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A Deeper Dive

Caseload Standards and Efficacy

Balancing Responsibilities

Establishing a team of dedicated outreach and screening staff or referral managers who are not responsible for a caseload allows the case management team to respond more consistently to unscheduled incidents and situations in the field, including responding to calls from officers or community partners; outreach staff can be responsible for ongoing efforts to connect with referred individuals who have not yet completed intake, or with enrolled participants who have disappeared “in the wind.”

In the absence of a dedicated outreach/screening/referral management wing, case managers need to integrate these activities into their daily activities; this can be challenging to accomplish while juggling scheduled appointments with participants and service providers.

Regardless of whether a site forms dedicated outreach/referral management staff, all case managers should spend time in the field engaging participants where they are. LEAD case management is not an office-based role, though adequate time in the office is needed to recruit resources for participants, to engage in clinical supervision, and to hold some private meetings with participants if that is where they are most comfortable.

Managing Capacity

Many LEAD sites begin with a small pilot population (whether defined geographically, through local analysis of repeated arrests, or other criteria) and expand their reach only as case management capacity increases.

LEAD uses an intensive case management model. Nationally, an intensive case management standard is generally 12-15 individuals per case manager.  Because LEAD also includes individuals who are “in the wind” and not actively engaging – although case managers are actively seeking them out – LEAD caseloads may average up to 20 participants per case manager. But under no circumstances should a case manager be assigned more than 25 individual participants at any point in time. Experience has shown that caseloads higher than this have profound negative effects on the efficacy of the model.

New referrals should be declined if caseload averages exceed 20 and individual case managers would have to take on more than 25 participants at a time. However, because LEAD is a model intended to be constantly open to new referrals, case management staffing should be paced to expand slightly ahead of current caseloads, and referral recruitment and acceptance should be paced to land slightly under the levels that can be supported by anticipated funding. This combination is designed to ensure that there is always room for highest priority new referrals, especially from law enforcement for individuals who would otherwise be destined for jail and prosecution.

Accepting pretrial diversion referrals from courts or prosecutors should occur only if there is adequate capacity to also receive all priority appropriate referrals from law enforcement or community sources.