Case Management & Continuing Care Flashcards

A client with opioid use disorder completes 28 days of residential treatment and is stepping down to intensive outpatient care. The client has no stable housing, and the only available IOP is a 90-minute commute from the shelter bed the client has been offered. The client says they will 'just figure it out.' Which case management action best supports continuity of care?

Answer: Coordinate transportation (e.g., transit passes or ride vouchers), arrange a warm handoff to the IOP, and set a defined follow-up contact within 48-72 hours of discharge

Continuing care transitions are highest-risk in the first days after discharge. Effective case management addresses concrete barriers (transportation, housing instability) and uses a warm handoff plus early follow-up contact. Accepting a vague plan ignores a predictable barrier, indefinitely delaying discharge is not typically justified or supported by authorization, and stepping down to a lower level of care than the assessment indicates compromises the ASAM-based placement.

During a care-planning meeting, a case manager realizes that a client's 42 CFR Part 2-protected SUD treatment records were included in a packet sent to the client's primary care physician under a general HIPAA authorization signed at the PCP's office. What is the most accurate assessment?

Answer: The disclosure was likely improper because 42 CFR Part 2 requires written consent that specifically meets Part 2 requirements for disclosure of SUD treatment records, and a general HIPAA authorization may not suffice

42 CFR Part 2 is generally more restrictive than HIPAA for records from federally assisted SUD programs. Disclosure typically requires a Part 2-compliant written consent that names the recipient and the purpose, so a general HIPAA authorization signed at another provider's office may not meet the standard. The case manager should assess the breach, document it, and follow the program's incident and notification procedures. (Note: recent regulatory changes have aligned some provisions with HIPAA, but Part 2 consent specificity remains central.)

A client in a drug court–mandated treatment program discloses to the case manager a new use episode and asks that the court not be told. The signed release permits reporting 'treatment participation and compliance.' Which response best aligns with ethical case management?

Answer: Review the signed consent scope with the client, explain what will be reported and why, document the discussion, and report only within the consent's scope while engaging the client in a plan to address the lapse

In mandated treatment, confidentiality is governed by the scope of the signed consent. Ethical practice means transparency with the client about what will be shared, reporting within that scope (including compliance information the consent covers), and responding clinically to the lapse. Neither blanket secrecy nor unlimited disclosure is correct, and transferring the client to avoid obligations is evasion.

Which of the following best distinguishes a recovery-oriented continuing care model from a traditional acute-care model of SUD treatment?

Answer: Continuing care emphasizes sustained, lower-intensity monitoring and support over months to years, with re-engagement protocols when early signs of relapse appear

Recovery-oriented continuing care treats SUDs as chronic conditions, using extended, flexible support (check-ins, recovery coaching, peer support, telephone-based monitoring) and prompt re-engagement when warning signs emerge, rather than a discrete episode that ends at discharge.

A case manager is coordinating care for a client stabilized on buprenorphine who also has a co-occurring generalized anxiety disorder. The client's psychiatrist wants to add a benzodiazepine, and the client's outpatient SUD counselor objects. What is the most appropriate case management role?

Answer: Convene or facilitate communication among the prescribers and the counselor, with client consent, share relevant information about the combined-use risk, and support the client in making an informed decision

Case managers coordinate and advocate; they do not make prescribing decisions. Because benzodiazepine co-use with buprenorphine carries respiratory-depression risk, the case manager should facilitate informed, consented communication among providers, ensure the client understands the risks and alternatives, and document the coordination.

At a 6-month review, a client's goals on the treatment plan are largely unchanged from intake, and the client has missed three consecutive case management appointments. Which action is the most appropriate first step?

Answer: Attempt outreach through the client's consented contact methods, explore barriers and changes in readiness, and reassess and revise the plan collaboratively

Case management involves ongoing monitoring and reassessment. Missed appointments and stalled goals suggest changes in barriers, readiness, or relevance of the plan. Outreach through consented methods and collaborative revision of goals follows person-centered practice, whereas discharge for non-compliance or stricter enforcement tends to worsen disengagement.