LMSW LMSW Case Management and Service Coordination 5 — Questions and Answers
Question 1: A hospital social worker is coordinating discharge planning for a client who lacks decision-making capacity and has no identified next of kin. The FIRST step is to:
- Proceed with discharge to a skilled nursing facility based on clinical recommendation
- Contact the state's adult protective services to appoint a guardian
- Identify whether any advance directives exist and consult the hospital's ethics committee (Correct answer)
- Hold the client in the hospital until capacity is regained
Correct answer: Identify whether any advance directives exist and consult the hospital's ethics committee
When a client lacks capacity and has no surrogate, reviewing advance directives and engaging the ethics committee ensures decisions align with the client's prior expressed wishes and legal standards.
Question 2: A case manager working with a child welfare client must balance family reunification goals with child safety. Which framework BEST guides this ethical tension?
- The child's best interest standard, which places child safety as the paramount consideration (Correct answer)
- Family preservation, which always prioritizes keeping the family intact
- Client self-determination, allowing parents to define what is safe
- Normalization theory, which assumes all families can achieve adequate safety with services
Correct answer: The child's best interest standard, which places child safety as the paramount consideration
The best interest standard in child welfare law and practice establishes that child safety and well-being take precedence over family preservation when the two conflict.
Question 3: Which type of case management model assigns one social worker to provide both clinical therapy and service coordination to the same client?
- Brokerage model
- Assertive Community Treatment (ACT) model
- Clinical case management model (Correct answer)
- Intensive Case Management (ICM) model
Correct answer: Clinical case management model
The clinical case management model integrates therapeutic intervention with service coordination, with one worker providing both functions to promote a strong therapeutic alliance.
Question 4: A case manager is helping a client navigate an appeal after their disability benefits were denied. This activity is BEST described as:
- Supportive counseling
- Systems advocacy (Correct answer)
- Case consultation
- Crisis intervention
Correct answer: Systems advocacy
Systems advocacy involves helping clients navigate and challenge institutional or bureaucratic decisions that affect their access to resources and entitlements.
Question 5: An LMSW conducting a functional assessment for an older adult is PRIMARILY trying to determine:
- The client's psychiatric diagnosis and medication needs
- The client's ability to perform activities of daily living and instrumental activities of daily living (Correct answer)
- The client's eligibility for Medicare Part D
- The client's level of cognitive impairment using standardized screening tools
Correct answer: The client's ability to perform activities of daily living and instrumental activities of daily living
Functional assessments evaluate a client's capacity to perform ADLs (bathing, dressing) and IADLs (managing finances, transportation) to determine service needs and appropriate care level.
Question 6: A case manager learns that two agencies serving the same client are providing duplicative services and billing Medicaid separately for them. The social worker's MOST appropriate action is to:
- Ignore the issue since each agency's billing is handled independently
- Report the concern through appropriate channels, such as a supervisor or compliance officer, as potential Medicaid fraud (Correct answer)
- Confront the agencies directly and demand they stop billing
- Discontinue the client's services from one agency without informing the client
Correct answer: Report the concern through appropriate channels, such as a supervisor or compliance officer, as potential Medicaid fraud
Duplicate Medicaid billing constitutes potential fraud; reporting through proper compliance channels is both an ethical and legal obligation for social workers.
Question 7: When evaluating the effectiveness of a case management intervention, which outcome measure is MOST aligned with client-centered practice?
- Number of referrals made by the case manager
- Rate of appointment attendance across referred services
- Client-reported goal attainment and satisfaction with services (Correct answer)
- Reduction in emergency department visits
Correct answer: Client-reported goal attainment and satisfaction with services
Client-centered practice prioritizes the client's own assessment of goal progress and service satisfaction as the most meaningful indicator of effective case management.
LMSW LMSW Case Management and Service Coordination 5
A hospital social worker is coordinating discharge planning for a client who lacks decision-making capacity and has no identified next of kin.
The FIRST step is to: