Case Management & Continuing Care Flashcards

A client with opioid use disorder has completed 90 days of residential treatment and is stepping down to intensive outpatient care. The case manager notices the client's housing plan depends on a sober-living bed that will not open for 3 weeks. Which action best reflects sound continuing-care planning?

Answer: Arrange interim recovery housing or a bridge placement, document the contingency plan, and schedule an early post-transition check-in

Continuing-care planning requires anticipating gaps in transition. An interim or bridge placement with a documented contingency plan and early follow-up prevents loss of recovery environment during a high-risk period. Extending residential care without reassessment ignores level-of-care criteria, and reactive or preference-based approaches leave the client unsupported.

A case manager receives a request from a probation officer for treatment progress details on a client whose consent form authorizes release of 'attendance and drug screen results' only. The officer also asks about counseling session content. How should the case manager respond under 42 CFR Part 2 principles?

Answer: Release only attendance and drug screen results as authorized, and obtain a new or amended consent before disclosing anything further

Disclosures under 42 CFR Part 2 are limited to the scope specified in the written consent. Criminal justice referral does not broaden consent beyond what the client signed; additional disclosure needs an amended consent.

During a multidisciplinary case conference, the treating psychiatrist recommends discontinuing medication for a client's co-occurring bipolar disorder, while the client's substance use counselor strongly disagrees. As case manager, what is the most appropriate role?

Answer: Facilitate a structured resolution that includes the client's input, ensure the prescriber retains medical authority, and document the outcome

Case managers coordinate and advocate but do not override prescribers' medical decisions. Facilitating communication, centering client voice, and documenting the process is the appropriate role in integrated care for co-occurring disorders.

A client in continuing care has missed three consecutive recovery-support appointments after a job loss. Which case management response is most consistent with a strengths-based, recovery-oriented approach?

Answer: Conduct assertive outreach, reassess barriers collaboratively, and adjust the plan (e.g., scheduling, transportation, employment supports)

Missed appointments after a major stressor signal increased relapse risk. Assertive outreach and collaborative reassessment of barriers maintain engagement and respect client self-determination; punitive responses tend to push clients out of care.

When evaluating the effectiveness of a continuing-care plan at 6 months, which measure provides the most meaningful indicator of case management outcomes beyond abstinence alone?

Answer: Improvement across recovery domains such as stable housing, employment or education, social support, and health engagement

Recovery-oriented outcome evaluation looks at functioning across life domains, not just abstinence or process counts. Referral and appointment counts measure activity rather than client outcomes.

A client with limited English proficiency is referred to an outpatient program that offers services only in English. What is the best case management action?

Answer: Identify a linguistically appropriate provider or arrange qualified interpreter services, and confirm the client's understanding of the plan

Culturally and linguistically competent case management requires qualified interpreters or matched providers. Using family members, especially minors, compromises confidentiality and accuracy, and deferring care creates unnecessary risk.