Educational Module for Case Managers Caring for the Chronically Homeless

Every chronically homeless individual in Utah costs the public approximately $30,000 to $50,000 a year in healthcare resources. One potential reason for the high cost of care delivery to those who are chronically homeless is that case managers (CMs) caring for this population lack clinical background or training, which may result in inappropriate referrals to expensive healthcare services and unmet health needs. The purpose of this scholarly project was to develop and deliver an educational module to facilitate appropriate decision-making regarding referral to healthcare community resources by CMs caring for the chronically homeless. The project's objectives were to evaluate CMs' needs when trying to make community healthcare referrals, and to develop and deliver resources responsive to their needs. CMs were first interviewed in order to identify common themes, and to assess perceived competency related to making healthcare referrals. An educational module with easy-to-interpret information was then developed and delivered through an in-service and written resource. Finally, a follow up email communication was used to assess improved confidence among CMs providing appropriate healthcare referrals. The literature review for this project focused on challenges non-clinical staff face when directing clients to available healthcare community resources and services. The main challenge they face appears to be when trying to make clinical decisions without a clinical training. Consequently, recommendations included delivering education and resources to assist CMs in order to improve the use of community healthcare resources and to decrease cost to the public. There is scant research-based literature regarding education of non-clinical staff serving this population. Implementation of this project included (a) development of a CM interview guide informed by existing research literature; (b) interview of CMs currently working with this patient population in order to identify healthcare topics used to educate non-medical staff; (c) development of the CM education module; and (d) in-person CM training using the newly developed education resources. Evaluation of this project was done through a follow up email to assess whether they feel increased comfort with, and knowledgeable about, the healthcare referral process after education and training. Evaluation of this project's outcomes was limited because referrals to healthcare services do not occur on a daily basis. However, CMs reported positive feedback regarding the developed reference tool that included a thorough community based service directory in addition to information on how to identify and proceed with common health complaints. The outcomes of this project were disseminated through a presentation to community stakeholders and to the University of Utah faculty on March 21, 2017. In summary, non-clinical staff caring for the chronically homeless face increasing challenges when asked to refer clients to healthcare services without having a clinical background or training. Therefore, the main purpose of this project was to provide education and resources to assist these non-clinical staff when making healthcare decisions for this vulnerable population.