CCMC announces changes to CCM credential

Could open the door for more hospital-based CMs

The Commission for Case Manager Certification (CCMC) in Rolling Meadows, IL, has announced changes to the eligibility criteria for the popular Certified Case Manager (CCM) credential. The changes could open the door for more hospital-based case managers to sit for the CCM exam.

According to Susan Gilpin, chief executive officer of the CCMC, the eligibility criteria changes are in effect for the applications submitted by the Nov. 15 deadline. The changes include a redefinition of "continuum of care" and elimination of the requirement that case managers apply the core components of case management in "multiple environments." Further, the new standards eliminate the requirement that case managers never provide direct patient care.

Gilpin says the eligibility criteria were adjusted based on research the CCMC conducted with regard to how case management has changed over the years.

"The available knowledge of the field of case management has grown so much, making the certification eligibility criteria that were appropriate and applicable 10 years ago no longer reflective of the field today," says Hussein A. Tahan, MS, DNSc(C), RN, CNA, director of nursing for cardiac specialties at Columbia Presbyterian Medical Center, New York Presbyterian Hospital in New York City. Tahan also is a commissioner with the CCMC. "The field is constantly changing. Therefore, as a commission, we had to revisit the eligibility criteria for the case management certification credential and revise them to meet the standards and the practices of case management as we know them today," he adds.

The changes were based in part on a CCMC-conducted pilot study of a random sample of 107 case manager job descriptions. "In reviewing the preliminary results, it did appear that case management had changed in a number of ways," Gilpin says. "Indications were that the definitions that the commission had been using with regard to continuum of care and the multiple environment issue did not necessarily work in the current environment." A more intensive job description study currently is under way and should be completed by summer 2003.

Previously, the CCMC required that a case manager function in "at least one environment beyond his/her work setting," a requirement that many hospital-based case managers found difficult to meet. The new standard, however, defines the continuum of care as matching "ongoing needs with the appropriate level and type of health, medical, financial, legal, and psychosocial care for services within a setting or across multiple environments."

According to Gilpin, "the biggest consideration was what this research was showing about the fact that people can practice case management without the additional step of referring out and having constant interaction with the individual receiving services once he or she has left the facility."

Earlier this year, the commission revisited its certification eligibility criteria and examined whether they were still necessary and relevant for today’s case management practice, Tahan says.

As a result and due to the changing case management knowledge, the commission made three main modifications in the criteria. First, it waived the criterion of "license in one’s specialty or field provided on the basis of an examination," he explains. It was necessary to eliminate this criterion because not every state provides or requires a professional license based on an exam. For example, the social work licensure by exam requirement varies based on regional location; not every state mandates social workers to have a professional licensure to be able to practice social work.

The second eligibility criterion the commission re-examined was that of the "multiple environments." Case managers were required to apply the core components of case management as defined in the certification handbook into more than one environment or setting. This criterion presented a challenge for case managers to meet, especially for those who function in the hospital setting.

This criterion was redefined focusing more on the behaviors and interactions of case managers with other providers and health care professionals across the continuum of care. For example, case managers in the hospital setting would be able to meet this criterion by virtue of their communication and interactions with other providers along the continuum of care such as home care agencies, skilled nursing facilities, case managers in managed care organizations, and durable medical equipment agents. Case managers also would be able to meet this revised criterion based on their role responsibilities that include assessment, planning, implementing, monitoring, evaluating, and following up on the care they provide to their patients. These activities require case managers to work with a patient and his or her family over time and to interact with multiple care providers and community agencies along the way.

Tahan notes that, in the hospital setting, the case manager plans the care to be received during the patient’s hospital stay and arranges for the community services necessary to meet the patient’s after discharge care needs. As a case manager, "you’re also making sure that you help transition the patient to the care setting where the most relevant level of care can be provided; that is, to ensure that the patient goes to the setting where his or her needs will be appropriately met. Even though case managers do not normally travel physically across care settings, they follow up on the patient’s plan of care and ensure that the patient’s transitional plan is appropriate and the care provided as needed."

The third criterion the commission eliminated is the "no direct care involvement." Since the practice of case management varies based on the organization and setting where case managers are employed and the patient population they care for, it sometimes is necessary for case managers to be involved in direct care providing.

For example, those in the hospital setting may be involved in care activities such as complex wound dressing changes (considering they are expert practitioners) or patient and family teachings regarding the plan of care and medical regimen. This change allows case managers whose job description includes both direct and indirect care responsibilities to be eligible for the certification exam compared to in the past, when eligibility was limited only to those who were not involved in direct care provision.

[For more information, contact:

  • Commission for Case Manager Certification, Rolling Meadows, IL. Telephone: (847) 818-0292. Web site: www.ccmcertification.org.]