Standards of Practice for Case Managers
STANDARDS FOR PROFESSIONAL CONDUCT
Section 1 – Advocacy
S 1 – The Advocate
Certified case managers will serve as advocates for their clients and ensure that:
a) a comprehensive assessment will identify the client’s needs.
b) options for necessary services will be provided to the client.
c) clients are provided with access to resources to meet individual needs.
Section 2 – Professional Responsibility
S 2 – Representation of Practice
Certificants will practice only within the boundaries of their competence, based on their education, training, professional experience, and other professional credentials. They will not misrepresent their role or competence to clients.
S 3 – Competence
Certificants will not:
a) handle or neglect a case in such a manner that falls below the Certificant’s reasonable obligations and responsibilities.
b) exert undue influence that adversely affects the outcome of case management service to the client.
c) exhibit a pattern of negligence or neglect in the handling of the Certificant’s obligations or responsibilities.
S 4 – Representation of Qualifications
Certificants will not represent the certification designation to imply a depth of knowledge, skills, and professional capabilities greater than those reasonably demonstrated by achievement of certification. Certificants will take the necessary steps to correct a misstatement made by a third party with respect to the Certificant’s qualifications.
S 5 – Legal and Benefit System Requirements
Certificants will obey state and federal laws and the unique requirements of the various reimbursement systems by which clients are covered.
S 6 – Use of CCM Designation
The designation of Certified Case Manager and the initials “CCM” may only be used by individuals currently certified by the Commission for Case Manager Certification. The Certificant will not utilize the designation or initials as part of a company, partnership, or corporate name,
trademark, or logo.
S 7 – Conflict of Interest
Certificants will fully disclose any conflict of interest to all affected parties. If, after full disclosure, an objection is made by any affected party, the Certificant will withdraw from further participation in the case.
S 8 – Reporting Misconduct
Certificants possessing knowledge, not otherwise protected as a confidence by this Code, that another Certificant has committed a violation of any provision of this Code will promptly report such knowledge to CCMC and to such other authority as may be empowered to investigate or to act upon such actions or violations. Certificants will not initiate, participate in, or encourage the filing of complaints that are malicious, unwarranted, or without a basis in fact.
S 9 – Compliance with Proceedings
Certificants will assist in the process of enforcing the Code by cooperating with investigations, participating in proceedings, and complying with the directives of the Committee on Ethics and Professional Conduct.
Section 3 – Case Manager/Client Relationships
S 10 – Description of Services
Certificants will provide information to the extent reasonably necessary to permit clients to make informed decisions. At a minimum, information provided by Certificants to clients about case management services will include a description of the services, possible benefits, significant risks, alternatives and the right to refuse services. Where applicable, Certificants will also provide the client with information about the cost of case management services prior to initiation of services.
S 11 – Relationships with Clients
Certificants will not enter into any relationship with any client (business, personal or otherwise) that will interfere with the Certificant’s professional objectivity.
S 12 – Termination of Services
Prior to the discontinuation of case management services, Certificants will provide written notification of that discontinuation to all relevant parties consistent with applicable statutes and regulations.
S 13 – Objectivity
Certificants will maintain objectivity in their professional relationships and will not impose their values on their clients.
Section 4 – Confidentiality, Privacy and Recordkeeping
S 14 – Legal Compliance
Certificants will be knowledgeable about and act in accordance with federal, state, and local laws and procedures related to the scope of their practices regarding client consent, confidentiality, and the release of information.
S 15 – Disclosure
At the outset of the Certificant-client relationship, Certificants will inform the client that any information obtained through the relationship may be disclosed to third parties. Disclosure of information will be made only to clients, payors, service providers, and governmental authorities and limited to what is necessary and relevant, except that the Certificant must reveal information to appropriate authorities, as soon as and to the extent that the Certificant reasonably believes necessary, to prevent the client from: a) committing acts likely to result in bodily harm or imminent danger to the client or others; and b) committing criminal, illegal, or fraudulent acts.
S 16 – Client Identity
As required by law, Certificants will hold as confidential and private the client’s identity, especially when using data for training, research, publication, and/or marketing unless a lawful, written release regarding this use is obtained from the client.
S 17 – Records
Certificants will maintain client records, whether written, taped, computerized, or stored in any other medium, in a manner designed to ensure confidentiality.
S 18 – Electronic Recording
Certificants will not electronically record communications with clients without first obtaining the client’s written permission.
S 19 – Reports
Certificants will be accurate, honest, and unbiased in reporting the results of their professional activities to appropriate third parties, to avoid exerting undue influence upon the decision making process.
S 20 – Records: Maintenance/Storage and Disposal Certificants will maintain records necessary for rendering professional services to their clients and as required by applicable laws, regulations, or agency/institution procedures. Subsequent to file closure, records will be maintained for the number of years consistent with jurisdictional requirements or for a longer period during which maintenance of such records is necessary or helpful to provide reasonably anticipated future services to the client. After that time, records will be destroyed in a manner assuring preservation of confidentiality.
Section 5 – Professional Relationships
S 21 – Testimony
Certificants, when providing testimony in a judicial or non-judicial forum, will be impartial and limit testimony to their specific fields of expertise.
S 22 – Dual Relationships
Certificants who provide services at the request of a third-party payor will disclose the nature of their dual relationship at the outset of the Certificant/client relationship by describing their role and responsibilities to parties who have the right to know. Dual relationships, other than
payor/client, include, but are not limited to, Certificants working with clients who are the Certificants’ employer, employee, friend, relative, and/or research subject, and must also be disclosed.
S 23 – Unprofessional Behavior
It is unprofessional behavior if the Certificant:
a) commits a criminal act;
b) engages in conduct involving dishonesty, fraud, deceit, or misrepresentation;
c) engages in conduct involving discrimination against a client because of race, color, religion, age, gender, sexual orientation, national origin, marital status, or disability/handicap;
d) engages in sexually intimate behavior with a client; or accepts as a client an individual with whom the Certificant has been sexually intimate.
S 24 – Fees
Certificants will advise the referral source/payor of their fee structure in advance of the rendering of any services and will also furnish, upon request, detailed, accurate time and expense records. No fee arrangements will be made that could compromise health care for the client.
S 25 – Advertising
Certificants who describe/advertise services will do so in a manner that accurately informs the public of the services, expertise, and techniques being offered. Descriptions/advertisements by a Certificant will not contain false, inaccurate, misleading, out-of-context, or otherwise deceptive material or statements. If statements from former clients are to be used, the Certificant will have a written, signed, and dated release from the former clients. All advertising will be factually accurate and will not contain exaggerated claims as to costs and/or results.
S 26 – Solicitation
Certificants will not reward, pay, or compensate any individual, company, or entity for directing or referring clients to the Certificant. Nothing contained herein will preclude Certificants from making reasonable expenditures in entertaining individuals who have referred or may in the future refer clients to the Certificant or from giving gifts of minimal value to such individuals.
Section 6 – Research
S 27 – Research: Legal Compliance
Certificants will plan, design, conduct, and report research in a manner consistent with ethical principles and federal and state laws and regulations, including those governing research with human subjects.
S 28 – Research: Subject Privacy
Certificants who supply data, aid in the research of another person, report research results, or make original data available will protect the identity of the respective subjects unless an appropriate authorization from the subjects has been obtained or as required by law.