Integrated Case Management

Integrated case management facilitates the triage and acceptance of participants into programs. It also facilitates the ongoing maintenance of both participant's eligibility for the program, and the supporting evidence for each application.

Integrated case management consists of a number of core social industry components.

Intake

Intake refers to the collection of data about one or more individuals and their circumstances to achieve a particular goal. It consists of multiple phases of data collection, such as triage, or screening.

IBM Cúram Social Program Management Intake has two main aims:
  • To enable workers in an organization to comprehensively and easily complete the intake process.
  • To facilitate agencies in providing a collaborative, No Wrong Door approach to the intake process for clients in need of benefits or services
This approach reduces the number of contacts a client must make to access benefits or services across multiple agencies.
Social Program Management Intake supports the following intake processes:
  • Triage
  • Screening
  • Application
  • Referrals

Eligibility and Entitlement

Eligibility and entitlement management is a complex process that includes evidence capture, entitlement calculation, and change in circumstance processing, including over and underpayment management.

Eligibility and Entitlement support consists of the following default features:

  • Business user tools for rapid implementation of legislation and policy
  • One time evidence capture and reuse
  • Cross-program eligibility
  • Assistance unit determination
  • Default under and overpayment calculations
  • Auto-generation of overpayment cases
  • Nominee management
  • Creation of financial schedules

Food Assistance is an example of a program where a client can check to see if they are eligible to receive a benefit. Household, Resources, Income, and Expenses are the four categories of evidence that are collected from clients. The evidence supports the Eligibility and Entitlement process, which checks for eligibility across the programs.

Evidence management

Social Program Management evidence is data that is collected in respect of a participant or case. Evidence management supports the evidence lifecycle (Design, Collection, Verification, Activation, Correction, Sharing), while reusing evidence over multiple programs. Evidence management is a key part of the overall Eligibility and Entitlement process. Eligibility is continually reassessed due to changes in circumstance, rules, or rates that occur over time.

Evidence management provides the following features:

  • Business user tools for rapid translation of legislation and policy to evidence structure and verification requirements.
  • Prebuilt evidence correction security, history, and audits.
  • Prebuilt workflows monitor verification validity and initiate reverification process.
  • Prebuilt evidence management tools for improved case worker productivity.
  • Consistent user experience across evidence lifecycle such as intake, verification, activation, correction, and sharing across programs.
  • Evidence visualization focuses user attention on pending tasks such as verification, activation.
  • Workspace and workflows for managing shared evidence to incorporate program-specific reviews.

Participant management

The business of a social enterprise organization involves many participant individuals and bodies. Participant types play a role in the delivery or receipt of benefits and services.

A set of information is stored for each participant type. This set includes common information that is stored for all participant types and extra information that is stored only for some participant types. For example, address information is stored for all participant types whereas deduction information is only stored for persons.

Each participant's information is stored in a central location. This approach allows the participant's information to be easily accessed and maintained by users. Participant information can also be reused as necessary throughout the application.