Workforce Challenges & DDS Waiver Services Analysis
Person-Centered Planning & Case Management
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Recommendations
A&M recommends re-examining the current caseload ratio to understand whether it is sufficient, given the changing
nature of the community-based services. The caseload was established when people were receiving residential and
day services in larger congregate settings. As North Dakota continues to support people to live in smaller settings and
more individualized day services, including employment, it is more challenging for service coordinators to meet each
person's individualized needs. A&M recommends reviewing current duties to determine whether there are
administrative functions that could be carved from case managers' jobs and done by administrative support to create
leverage
For the Cross Disability Individual and Family Support waiver, A&M recommends using family navigators instead of
traditional case managers. These are people, often family members themselves of people with disabilities, who are
highly knowledgeable of the service delivery systems and the community. They may have different educational
backgrounds and requirements than case managers. This will allow the state to tap into a wider workforce net of non-
traditional case managers for expansion, while providing the connection and navigation support that families need.
Family navigators could be state employees, contractors, or providers (but must not also provide other services to the
person to avoid conflict of interest). A&M also recommends a smaller caseload ratio for family navigators to ensure that
they have the time to provide the family with this more intensive support.
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ALVAREZ & MARSAL
LEADERSHIP ACTION. RESULTS.View entire presentation