Karisha networking - Blogs, Newspapers, Brief Reports, Websites ...

I know that I will change careers many times in my life just as you will. One major thing that has changed for me & you is that my next job will not be determined by the health care that I can receive. You can now follow your dreams with out the extra concerns!
I have continued to follow my interests in other ways besides my career. You should do the same to keep narrowing down on your talents and spreading the word about what you can offer as a gerontologist.

A few ways I network:
I wrote my thesis on an interest of mine (that made it a lot more fun to complete)
Check it out on a website that I like to chat and see what is new in the field
Creating Aging Friendly Communities .

I also write anything I can related to aging in place, universal design, livable communities, interior design, architecture, products and of course relate it to gerontology. You have to put effort into networking and that does not stop because you have a job.

Another way I have tapped into my interest is through a blog called Homebody.
Homebody
It is a blog that shows people how they can have stylish and functional homes. You really need to check it out.

Here is a brief report I co authored:
Scripps Gerontology Center Brief Report
Livable Communities: Helping Older Ohians Live Independent and Fulfilling Lives

Below is an article in the local paper about my thesis project



I am also a member of Linkedin. This web based networking is like the career related facebook where you post your resume and interests.

At this time I can not afford to attend conferences with out the student rate so
I am always looking for new ways to network. If you have any ideas please let me know!

Note: Always be true to yourself and treat people the way you want to be treated
Send a thank you note (not an email or text but a hard copy card)to each person that has helped you along your journey and your kindness will be repaid in untold ways in the future.

Case Managers working with Contractors- Karisha

When I first started working as a case manager I agreed to help my supervisors create a training binder for all case managers. As I learned something new I wrote it down anyway and put it into a binder as a reference for everyone else. This helped everyone compile needed information in one spot and to create new documents where there were none. For example, it was very confusing for the case manager to work with the contractors when doing home modifications because our relationship is different than if the contractor was working for the client private pay. I created the documents below to help the contractors understand the role of the case manager and they all appreciate having this.

Environmental Modification Guidelines for Contractor and Case Manager/ Client
1. Determine client need for environmental modification
2. Case manage contact the doctor to have a script written stating the need for the environmental modification
3. Client to choose 3 contractors from the Pick List and put them in order by choice.
4. Case manager determines the needs of the client and with the clients input decides on the design of the construction to be done.
5. Case manager calls contractor asking to send information to their business if they are interested in the environmental modification job
6. Case manager sends a fax including
o Drawing outlined by the case manager and client
o Check list of what to bid on
o Case managers responsibilities and contact information
7. All contractors are to bid on the same job/materials needed to complete the home modification


Contract between Case manager and contractor

I __________ agree to communication with the case manager ___________________ who is representing the needs of the client _____________. I understand that no deviations from the drawing presented for the bid can be made unless discussed in detail with the case manager. All bids that do not follow these guidelines will be dismissed from the bidding process. All communication from the contractor is to go through the case manager and will be discussed with the client. I understand that all code requirements and permits are the responsibility of the contractor that bid the job through Area 9 Agency. If any sub contractors are working under the main contractor the contactor signing this agreement is held responsible. A satisfaction release form will be signed by the client.


Name:_________________________ Date:______________________________

By signing below you acknowledge that you have read and understand the relationship between the client, case manager and contractor.

1. Case Manger will assess individual and determining need for service and environmental modifications
2. Case Manager will develop Plan of Care
3. Case Manager will be determining the cost effectiveness of environmental modification
4. Case Manager will ensure use of Person Centered Planning in having the environmental modification fit the needs of the individual being serviced
5. Client and Case Manager will determine the environmental modification that will be done
6. Case manager will submit one drawing to the 3 selected contractors
7. No deviations are to be made from the drawing by the client or contractor
8. Case manager is acting as the advocate between the client and contractor
9. No additions by the client or contractor to the environmental modification are to be made after the construction has started unless discussed with the case manager
10. Any additional construction being done to the home must be completed separately from the approved bid.
11. Case manager and supervisors will be reviewing all bids from contractors and selecting one to complete work
12. Case Manager will be explaining to client services that will be provided
13. Case Manager will be supervising implementation of construction for the client
14. Case Manager will be advocating on behalf of the clients’ interests and having all decision making communication with contractors
15. Case Manager will be monitoring the quality of HCBS and ensuring that POC objectives are being met
16. Case Manager will be performing record keeping of all construction activity
17. Case Manager will reassess POC to determine need for additional modifications
18. Case Manage and contractor will ensure confidentiality of individual information
19. Case Manager and contractor will maintain the highest professional and ethical standards

Client ___________________________________________ Date: ___________
Case Manager:_____________________________________ Date:____________
Contractor:_________________________________________ Date:___________

Salary and Benefits for Case Managers

Oh I almost forgot the niddy griddy:

Case Manager salaries range from $25,000- 40,000
Supervisors $35,000 - 45,000
Administrators $45,000- 65,000

I work for a University so I have really good health care benefits and 6 weeks of vacation a year.

I have the opportunity to attend lots and lots of continuing education seminars ranging from domestic violence training, eating healthy, wheelchair evaluations, dealing with difficult clients, elder fraud and abuse...

The best part of my job is the flexibility. I work 40 hours a week. We are not allowed to go into overtime. If I have a late visit with a client I leave early on Friday or come in late the next day. I independently monitor my hours and can work out during my lunch break or not take one and go home early.
I would not want it any other way.

