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Analysis of case management services and caseloads

1:51:40

·

4 min

Council Member Crystal Hudson inquires about recent changes in case management services, including a decrease in clients served but an increase in case management hours. Commissioner Lorraine Cortés-Vázquez explains the reasons behind these trends and discusses potential resource needs.

  • Case management budget for FY2026 is projected to be $46 million
  • The complexity of cases has increased, requiring more case management hours per client
  • Current ratio averages around 59 clients per case manager
  • Discussions with OMB ongoing about potentially reducing caseloads and increasing resources
Crystal Hudson
1:51:40
Okay.
1:51:42
The recently released PMMR indicated there was a decrease in the number of clients served, but an increase in the number of case management hours provided.
1:51:51
Case management served 24,007 older city residents in the first four months of fiscal twenty twenty five with a total of 616,000 case hours.
1:52:04
This is a 4% decrease in the number of clients served and a 2.9% increase in the number of hours compared to the same period in fiscal twenty twenty four.
1:52:13
These variances are attributed to a variety of reasons, such as staffing deficits, provider transitions, and state MLTC guidelines.
1:52:21
These services are vital to older adults assisting them in getting connected to needed services and resources.
1:52:27
What is the current budget for case management for fiscal twenty twenty five, for fiscal twenty twenty six, and the out years?
Lorraine Cortés-Vázquez
1:52:41
Kate, for 2026 it'll be 46,000,000.
1:52:47
And one of the reasons that we've noticed is the number of clients, the number of hours are not reduced.
1:53:06
As a matter of fact, the number of hours are increased because the complexity of the cases require more case hours than we have had in the past.
1:53:17
And we've seen that trend started post COVID.
Crystal Hudson
1:53:22
Okay.
1:53:23
So then one might conclude you need more resources for more intensified, let's say, case management services.
1:53:35
Maybe those case managers need to have their caseloads reduced.
1:53:41
If we add more case managers and cases are becoming more intense or more
Lorraine Cortés-Vázquez
1:53:48
of higher The ratio is something that we're always looking at and we find what the adequate ratio is.
1:53:59
But yes, your analysis is it's odd talk.
Crystal Hudson
1:54:05
You can say it's correct.
1:54:08
Okay.
Lorraine Cortés-Vázquez
1:54:10
Your analysis is correct.
Crystal Hudson
1:54:12
Thank you.
1:54:13
Thank you.
1:54:17
Can you provide further explanation as to the variance in these indicators between FY24 and FY25?
Lorraine Cortés-Vázquez
1:54:26
I'm not sure that I can add any more than what I just said.
Crystal Hudson
1:54:30
Okay.
1:54:35
I'm not going to ask you how NYC Aging is working with OMB to ensure there are enough resources for case management?
1:54:41
Because I know you're having conversations.
1:54:44
Does NYC Aging advocate for increased funding for case management?
1:54:48
And if so, how much additional funding is needed to adequately meet the level of demand?
1:54:51
So if you're going you know, switch those ratio numbers, does that have an equivalent dollar amount?
Lorraine Cortés-Vázquez
1:54:58
It's something that, I mean we're in earnest conversations with them about it particularly as we're moving more and more to a community care approach and the need for additional home care services and things of that nature.
1:55:16
Okay.
1:55:16
As a corresponding relationship.
Crystal Hudson
1:55:18
Right.
1:55:19
I don't think you shared what the current ratio is.
1:55:22
Do you have that, the
Lorraine Cortés-Vázquez
1:55:23
case management The current ratio is I'll give it to you.
1:55:28
I just had that this way.
1:55:30
The case manager ratio is between 53 or 69, And it averages around 59 clients per worker.
Crystal Hudson
1:55:41
It averages at 59?
Lorraine Cortés-Vázquez
1:55:42
Yeah.
Crystal Hudson
1:55:46
Sounds like that's a lot for a case manager.
1:55:50
And specifically if those if the clients have greater needs, do you have a sense of where you're trying to get to in terms of that ratio?
Lorraine Cortés-Vázquez
1:56:02
Can get back to you on
Crystal Hudson
1:56:03
that.
1:56:04
Okay.
Lorraine Cortés-Vázquez
1:56:06
All
Crystal Hudson
1:56:06
right.
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