Case management support is designed to be short-term and goal oriented.
This means that eventually there should come a time in the case that a case manager has provided all the support they can by reducing the students’ risk, connecting them to resources, and addressing any barriers or obstacles the student may face. When this happens, cases should be brought forward for case review to decide whether the case should remain active (in instances where there are unresolved issues), moved to inactive (initial rating was Mild or Moderate and the action plan is complete), or moved to a monitoring plan. Monitoring plans should be developed for cases where a student’s action plan has been completed but where the initial risk level was high (either Elevated or Critical). It is important to engage in long-term monitoring in these cases to ensure the student remains at a reduced risk level over time. This monitoring, or follow up, is the responsibility of the case manager – not the student. The case manager needs to engage in follow up actions to make sure the student remains at a reduced risk level and is not engaging in any concerning behavior that would alert the attention of the BIT or the case manager. The follow-up items should be directly tailored to the student and tied to the risk factors for the student.
Take for example a student who was initially referred to case management for significant disordered eating concerns that were risky but not life threatening, and which disrupted others. The student came to the attention of the BIT and case manager as they were concerning others in the residence hall and performing poorly on their athletic team. This student would be rated at Elevated on the NABITA Risk Rubric and connected with the BIT and case management. Depending on the extent of the disruption, there may also be a referral to student conduct. Given these concerns, the case manager is likely working with the student across several appointments to build rapport, connect them to counseling and medical services, assist through the conduct process, and work on behavioral skills to increase coping and reduce the likelihood of future disruption. Once the student has connected with a counselor and a doctor, concluded the conduct process, and demonstrated improved coping and behavioral skills, the action items would be considered complete. However, given the high-risk nature of the initial referral, the need for continued engagement with resources, and the need to maintain appropriate coping skills, it would be prudent for the case manager to continue monitoring the case to ensure these things happen. For this case, the risk factors presented themselves in the residence hall and to the athletic trainers. Check-ins with these staff periodically would therefore be helpful in assessing how the student is doing. Further, releases of information with the counselor and medical provider should be in place so that the case manager can check that the student remains engaged with the resources. The Sample Monitoring Plan below operationalizes this by creating deadlines and actions around these check-ins.
|Month||Case Management Action|
|November||Case Management action items complete and risk reduced to Moderate. Moving case to monitoring plan.|
|December||Email to student to check in re: end of semester. Check in with medical doctor and counselor re: engagement in services.|
|January||Welcome back from break email to student. Remind to schedule with counselor and medical provider.|
|February||Check in with counselor re: reengagement in services. Check in with Residence Life and Athletic Trainer to see how the student is doing.|
|March||Email check in with student re: midterms and semester overall.|
|April||Check in with counselor re: engagement in services. Check in with Residence Life and Athletic Trainer to see how the student is doing.|
|May||End of semester check in with student.|
|June||Re-staff case for case review.|
The goal of the monitoring plan is to increase the likelihood that the student remains engaged in the resources and/or behavior that helped them reduce their risk and stay healthy. If the case manager continues to monitor the student over a semester and no new risk factors become present, the case manager can move the case to inactive. However, if there are any indicators that the student may be struggling, disrupting others, experience barriers, disengaged from services, etc., then the case should be moved back to active and referred to the BIT and the student should be brought back in for further case management services.