CCM Client Advocacy and Engagement 2 — Questions and Answers
Question 1: A client with limited English proficiency refuses a recommended surgical procedure. What is the case manager's priority action?
- Document the refusal and close the case
- Arrange for a qualified medical interpreter and ensure informed consent is fully understood (Correct answer)
- Ask a family member to translate the risks and benefits
- Proceed with scheduling as the physician has already explained the procedure
Correct answer: Arrange for a qualified medical interpreter and ensure informed consent is fully understood
A qualified medical interpreter must be provided to ensure the client fully understands the procedure and can give true informed consent.
Question 2: Which principle best describes a case manager acting as a client advocate when the insurance plan denies a medically necessary treatment?
- Accepting the denial to avoid conflict with the payer
- Filing an appeal supported by clinical evidence on the client's behalf (Correct answer)
- Encouraging the client to pay out-of-pocket
- Referring the client to a different physician who may order less expensive care
Correct answer: Filing an appeal supported by clinical evidence on the client's behalf
Advocacy includes initiating and supporting appeals with clinical documentation when a denial conflicts with the client's medical needs.
Question 3: A case manager notices that a client's care plan goals were set entirely by the medical team without the client's input. What should the case manager do?
- Implement the plan as written since clinicians are the experts
- Revisit the care plan with the client to incorporate their preferences and priorities (Correct answer)
- Suggest the client speak with the physician directly
- Document that the client was informed of the plan
Correct answer: Revisit the care plan with the client to incorporate their preferences and priorities
Person-centered care requires that clients actively participate in developing their own care plans, not merely be informed of them.
Question 4: A client discloses they cannot afford their prescribed medications and has been skipping doses. The case manager's best initial response is to:
- Advise the client to contact the pharmacy for a discount
- Assess all barriers, then connect the client to manufacturer assistance programs, copay cards, or community resources (Correct answer)
- Document medication non-adherence in the chart
- Notify the prescribing physician that the client is non-compliant
Correct answer: Assess all barriers, then connect the client to manufacturer assistance programs, copay cards, or community resources
The case manager must first conduct a thorough needs assessment and then proactively connect the client to financial assistance resources.
Question 5: Which action demonstrates the highest level of client engagement in discharge planning?
- Handing the client a printed discharge summary
- Scheduling a follow-up appointment without consulting the client's schedule
- Collaborating with the client to set post-discharge goals and confirm they have transportation and support (Correct answer)
- Having the social worker finalize all arrangements
Correct answer: Collaborating with the client to set post-discharge goals and confirm they have transportation and support
True engagement means the client co-creates the discharge plan, including identifying personal barriers such as transportation and social support.
Question 6: A client with a serious mental illness lacks insight into their condition and refuses all services. What ethical principle is most in tension with mandating treatment?
- Beneficence
- Justice
- Autonomy (Correct answer)
- Nonmaleficence
Correct answer: Autonomy
Autonomy — the client's right to self-determination — is in direct tension with beneficence when a client with limited insight refuses beneficial treatment.
Question 7: When advocating for a client experiencing homelessness, the case manager should FIRST:
- Contact housing authorities to place the client on a waiting list
- Conduct a comprehensive assessment of the client's immediate safety, health, and social needs (Correct answer)
- Refer the client to a shelter and close the case
- Notify the employer of the client's living situation
Correct answer: Conduct a comprehensive assessment of the client's immediate safety, health, and social needs
A thorough biopsychosocial assessment must precede any referral to ensure interventions match the client's actual and priority needs.
CCM Client Advocacy and Engagement 2
A client with limited English proficiency refuses a recommended surgical procedure.
What is the case manager's priority action?