STANDARDS OF PRACTICE AND COMPETENCIES

IAECM has chosen to focus on the predominant Standards of Practice and Competencies considered fundamental for medical case management, vocational counseling, and placement in the private sector. This format change recognizes that different methods may apply in various jurisdictions or systems as to medical case management, vocational assessment, rehabilitation plan development, job development and placement, on-the-job training, occupational retraining, and self-employment. IAECM members should choose the methods applicable to their area of practice or refer to professional literature regarding accepted methods. Regardless of the method employed, IAECM members ascribe to and support a basic level of Standards of Practice and Competencies as outlined below.

Medical case management and elder care management services are provided directly to a client, the goal of which is to maximize medical recovery. IAECM members recognize the uniqueness of providing medical case management or elder care management services under various federal and state laws and insurance systems, and the importance of Standards of Practice and Competencies in the delivery of primary care services.

Standards of Practice and Competencies are defined as the knowledge, skills, abilities, personal qualities, experience, and related characteristics necessary to provide primary care services in vocational counseling/placement for individuals with or without disabilities. Beyond general Standards of Practice and Competencies, a member may have additional knowledge, skills, abilities, personal qualities, and professional experience resulting in specialized expertise that binds them to the Standards of Practice and Competencies of that specialty.

Elder Care Management Standards of Practice and Competencies

Elder care management is defined as the process of assessing, planning, coordinating, monitoring and evaluation of the services required to respond to an individual’s health care needs to attain the goals of quality and cost effective care. This service may be performed in conjunction with managed care; however, it is differentiated from managed care, which is recognized as an organized process designed to ensure the medical necessity and cost effectiveness of a proposed service. Case management is designated to promote optimal recovery and rehabilitation by professional involvement in the rehabilitation process. Elder care management in the optimum sense is a balance in terms of both quality assurance and medical cost control. The Elder Care Manager advocates on behalf of the individual to assure quality of care and attainment of appropriate goals, as well as promotes self-advocacy skills to achieve maximum independence.

Professional Standards for Elder Care Management include:

a) Accepting referrals relevant to elder care manager’s qualifications, expertise, education, licensure, or certification relevant to the diagnostic category, needed services, working guidelines, and on legislation;

b) Providing adequate information when referring a client to a provider (e.g., contact, identification, medical, purpose, special instructions, payor, etc.);

c) Understanding conditions of the assessment/evaluation

i. Recognizing importance of timely client assessment (e.g., onset of injury/illness)

ii. Release(s) of information

iii. Medical/Mental health status review

iv. Client’s understanding/learning needs related to the diagnosis, treatment, resources, adjustment, and coping mechanisms

v. Family knowledge base and need for education, health status, expectations, support or caregiver potential;

d) Developing/Implementing a plan that integrates the client and/or parties in the decision-making process to meet recommended and cost-effective short- and long-term goals and objectives, and recognition of potential complications. Plan may involve the identification, procurement, and coordination of services and resources to implement the plan, and may involve ongoing evaluation of client’s progress and the effectiveness or appropriateness of the plan;

e) Acknowledging and compensating for strengths/weaknesses of on-site, electronic, and/or telephonic services;

f) Coordinating services among medical or allied health professionals and inpatient, outpatient, home services, or environmental modification providers;

g) Understanding rehabilitation principles for optimum delivery and outcome of services, including accelerated and/or alternative options;

h) Coordinating vendor and resource utilization involving medical equipment, supplies, medications, and services;

i) Identifying and addressing education needs of client, family, support system, or service provision team;

j) Awareness of laws, statutes, standards, and regulations covering written documentation and recordkeeping (e.g., cost/benefit analysis, individualized medical rehabilitation or independent living plans, initial or status reports, etc.);

k) Documenting termination of services to the client or representative; and

l) Coordinating communication formally or informally to resolve disputes between parties, documenting efforts appropriately, or referring parties to resources able to resolve such disputes.