What is the one of the first things you have to do when your child is accepted to your state’s Medicaid Waiver program? Choose a case management company, who will assign a case manager to you. Yet, how do you select a case manager and then what is the best way to work with them? Having a good relationship with your autistic child’s case manager for the Medicaid Waiver is essential to getting the most out of their benefits.
What is a case manager?
First, what is a case manager? I like to think of them as a facilitator between you, Medicaid and the providers of services for your child.
According to the Merriam-Webster Dictionary, a case manager is “a person who assists in the planning, coordination, monitoring, and evaluation of medical services for a patient with emphasis on quality of care, continuity of services, and cost-effectiveness.”
I think this is an accurate description of what my son J’s case manager did for us for the Medicaid waiver. During the pandemic, she also did a great job in checking on us regularly. She wanted to make sure we were doing okay and didn’t need any help.
How to choose your child’s Medicaid waiver case manager
When asked to choose a case manager, you originally pick one of the case management companies that your state’s Medicaid program offers. You usually do not interview and choose a specific case manager.
The Arc of Indiana offers some good advice about choosing a case management company. They suggest you call a few of them to ask about their company and services. You should receive a list of case management companies from your contact at your local disability services agency that manage the Medicaid waiver for your state. You can do some online research first to narrow them down to two or three you can call. The Arc recommends noting whether they wanted to talk to you; if you had to leave a message, did they respond quickly; and do they ask about you and your child.
What questions should you ask?
Once you have them on the phone, ask some important questions to obtain a feel for the company:
- How are your case managers structured (do they specialize in one area such as autism or do they handle all conditions)?
- Are your case managers at the company assigned to individuals? What is the process of determining what services may be needed and which are the best providers to choose?
- How do their case managers handle conflicts between the families and a provider?
- What is their case manager turnover? How do they communicate if there will be a change in personnel to you and your child? In addition, what is the transition plan if this happens?
- How will their case managers coordinate services for your child?
- How many cases does each case manager manage?
- What is the process for choosing a different case manager if the one assigned is not a good fit?
- Why should you choose their company over another?
Finding out the answers to these and any other questions you have can help you find a case manager who will do a good job managing your child’s services.
My son J’s long-time case manager was wonderful and a perfect fit for us. We lucked out because I didn’t know anything at the time about choosing a case manager. I wish I would have known so that I would have done more research and investigation going into it. Fortunately, it worked out for us.
Make the most of your quarterly meetings
You will have quarterly meetings with the case manager. I found these were golden opportunities to update our son’s case manager on any changes in his overall treatment. This could be any new treatments outside of waiver services, new interests/hobbies, changes in medication, increase in skills, etc. She would help me think through if that meant any changes needed in the services from his waiver.
The annual meeting is a great time to really think about the progress your child has made during the past year and what goals you and their providers should set for them in the coming year. Sometimes, we focus too much on everyday activities. We forget to think more broadly and long-term about our child’s care and services. If you have a good case manager, they can help guide you through that process.
Communication is key
While you meet with your child’s case manager for Medicaid waiver services once per quarter, it’s best if you keep in regular contact. I would text J’s case manager about once per month to ensure she knew how everything was going. That way, if anything changed, she was already aware and if we were having any difficulty with a provider, then she could reach out sooner rather than later to help solve the issue. I also didn’t hesitate to call or email her with any questions I had. She was so patient, answered my questions and provided me with resource information when needed.
Your case manager can be a wealth of knowledge
If you find a good case manager, they are a wealth of knowledge in guiding you through the processes and making recommendations for services for your child. Also, while they cannot directly recommend any providers to you, they can note which ones receive high praise from other clients.
Navigating through the Medicaid waiver maze isn’t always easy, but a good case manager will guide you well to ensure your child is receiving the care and services they need.
Has your child received waiver services? If so, what tips do you have to ensure a good partnership with your child’s case manager for Medicaid waiver services? Leave a comment below so that we can share and encourage one another on this journey.
