Leaders urge following CMSA standards

A unified front is needed, industry leaders say

The best definition of the roles and functions of a case manager to date are the 1995 CMSA Standards of Practice for Case Management, written and published by the Case Management Society of America (CMSA) in Little Rock, AR, according to many case management industry leaders interviewed by Case Management Advisor.

"The standards are our best defense. They should be every case manager’s bible. If we all follow the standards, we present a unified front no matter where or how we practice case management," says Sandra G. Colahan, RN, CCM, a nurse case manager with Aetna in Branford, CT, and the president of the Connecticut state chapter of CMSA.

"I get very concerned when professionals call themselves case managers but fail to follow the standards of practice," she says. (The CMSA Standards of Practice provide a framework for writing a concise job description for case managers. In many cases, an accurate job description may be the most vital document a case manager presents when seeking relicensure or recertification. See cover story for more information.)

Case managers should review their job descriptions and, at a minimum, assure that both their job descriptions and their actual practice adhere to the core functions of a case manager outlined in the CMSA standards, agrees Sandra L. Lowery, BSN, CRRN, CCM, president of Consultants in Case Management Intervention in Francestown, NH, and president-elect of CMSA. "I believe that this will allow case managers to respond to challenges, such as those raised by the New Hampshire State Board of Nursing."

The standards define the case management role and outline these four case management functions:

Assessor. The standards require a case manager to gather all relevant data and information regarding a case by interviewing the client, the family, and performing an evaluation of the entire situation. Case managers are also required to objectively evaluate all current treatment information to identify barriers, clarify realistic goals and objectives, and seek potential alternatives.

Planner. The standards require case managers to work with the client and family to develop a treatment plan that enhances client outcome and reduces the payer’s liability. Case managers also are required to initiate, implement, and monitor treatment progress.

Facilitator. The standards require case managers to promote communication between all team members, the client and family, and all concerned parties.

Advocate. The standards require case managers to incorporate the client’s individual needs and goals. Case managers also are required to educate and empower the client.

[Editor’s note: Every CMSA member receives one free copy of the 24-page document. Additional copies are available to members for $10. Nonmembers may buy copies for $12. Bulk rates are available. For more details, contact CMSA, 8201 Cantrell Road, Suite 230, Little Rock, AR 72227-2448. Telephone: (501) 225-2229. Fax: (501) 221-9068. Web site: www.cmsa.org. E-mail: cmsa@cmsa.org.]