What is the case manager’s role in meeting the qualified providers assurance?
Case managers play an important role in making sure that workers providing services meet the needs of HCBS waiver participants. Your involvement in making certain that workers are qualified will vary.
Some states require case management agencies to verify that direct care agencies and workers are qualified to provide the type of services they are providing. The state will review the records of the case management agency to make sure that this task is being done and that providers are qualified.
In other states, the role of making sure that providers are qualified is a function that state agencies perform. This includes making sure that case managers and case management agencies meet state requirements.
In either case, the case manager has a role in matching the needs of the participant with the qualifications of the workers. This starts with the development of the service plan. It continues as part of the referral process when case managers orient the service provider to participant needs and verify that the provider can meet those needs.
If a case manager or participant thinks that a worker is not doing his/her job the way it should be done, the case manager must respond. This may be an issue related to qualifications or training of the worker or it may be for other reasons. Your role as case manager is to identify the problem or issue and notify the appropriate people in the provider agency, your agency or state to remedy or investigate the situation. (click here for more information about a case manager's role under consumer-directed waivers)
Let’s go back to our case study now to see how Ruby is doing. Please click on the case study that you are following:
Case Study #1 - Mr. Richard Kaye, an older adult with medical conditions
Case Study #2 - Mr. Sam Wilson, an adult with intellectual disabilities
