The role of case management in substance abuse treatment services for women and their children.

Given that addiction is a chronic, relapsing disease, ongoing support services are considered a crucial part of preventing relapse and assisting clients in building the foundation for a drug-free life. Building on the substantial history of case management services with other at-risk client populations, drug treatment programs have begun to integrate case management services as an effective, cost-efficient method of delivering coordinated care. This article summarizes what managed care is, describes three conceptual models, discusses the primary functions of case management, and reviews various programs that have used case management for chemically dependent women and their children. Also included is a presentation of the results of a survey of 46 cases managers involved in seven pilot sites of California's Options for Recovery (OFR) treatment program, which combines case management and drug treatment. More than 50% of the respondents had worked as case managers previous to joining OFR. Approximately 38% of the OFR case managers spent 20% to 30% of their work week completing paperwork; 26% met with clients at least once per week and 25% met with clients every other week. The average case load was 20 clients, but case managers reported that 15 clients would be ideal. Nearly all the clients had a high-risk profile, with histories of varying problems ranging from drug use and abusive relationships to homelessness.