Service
Coordination
Frequently Asked Questions
What is the distinction between service coordination and case management
practices?
Service coordination, as noted above, entails working with youth
with disabilities and their families to identify needs and strengths
in all areas of their lives. Service coordinators review all assessment
information from across disciplines (educational, health, psychological,
vocational, etc.) and consider its impact upon the goals of the
youth and their families. They also use this information to assess
accommodation/support needs. In addition, service coordinators have
access to formal and informal resources for youth and their families,
including housing, social services, social security, recreation,
postsecondary education, and other areas. In addition, they can
help the youth and family acquire an analysis of the financial impact
of employment on benefits received.
Case management differs primarily in its focus and access to services
and resources. A case manager manages an individual plan through
a specific discipline. For example, a special education teacher
manages the IEP, a social worker manages the Individual Service
Plan (ISP), a rehabilitation counselor manages the Individual Plan
for Employment (IPE), and the health care provider manages the health/mental
health plan. These professionals do not generally work together
or understand how each of their assessment and service plans influence
each other.
How does service coordination support transition planning?
A major barrier to post-school employment and related outcomes
for youth with disabilities and their families is the lack of access
to needed adult services and supports. Young people with disabilities,
their families, and their teachers, who typically take a lead in
the planning process, often fail to receive critical and timely
information and assistance from agency personnel (Johnson, Sharpe,
& Sinclair, 1997). In addition, many educational and agency
personnel do not have experience and knowledge across systems and
therefore cannot provide families and youth with options, identify
gaps in services, or analyze the impact of services on benefits.
A service coordinator can act as a single contact for families and
professionals, taking a lead in organizing information, contacting
transition team members, analyzing the assessment information, considering
future plans, asking families and youth what they want and need,
prioritizing programs and services, and assessing the impact of
wages and services on benefits.
A service coordinator can help families gain services or appeal
eligibility decisions and typically has an understanding of eligibility
requirements for each system as well as reporting needs, the availability
of options, and the appeals process. A service coordinator also
understands the impact of the disability on independent living,
employment, postsecondary education, relationships, and advocacy
and communication skills.
What are the different models for service coordination?
Many service coordination models have been developed to provide
options for interagency teams based on the needs of their area and
the individuals and families they serve. Listed below are four models:
Dedicated Independent |
Primary Interventionist |
Interagency Team |
Mixed |
The community has a group of people whose
sole function is to coordinate services. They are typically
independent from the direct service system. Service coordinators
are categorized as personnel, and can be either employed by
or affiliated with a program or independent of any program.
Often personnel are co-funded by the various agencies and/or
made up of service coordinators from the various agencies.
The model utilizes the expertise of parents, paraprofessionals,
and volunteers. |
Providers most involved with day-to-day services
also fulfill the role of service coordination. In some situations,
an agency provides the majority of the day-to-day interventions
and the service coordination function is assigned to a member
of that agency. The agency assumes responsibility for service
coordination funding. |
Each agency or program involved with the individual/family
can be chosen to provide service coordination. The choice
is determined by the overriding needs of the individual/family
or by individual/family choice. |
This is any combination of the first three
models. For example, some areas may utilize a dedicated model
for the initial intake and development of the intervention
plan. Other areas may creatively use all of the models or
create a new system of service delivery. |
Individuals/families may choose from an existing
pool of dedicated service coordinators. |
Individuals/families have limited choice in
selecting the individual who will carry out service coordination,
as service providers and teams are typically assigned by a
program. However, they may have some choice within the program
and an option for selecting another service provider or team
if an individual or family is dissatisfied with their assigned
coordinator. |
Individuals/families have a greater pool of
personnel from which to choose and a greater opportunity to
make a choice that meets their specific needs. |
|
Minnesota System of Interagency Coordination. (2001, Fall).
What are some best practices for service coordination?
The following best-practice components are promoted by the Arc:
- Clear and enforced standards at the state level outlining key
elements that indicate quality coordination;
- Implementation of individual service coordination at a level
closest to the individual;
- Individual service coordination program operation by government
or private entities that do not directly provide service, in order
to reduce conflict of interest in decision-making;
- Service coordinators with an adequate knowledge base and values
orientation to carry out their duties;
- Qualified service coordinators who receive adequate pre-service
and in-service training and continuing education;
- Adequate supervision and support for service coordinators on
the job;
- Manageable numbers of individuals served;
- An external process at the state level to monitor and evaluate
the quality of individual service coordinators (with a capacity
to provide technical assistance);
- Adequate funding for individual service coordinators;
- A system without serious gaps in services; and
- A system that has included informal supports and services through
a resource mapping process.
