UD 029 894
ED 405 392
Smith, Albert, Jr.; Oaks, Merrill
C-STARS. School Based Interprofessional Case
Management: An Interagency Program for At-Risk
Students and Their Families.
Washington Univ., Seattle. Center for the Study and
Teaching of At-Risk Students.
32p.; The attached list of suggested readings
contains broken print.
MF01/PCO2 Plus Postage.
Academic Achievement; *Agency Cooperation;
Attendance; *College School Cooperation; *Delivery
Systems; Elementary Secondary Education; Family
Programs; Formative Evaluation; Higher Education;
*High Risk Students; Integrated Activities; Models;
*Social Services; Student Behavior; Summative
Evaluation; Urban Education
*Case Management; C STARS
The documents in this collection provide information
about the Center for the Study and Teaching of At-Risk Students
(C-STARS), a center committed to meeting the challenge of providing
integrated services for at-risk youth and their families. Because
C-STARS is housed in a vn;varsity setting, it has the opportunity to
promote interprofessiona and interagency cooperation. Fundamental to
the operations of C-STARS is interprofessional case management (ICM).
ICM attempts to ensure that services are provided in a supportive,
efficient, and coordinated manner. Seven functions of the ICM model
are described, and the structural components of its operation are
presented. Preliminary results of a formative evaluation indicate
that implementation of the model's functional and structural elements
has been high in project sites. The summative evaluation design in
progress suggests a positive impact on students, with reduced
absenteeism and better student grades and conduct. Attachments
include: (1) a list of 47 suggested readings, (2) a discussion of the
C-STARS model, (3) anticipated benefits of the ICM approach, (4)
background material on C-STARS, and (5) guidelines for ICM. (SLD)
Reproductions supplied by EDRS are the best that can be made
from the original document.
. DEPARTMENT OF EDUCATION
Educatanai Research and Improvement
ATIONAL RESOURCES INFORMATION
MATERI L HAS
is document has been reproduced as
anted from the person or organzatoon
0 Minor changes have been made to Improve
Paints PI view or opinions slated in this Poet,
ment do not necessarily represent official
OERI position or policy
TO THE EDUCATIONAL
Center for the Study and Teaching of At-Risk Students
Dr. Albert Smith Jr.
University of Washington
Seattle, WA 98195
Dr. Merrill Oaks
Pullman, WA 99164
BEST COPY AVAILABLE
SCHOOL BASED INTERPROFESSIONAL CASE MANAGEMENT
AN INTERAGENCY PROGRAM FOR AT-RISK STUDENTS AND THEIR FAMILIES.
Perspective On Need
Virtually every person in this country is aware that increasing
numbers of students are at risk of dropping out of school and of
the disastrous results when students drop out and never return to
At present approximately 25% of all school children are
at risk of dropping out and never complete a secondary program
Many urban schools have dropout rates that far
exceed national averages, for example, drop out rates of 40 to 50%
are frequently reported (Cattrell, 1987).
The Ford Foundation (1990) reports that one of every four teenagers
will drop out of school before graduating, four of every ten girls
will become pregnant during their teens,
teenagers will become a problem drinker and one teenage suicide
occurs every nine minutes.
On January 30, 1991, National Public
Radio announced that the national school dropout rate for all
Hispanic males is now 44%.
In New York City, one of every three children grows up in a single
There are currently more than 20,000 homeless
children who wander the streets, and between 60,000 and 125,000
students are absent from school each day. -For all students between
the ages of 16 and 19,the unemployment rate is 35%, for Hispanic
and black youth, the unemployment rate is approximately 50%.
Students who drop out pay a high price throughout their lives.
example, in the State of Washington, 50% of all adults receiving
A recent survey of state prison inmates indicated that
62% of that population are school dropouts.
It is clear that
responding to the needs of students at risk of dropping out is a
crucial challenge for schools, families and communities in this
To meet this challenge, schools, families, social service
providers and communities must work together to develop new
This article provides information on the Center for the Study and
Teaching of At-Risk Students
a center committed to
meeting the challenge of providing integrated services for at risk
youth and their families.
Background - Center for the Study and Teaching of At-Risk Students
The Center for the Study and Teaching of At-Risk Students
STARS) is a division of the Institute for the Study of Educational
Policy located at the University of Washington and the College of
Education at Washington State University..
