Conflict Free Case Management Helps People with Disabilities and Families

When you are struggling to get the supports you or your family member need to live independently, it’s important to have an advocate who’s knowledgeable about the disability service system.  This is what a case manager (otherwise known as a service coordinator) is supposed to do. He or she is supposed to help you to understand the services you qualify for and how to access them, while maximizing your independence.

People who receive services from an area agency most often receive case management from the area agencies although they can choose to receive independent case management. Sometimes, those area agencies also provide direct services which can create a conflict of interest.
In another model in New Hampshire, people who receive CFI (Choices for Independence) services have independent case managers from a variety of case management organizations across the state.

In 2016, the federal Medicaid agency told NH’s Bureau of Developmental Services that there are potential conflicts of interest with the current service delivery system for the DD and ABD waivers because most case managers for people with developmental disabilities are employed by area agencies that also provide services.

A conflict of interest occurs when there are situations where the case manager is caught between the needs/interests of the client and the needs/interests of the area agency. Conflicts for case managers can include:

The federal Medicaid agency directed NH’s Bureau of Developmental Services to come up with a plan to address the potential conflicts in the current case management system and BDS is working with a variety of stakeholders to look at the issue now.
Disability Rights Center believes that strong and independent case management is vital to a system of services that is person-centered and promotes the rights of the individual. This should include:

As New Hampshire examines its current system of service delivery for people with disabilities, it must not be bound by the status quo. It’s important that we are open to changes to ensure we are providing the best quality services to people with disabilities.


updated April 3, 2018