From the Arc, “Individual Service Coordination for Individuals
with Mental Retardation,” at: http://www.thearc.org/faqs/servicecoord.doc
Why have current case management practices been insufficient in
meeting the needs of youth with disabilities and their families?
Case management approaches are typically agency-specific; that
is, a plan is developed based on eligibility criteria and the services
available through one agency. There is little consideration for
additional services, programs, or resources available through other
agencies. Case managers rarely communicate with each other across
agencies. Moreover, agencies differ widely in terms of public-professional
orientation, institutional mandates, and private-sector regulations.
Communication styles within agencies, as well as political and financial
issues, may contribute to a lack of collaboration. Providers typically
concentrate on what they are able to provide rather than on what
individuals need. Children, youth, and families in such a system
bounce from one agency to the next with little cooperation, follow-up,
or evaluation of services from the agencies.
Case management can result in services that are fragmented, duplicated,
or insufficient. When case managers concentrate on a single solution
to an area of need, they can lose site of how services can be cohesive
and holistic to better meet the needs of youth with disabilities
and their families. When services and supports are fragmented, duplicated,
or insufficient due to gaps, they lose effectiveness both in terms
of outcomes and cost. For example, a young person who receives mental
health services through a school and a mental health provider that
do not communicate with each other may be receiving two contradictory
interventions at the same time. The effect of the uncoordinated
interventions may adversely impact the person’s mental health
and the agencies’ resources.
If you are a person with a disability, what kind of interaction
should you have with a service coordinator?
Listed below are some practical suggestions for how service coordinators
can interact and communicate with you and your family. A service
coordinator can:
- Talk with you about future plans, how the disability may impact
those plans, what supports are needed, and what strengths can
be built upon;
- Ask for your opinion;
- Help you with the things you need to learn;
- Fulfill commitments and obligations in a reliable way;
- Treat you with respect;
- Listen to you;
- Talk with you about concerns or problems;
- Ask you about your likes and dislikes;
- Be reasonably available;
- Help you get the services or supports you need;
- Talk with your family or friends when you agree that it would
be helpful;
- Give you the opportunity to be involved in all the decision-making
about your life;
- Encourage you to be involved with recreation, work, school,
and religious or social activities;
- Protect your rights;
- Ensure that you have opportunities to experience new things;
- Coordinate services and meetings based on your needs and preferences;
and
- Help you enjoy living in the community and assist you with becoming
as independent as possible.
From Partners in Policymaking curriculum for service coordination,
http://www.partnersinpolicymaking.com/curriculumcoordination.html
Who is currently doing service coordination for youth with disabilities,
their families, and professionals?
There are no legislative requirements for service coordination
for youth with disabilities. Across the country models and services
have been developed to meet this need in various ways. Some transition
programs that serve youth ages 18-21 are providing service coordination
because they are working with youth in the community, on the job,
and at home. They have developed relationships with physicians,
mental health workers, social security personnel, probation officers,
postsecondary staff, rehabilitation services staff, and human services
professionals. Since service coordination is not policy-driven,
much of the training for service coordinators is learned on the
job. In addition, some private providers are marketing service coordination
(for example, the Arc’s Independent Living Centers and some
waivered service providers). These would be funded either through
federal and state grants, private foundations, or through Medicaid
waivered dollars.
In most situations, however, families are attempting to coordinate
the services for their son or daughter with a disability. Some parents
have Consumer Directed Support Services (CDSS), also referred to
as self-determination waivered dollars. For some parents who have
received a Mental Retardation or Related Conditions (MR/RC) waiver
to pay for in-home and community-based supports, this funding also
can pay for job supports, service coordination, and a variety of
services. Check with the local department of health and human services
to determine if it includes service coordination as part of its
waivered programs.
References
Arc, The. (2003). Individual service coordination for individuals
with mental retardation. Retrieved from http://www.thearc.org/faqs/servicecoord.doc
Johnson, D. R., Sharpe, M., & Sinclair, M. (1997). Evaluating
state and local efforts to implement the Part B transition service
requirements of the Individuals with Disabilities Education Act.
Minneapolis, MN: University of Minnesota, Institute on Community
Integration.
Minnesota System of Interagency Coordination. (2001, Fall). Service Coordination: What’s it all about?
National Center on Outcomes Research. (2001). Practice guidance
for delivery outcomes in service coordination. Towson, MD: Author.
Partners in Policymaking, Minnesota Governors Council on
Disabilities. (2002). Service Coordination. [Web-based
curriculum]. Retrieved from http://www.partnersinpolicymaking.com/curriculumcoordination.html
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