The mission of C-STARS
is to channel interdisciplinary university, research, training and
technical assistance in support of school,
service efforts to collectively redefine and reposition their
respective services to families with students at risk of school
Assumptions which form the foundation of C-STARS include the:
- no single institution, by itself, can effectively address
the multiple needs of at-risk children and their families.
At the center of our public service agencies sits a common
client who must be housed, transported, educated, fed, and
Professionals from diverse agencies must learn
to collaborate for the sake of the clients we share.
students and their families need holistic, consistent, and
enduring interventions, not the piecemeal interventions that
are all too common.
- Our schools, social and health service agencies receive
inadequate funds to handle the increasing caseload of children
and families with multiple public service needs.
not provide direct service to students and their families.
Rather C-STARS works with schools and community service
agencies to develop, test, and document interagency prevention
and intervention models.
Because C-STARS is housed in a university setting it has the
unique ability to advance interprofessional and interagency
through professional development (training), third and perhaps
Department of Community Development,
and the Washington State
To facilitate school-based delivery of the
multiple services needed by at-risk children and families, STAT
advises and provides technical assistance to staff(s) of Washington
State based C-STARS demonstration projects.
Interprofessional Case Management (ICM)
Interprofessional Case Management (ICM) is fundamental to C-STARS.
ICM nurtures a network of logical and appropriate interactions
among schools, health and social service agencies in order to
maximize opportunities for at-risk students and their families.
In place of piecemeal and haphazard service delivery,
devoted to providing services in a supportive,
Each professional who relies on case management, builds on his/her
experiences and perspectives to understand this approach.
professionals stress the C-STARS promise of linking the service
system with a
and coordinating the various systems
components to achieve a successful outcome.
chose ICM because it offers an avenue to overcome existing rigidity
and unnecessary red tape within and among educational and human
While case management will be interpreted
different ways, there is increasing consensus on the importance in
Consequently, at-risk youth must often access several different and
often disconnected programs.
As the number of organizations
involved in serving a student grows, managing and implementing
these services becomes more complex.
Acting as a mentor, a case
manager can help students identify and gain timely access to the
services they need and can offer them support to complete these
Seven Functions of Interprofessional Case Management
After a thorough review of the literature and interviews with case
managers from health, education, and social service agencies, seven
primary components emerged as central to the concept and function
of case management.
These functions became the foundation for
development of the school-based interprofessional case management
Accessing and Assessing Students.
involves reviewing program goals and objectives to develop
criteria for identifying youth to be targeted for services.
A system is then set in place to identify students, receive
referrals and select those youth to be served.
difficulties, both those unique to the student and those that
are a consequence of family or environmental situations.
Development of a Service Plan.
The service plan is one of
situation, (2) goals and objectives, (3) needed or recommended
(4) who is responsible for providing the service,
(5) timeline, and (6) possible date for re-evaluation.
Link the student to services that cannot be
provided by the case management team.
on the role of broker.
simply making a referral.
The case manager takes
Brokering involves much more than
Pre-referral counseling and family
outreach activities helps students and families to accept
In times of crisis, the case manager or a member
of the team will accompany .the student to the referral agency.
Service Implementation, Coordination and Communication.
role of the
interprofessional case management team is three-
to deliver on-site services as specified in the
service plan, (2) to ensure that all services to an individual
student are coordinated for the student's benefit, and (3) to
facilitate communication among service providers.
When taking on the role of advocate, the case
and helps families
One member of the case management team takes
primary responsibility for representing and caring for the
student within the school.
This one person is charged with
following through for the student.
The at-risk student has
usually not formed this kind of relationship with an adult.
To provide at risk students an opportunity to trust the case
management team identifies one member to become the adult to
whom these students can turn.
Monitoring and Evaluation.
Through ongoing monitoring and
evaluation, the case management team stays abreast of services
being delivered to the client and the client's progress and
This information is used to modify the
service plan as the situation involves.
INTERPROFESSIONAL CASE MANAGEMENT (ICM) OPERATIONALIZED (How it
Three Basic Structural Components
There are three structural components of this model at each school-
interprofessional case management team,
The case manager identifies students at risk of school failure,
refers at-risk students to the interprofessional case management
facilitates regular meetings of this team, monitors the
multiple service plan developed for each student, advocates with
service agencies on behalf of the student and his/her family, and
is often the single adult who maintains a sustained contact with
the student and respective family throughout the delivery of the
multiple services prescribed for the student.
