A Day in the Life of a Correctional Case Manager
My journey as a clinician began accidentally when I took a job as a care navigator, a natural extension of the eight years I’d spent in health care administration. The startup I worked for helped clients navigate the health care system to find talk therapy, alcohol and drug treatment, or both.
I worked remotely and emailed the tasks I performed each day to the business owner. Soon ads for substance abuse counselor certificate programs appeared on my Facebook feed.
Flash forward seven years. The Craigslist posting for a care navigator I responded to in 2014 has opened the door to a new and gratifying line of work. I am now a treatment specialist/clinical substance abuse counselor for Wisconsin’s Department of Corrections (DOC). Among the department’s 9,000+ employees, I am in the enviable role of working with clients when they are feeling hopeful, anywhere from six months to a year before their return to the community.
And the skills I learned as a care navigator still come in handy: once again, I am helping clients navigate a confusing web of services to access valuable resources.
According to DOC research, one in three persons in Wisconsin DOC’s care will return to prison within three years of release. This big loss of human potential costs taxpayers more than $38,000 annually for each person who is incarcerated.
Some clients are bound to return to prison because they haven’t committed to the straight life (steady employment, making supervision visits, not breaking the law). But post-release services can be a vital protective factor for the majority who genuinely want to stay outside the fence. Building these protective factors in before release is my central responsibility as a case manager.
Establishing housing is the most important piece of the release plan. Transitional Living Programs (TLPs) are a common need, as many clients lack family or friends who can or will put them up, or the money to get their own places. Some TLPs have such long waiting lists that I have to find other low-cost halfway houses in the community of release. Sometimes the best we can do is a shelter until a more stable housing option opens up. As was true with care navigation, Google is my friend in this pursuit.
A second major pillar of a successful re-entry is legitimate, ongoing income. Some clients have SSI or SSDI before incarceration and after release, but they have to re-apply if they’ve been locked up for a year or more. Getting through the application is a process in itself. I’ve had clients who simply wanted me to verify that their application was received and others with minimal reading comprehension skills who needed help through every step, from filling out the forms to scheduling the first post-release appointment with Social Security.
The majority of clients need to find work upon return to the community. In collaboration with their Division of Community Corrections agent, I connect clients to state-sponsored job centers (which assist with job searches, apprenticeships, and job training) or the Community Corrections Employment Program (CCEP), another means by which those under DOC supervision can gain on-the-job training and work experience.
To meet health care needs, persons in DOC care are automatically enrolled in BadgerCare (Wisconsin’s version of Medicaid) one month prior to release. But basic insurance coverage isn’t always enough. One client wanted a new therapist to help him process re-entry and general life traumas. Another had a complicated medication regimen which needed to be communicated to a community psychiatrist prior to release; once releases were signed, I coordinated the transfer of this information.
Sometimes clients return to a clinic they worked with previously. Often they do not, in which case I dig around online and call for coverage details and wait times. Some clients are eligible for the OARS (Opening Avenues to Re-entry Success) program, which connects them with a mental health diagnosis to affordable housing, psychiatric care and medications, employment access, and treatment.
Those ineligible for OARS access alcohol and drug treatment through other means. A client on community supervision working a first-shift, full-time job wanted occasional evening groups. Another wanted intensive outpatient treatment (a minimum of 8 hours/week). A third wanted dual diagnosis inpatient treatment in the community, which the agent helped secure.
With opioid overdoses on the rise, finding Medically-Assisted Treatment (MAT) for clients who have struggled with addiction has become increasingly important. The timing of admissions is especially critical, as a delay of even a few days in receiving methadone, suboxone, or Vivitrol can be fatal.
Clients also seek help with food assistance, post-incarceration education, AIDS-related care, or services for veterans.
By reaching out to probation and parole officers, human services workers around the state, and social services personnel at my correctional institution, I’ve compiled a template of resources for different locations, just as I did as a care navigator.
The major difference between the two positions is that care navigation was a paid service; it was presumed that we would do all of the work for the client. In an institutional setting, case managers offer some support, but clients are generally expected to take care of as much personal business as they can by utilizing the services available to them—personal tablets, Job Center computers, Internet kiosks, and the assistance of friends or family out in the community.
But even the most enterprising people can’t arrange everything on their own, and many clients lack the wherewithal, connections, or resources to set themselves up for success in the community. In those instances, the case manager has an incentive to step up. It can be tedious at times, but ultimately it serves your purpose as a prison treatment specialist (to do your part to lower recidivism) and as a clinician—to meet your client where they are.
Dan Benbow, CSAC, CSIT, is a treatment specialist at Oakhill Correctional Institution in Wisconsin.