Case Managers

Discussion in 'General Parenting' started by klmno, Apr 6, 2009.

  1. klmno

    klmno Active Member

    difficult child has never had a case manager- except for PO who called herself a case manager, although she never coordinated anything for difficult child. difficult child is in state juvy now, as you all know and I spoke to his case manager there last week. Ive been getting paperwork together that they need. I had to send permission for a temporary IEP to the school dept there and shot history to the infirmary. Then I had to send a form in about medication insurance- all these forms went to different addresses/people. The CM told me last week that the corrections division, mental health/physical health, and school divisions were all separate and no one from the other divisions see the records rec'd or kept for another division. She said she didn't have a clue what mental health records had been rec'd b/cc she only keeps up with the corrections portion. I'm putting together a package of the most important mental health stuff to send her so she can get it to the right people- although if I wasn't doing this, she wouldn't even be looking at them.

    I thought the role of any case manager was to have everything go through them and be the one person that has seen all sides and coordinate various disciplines and be the one who knows what both the right hand and left hand are doing, so to speak. Is that not correct?

    I realize I can't change what they do or how they do things, but I'm finding this disappointing. I thought a real benefit from difficult child being turned over to the state would be that one person (besides me) would finally see what the various different disciplines are saying, requiring, recommending, etc.
    Last edited: Apr 6, 2009
  2. Wiped Out

    Wiped Out Well-Known Member Staff Member

    I do think that is the idea but unfortunately it isn't how it always works.
  3. helpangel

    helpangel Active Member

    Ugh I would think a case manager is suppose to oversee all 3 areas, while putting together that packet I would send a copy of the shortened version (if there is one) to the school. I can't imagine trying to put together an IEP for anyone not knowing the mental health issues that are going on. How are they going to know what supports to put in place if don't know what's needed? If had a prior IEP I would also send a copy of that with a note of what I think should be added. Good luck with this.
  4. timer lady

    timer lady Queen of Hearts


    From having been in the system for so very long with the tweedles a case manager doesn't necessarily mean what you perceive it to mean. It sounds like this CM is simply for difficult child in the setting he's in.

    I asked for a CM to manage all the aspects of the tweedles mental health issues ~ from the scheduling of mtgs & evaluations to the possible admit to hospital or Residential Treatment Center (RTC).

    Our mental health CM had done it all from sitting at ER until wm was admitted to finding beds for the tweedles at Residential Treatment Center (RTC) & everything in between.

    AND I asked for a mental health CM. The county assigned "CY" ~ an incredible guy who's been with us since 2003. Will be with us until the tweedles turn 18 (unless he becomes a budget cut - God forbid). CM knows our family inside/out. CM is our biggest advocate; for me this is the most important part of his being a part of the treatment team. He attended husband's funeral ~ to lend us all support.

    klmno, that is really what you need for your difficult child as things are so complex that one woman cannot keep up with all the aspects of his ongoing issues. Is there a chance you can have a mental health case manager assigned?
  5. compassion

    compassion Member

    I am dealing with this right now. The cm is from the swate, she is helpin gme get s.s.i to get medicaid so difficult child's Residential Treatment Center (RTC) is paid. I thought she could help by faxing forms to the diabilies exsmineer but shr can only do dept. stuff.
    This is a mental helath manage which I hopw we can retain once difficult child is discharged;there is some quesiton as to fudning, we have private insuranec and they are mostly medicaid.
    Shw will help put wrap-around serives i place. She has connections with diagnosis diagnois program for under 18: I could have never ever have found that on my own. I am asking for aids, reaite, etc.: funding does not look like it is there but she wil do things like contact Auditory Processing Disorders (APD), etc.
    She sat in onher tratment team meeting last Wed. via speaker phone.
    I fel I am still doing the bulk of it but it is nice having others helping. She is putting togter as assessment:this will help in futre with documaentaion/services.
    Today, I pick difficult child up for neuropsychologist appointment., audiology appointment. and back to hapital for family therapy.
  6. klmno

    klmno Active Member

    Good morning! I need to clarify- I agree with a mental health CM being needed- I had asked for one a few mos ago but that was another issue with difficult child already being on probation- they said his PO was his CM. That's another thing I thought the GAL should have been trying to get, instead of spending her minimal time on the case trashing me.

    Anyway, this CM that I am referring to in this thread works for state juvy and is at the place where difficult child is now. The other divisions that I'm referring to- the school difficult child will attend and the mental/physical health profs- are all state operated and have nothing to do with any local jusrisdiction' Department of Juvenile Justice, sd, etc. State juvy is all encompassing- which is why I thought his CM there would be keeping up with all aspects of his requirements (corrections, education, and mental health).

    Another thing that makes me nervous about this- a psychologist will be in charge of his mental health treatment, including determining what info gets passed along to a psychiatrist. difficult child will only see a psychiatrist the legal minimal amount of time for the psychiatrist to write rx's. Given difficult child's sensitivity to medications and the way some (even allergy medications) have triggered mood cycling or something, I'm a little worried about this. What happens if a new medication is tried, difficult child falls asleep in school or gets really hyper in the "living quarters"- does staff even realize that it could be the medication change and does the info make it to the psychiatric? Does the psychiatric relay it to the psychiatrist? How many weeks does it take? difficult child is not to a point where he always sees it is the medication that contributed. If the point is not to consider or depend on the medications, and they are going to try to do this with behavior mod alone, then I want him taken off medications.

    I didn't want to bombard them with info, but I'm sending a copy of neuropsychologist testing, the MDE report, the last letters written from his treatment team I had him with, the treatment plan, discharge summary, and recommendations from the psychiatric hospital that the local detention tdo'd him to in Feb, and a 1 page bulleted list of previous acute psychiatric hospital stays, medications tried in the past, and an "other" category that includes medications he has had adverse reactions to (like zyrtec, albuterol, and SSRI's), and his seasonal pattern of depression and legal trouble. Then, I wrote a sentence saying my and difficult child's preference that he not be on any medications if their behavior mod or other therapy alone can get this under control- and letting them know that they can contact me if they need further info or release forms signed so they can verify any of this.

    They wouldn't have known any of this- the only info they got was sent by the PO and she didn't even believe in mental health issues, much less know what an SSRI was or that difficult child's crime spree 2 years ago could have something to do with it. I'd bet my house that the PO doesn't even have it in her file that difficult child was on prozac at the time that happened or that he'd been given abilify for 3 days before he whipped this knife out on me. The way things work here, the mental health treatment might as well be thrown out the window if a kid is involved in Department of Juvenile Justice. They will allow/provide/require mst in some cases but, at least the guy we have here, did nothing but a behavior contract and wanted things difficult child's time with other therapist cut out.

    I have seen the issue this way for 2 years- Department of Juvenile Justice wants to be in control of my and difficult child's lives (local level and now turned over to state) and want to require mental health treatment, yet the people in Department of Juvenile Justice overseeing us 1) ignore the profs recommendations 2) apparently believe mental health treatment is only supposed to be behavior mod, and 3) don't accurately document or make required decisions when it comes to mental health treatment- they just tell me that "they think I'm the source of the problem and they don't know anything about mental health stuff". So basicly, it ties my hands and leaves them in control but then they won't do anything to address the issue before it becomes another legal charge. This will be the first conversation I'm going to try to have with the parole officer as soon as I know who it is in a couple of weeks (so I've been told). How that conversation goes will have a lot to do with my future decisions regarding where I live and whether or not difficult child comes back home.

    I'm getting Occupational Therapist (OT)- sorry-
    Last edited: Apr 7, 2009