The school-based interprofessional case management team includes,
at minimum, the case manager, a social worker, and a health service
This team of service providers meets regularly with
the case manager to collaboratively exercise the seven functions
of this case management model.
Typically, the members of the team
are employees of local health, education and/or social service
agencies who, through interagency agreements with school districts,
provide in-kind staff time as school team members.
The community service network typically includes a range of service
providers who agree to coordinate with case managers and school
interprofessional case management teams in delivering specific
services as needed by students beyond the professional expertise
of the case managers.
Examples may include: Juvenile Justice,
Planned Parenthood, Council of Churches, and The Migrant Council.
Role of the Case Manager
associated with several personal, family, and/or school factors'
assess multiple Health, Education, and Social Service needs of
these students; develop an integrated school-community service
delivery plan, and advocate on behalf of at-risk students.
Their specific kev roles and functions are to:
Conduct initial student screening for referral to the building
Facilitate regularly held meetings of the building CM team for
coordinated interprofessional services to at-risk students and
Link students and their families with needed health and social
services that cannot be provided by the CM team in the school.
Determine the composition of each at-risk student's respective
CM team in consideration of his/her holistic needs and the
resources available and/or appropriate, e.g., family members,
DSHS case workers, etc.
Insure through monitoring and evaluation that all services
being delivered to an individual student are working together
for that student's benefit and that appropriate communication
is taking place between service providers,
Coach students in problem solving skills and in setting short
and long term life goals for themselves.
Advocate on behalf of students in order to secure for him/her
needed services and entitlement for them.
Insure that each student referred to the CM team has one team
member identified to serve as the primary caring adult who
will follow through with the student over a sustained period
Anticipate potential student crisis situations that are likely
to occur in the home, the school, and/or the community and
develop crisis intervention strategies with CM team members
and community service professionals.
Develop and maintain cooperative working relationships within
the school between CM team members, teachers, counselors,
administrators, etc.; and outside the school with the family
members as well as appropriate health and social service
Case Managers Professional Development (Training)
Prospective or practicing case managers typically come from a
variety of professional backgrounds including social
(social workers) education, (teachers, administrators, counselors,
understanding of one or more of the functions of interprofessional
For this reason the C-STARS professional training
program was developed using a three dimensional approach.
Case manager professional development starts with a thorough pretraining individual needs assessment.
This important first step
in the training process is designed to measure specific skills,
knowledge and affective competencies including values, attitudes
and behaviors associated with the role and responsibilities of
interprofessional case managers participating in C-STARS school
AsSessment methodology includes:
and standardized testing,
Skill competencies are assessed through observation, experience
Affective competencies are assessed through interview formats
addressing specific situational responses and open-ended questions.
Once this initial assessment process is
manager has two professional development options available.
first of these is a continuing program of inservice workshops,
colloquiums, seminars, and institutes developed to provide up to
date information and skills in new or emerging needs for all case
These activities are offered throughout the school year
and summer, and are typically one day to one week in length.
Topics may include the latest legislative state and information on
at risk and drop out programs, substance abuse issues, homeless
information or successful communication strategies when working in
an ethnically diverse environment.
One major inservice summer
institute is typically arranged for all new case managers who need
initial grounding prior to the start of the school year.
A second professional development option available to case managers
is professional graduate level course work.
These courses are
designed to strengthen case management skills and become a major
course work component for case managers working toward advanced
degree including the master's of social work (MSW) or the master's
in education (M.Ed.).
These courses are typically cross listed by
both research universities and offered both during the summer and
Plans are to develop a comprehensive "curriculum"
for case managers based on a statewide research survey currently
being conducted which involves five state agencies and school
Preliminary Research and Evaluation
Preliminary results from a formative evaluation conducted
implementations of the model's functional and structural
elements to be high, i.e., over .85 percent.
the attainment of multiple service goals set for students
and families has progressively risen over the initial
suggests evidence of positive impact on students. Through the
course of the projects initial fourteen months of coordinated
multiple service delivery,
percentages of students whose
absenteeism exceeded designated risk ceilings declined by
approximately 50 percent, percentages of students earning one
or more unacceptable grades decreased by approximately 35
percent, and the percentage of students for whom one or more
days of poor classroom conduct was recorded decreased by
approximately 31 percen ...
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