe the less poor can manage with our current services. It is important to know what we are up against and building a case management system that has a better chance dealing with the longer term stability pathway is critical. I say case management “system” because the time and labor needed to do this is extremely intense and we have to strive for economies of scale using technology, partners, coordinated efforts, efficient operations, data solutions, and so much more. More FTEs is not always the answer for solving this equation.