Roles and Standards for Providing Casemanagement

Providing Case Management Services to Students with Special Health Care Needs

The School Nurse provides Case Management Services * to children and families at risk in order to promote early Identification, Evaluation, Diagnosis, and Coordinated Treatment in Early Intervention Service Systems.

* NOTE: Nebraska uses the term Service Coordination in place of Case Management Services.

RATIONALE:

Nurses are particularly suited to provide case management to high risk children with multiple health problems and their families. Nursing care embodies several elements of case management: it is complex, highly interactive, facilitates client's self-care capability, provides environments which assist clients to gain or maintain health, promotes the efficient use of resources and the creation of new services.

STRUCTURE CRITERIA:

1. A mechanism is in place that allows nurses participation in the identification of at-risk infants and children and the determination of their designated case manager.

2. Procedures are developed for the assignment of a nurse case manager for infants, children, and families with multiple complex health problems, and children in transition from health care facilities to the community.

3. Lines of accountability for outcomes of case management are established to assure the well being of the client.

4. Adequate resources are available to provide case management to all eligible clients.

5. Systems to protect client confidentiality.

PROCESS CRITERIA :

The School Nurse:

1. Provides case finding and screening to identify appropriate clients for case management.

2. Completes appropriate assessments.

3. Develops, implements, monitors, and modifies a plan of care through an interdisciplinary and cooperative team process in conjunction with the family.

4. Advocates for the child and the family with appropriate community resources.

5. Coordinates service providers responsible for furnishing services needed by child and family.

6. Monitors the service plan to ensure quality, quantity, timeliness, and effectiveness of the services.

7. Monitors the child's/family's progress towards the achievement of goals specified in the care plan.

8. Periodically reassesses to assure that services are appropriate, necessary, and do not increase dependence.

9. Develops new services in local communities.

OUTCOME CRITERIA:

1 . Child's and family's self-care capability is enhanced.

2. Family has access to needed services.

3. Family receives appropriate, coordinated delivery of necessary services.

4. Families receive personalized care.

5. Families make informed decisions about services.

(This section adapted from and used with permission of the National Standards of Nursing Practice for Early Intervention Services 01993. The complete document is available from NEBRASKA HEALTH AND HUMAN SERVICES, School Nurse Coordinator.)