Karisha explains how to do a wheelchair ramp

This is an example of a ramp drawing. If the modification is over $1,000 the cm has to obtain 3 bids from separate contractors. I have found the more detailed and accurate the drawing is the easier it is to communicate with them and the quicker you get their bid back.

How a mentor can help you find a job- CM Karisha

Check out this Podcast about mentoring.

Having a mentor can help guide you in your career search. I have had several mentors help me on my career journal and when I switched paths I ended the mentor relationships in that field and built new ones to help me find my way. I am currently thinking about doing the national home builders association kitchen and bath design courses to become a certified bathroom and kitchen designer and I will be searching for a mentor to take me to the next level in my career.

Do you have a mentor?
Joining an organization like OAGE can help connect you with the right dependable professionals in the field of aging.

Karisha and Environmental Modifications

One of the favorite parts of my job are the home modifications. Each client that is on Medicaid has a life time cap allowance to have modifications done to their home to meet their needs. Most of the modifications case managers do are bathroom modifications, widening doorways and ramps.

These are need based modifications that need to be authorized by the state (because the state aka tax payers are paying for them)

Authorization of Environmental Modifications
A. Environmental modifications are minor physical adaptations to the home, as required by the individual’s Plan of Care/Cost Comparison Budget (POC/CCB), which are necessary to ensure the health, welfare and safety of the individual, which enable the individual to function with greater independence in the home, and without which the individual would require institutionalization.

Purpose of environmental modification:
• Necessary
• Access
• Function as independently as possible in home

B. A lifetime cap of $15,000 is available for environmental modifications. The cap represents a cost for basic modification of an individual’s home for accessibility and safety and accommodates the individual’s needs for housing modifications. The cost of an environmental modification includes all material, equipment, labor, and permits to complete the project. No parts of an environmental modification may be billed separately as part of any other service category (e.g. Specialized Medical Equipment). In addition to the $15,000 lifetime cap, $500 is allowable annually for the repair, replacement, or adjustment to an existing environment modification that was funded by a Home and Community Based Services (HCBS) waiver.
Cost:
• Material
• Equipment
• Labor
• Permits

Permit requirements to be determined by contractor depending on location and scope of job.

Here are some of the things I look at when I assess the client for their modification-

Environmental Safety
• Antiscald devices
• Hand held shower head
• Grab bars for bathroom
• Can remove
o Tub
o Toilet
o Sink
• Can install
o Roll in shower
o Grab bars
o ADA toilet
o Wall mounted sink
• Can install
o Floor if necessary
• Widen doors for access
• Completion of the medication, painting, wall coverings, door trim, flooring etc.. will be matched to the degree possible to the previous color/ style/ design

Incident Reporting by Case Manager Karisha

A Case Manager monitors and assesses ongoing services in the home. We also "monitor" what is going on with the client and anything out of the ordinary is to be reported to the case manager. If an incident occurs the person (aide, home maker, meals delivery) that discovers the incident has to report it with in 24 hours of the incident. Since the case manager has a history of the client we get to do the incident report follow ups. Our case notes are entered into a system that allows all the other case managers, supervisor in all offices and the state to review.

It is especially important to have a history of case notes when an incident report is made. When something happens to the clients such as theft, fall, or nursing home placement an incident report must be made to the state for review.
The following information must be added:

Cite the date
Identify the people and relationship
Identify the type of contact – face to face, phone conversation, etc.
Describe the event
Recount the transaction
Demonstrate how the contact relates to the ISP
Describe how the issue was resolved and/or next steps


Incident Example:

03/22/2010
Case Manager went to clients home on 3/22/10. While visiting the cm noticed a large bruise on clients right arm. Client is an 89 year old female with hypertension, diabetes, macular degeneration and amputation of both legs. Client lives in a one bedroom apartment with her daughter and her autistic 8 year old. The client said that her LPN dropped her while getting out of the bath tub a couple of days ago. The client did not want the LPN to get in trouble so she did not tell anyone. The home was neat and clean. The client was dressed in clean clothes and had good personal hygiene. CM followed up with unit manager at Sunshine Valley Care and Nurse Suzy will speak with LPN Brandy today at 2:00pm. CM will follow up with client and Nurse Suzy for further information regarding incident.

Follow up:
Nurse Suzy followed up with LPN Brandy on 3/22/10. Brandy said the bruise was on clients arm already when she came to give her a bath. Brandy asked client about bruise and client said she hit it on the kitchen door. Brandy noted that client has had other bruises on her body during the last 3 months but did not know she had to report it because the client told her not to. CM contacted Adult Protective Services to report bruising. APS went into the home on 3/25/10.

Follow up required in 7 days
Follow up 2: 3/28/10
Case manager followed up with APS on 3/25/10. Client was very hesitant and fearful to admit that daughter does "push her around". Client does not want to leave her home. Nurse Suzy has educated LPN on signs of abuse and how/when to report an incident. Case Manager has added respite hours for the daughter to get away and have some time to herself. The client is not pressing any charges against the daughter. The daughter has agreed to attend a caregiver workshop to help her deal with caring for her mother.

4/15/10 Case closed


All follow ups are required to be filed by the cm. The first person to see the incident is to be the first to report. Since the cm only goes into the home every 3 months we do not do all the initial reports but have to follow up on all the reports made for our clients.