Case Management

Case management and counseling are often interlinked. The main difference is counseling focuses on addressing personal issues involved in adoption and addressing external factors preventing a smooth adoption. On the other hand, case management encompasses preparing the client(s) for the various stages of adoption and properly handling of each part of the process. The case manager has to account for a number of variables in each adoption. A case manager might have to manage the following:

• Arrange or handle the counseling sessions
• Participating in conference calls between the adoptive family and the birth parent(s)
• Arrange or participate in any meetings between birth parent(s) and the adoptive family
• Reviewing medical and social history forms
• Preparing the birth mother for the physiological changes during the pregnancy
• Helping arrange doctors visits and explain any procedures
• Preparing the birth mother and the adoptive family for the hospital experience
• Explaining the process of signing the relinquishment/consent paperwork
• Arranging or handling the execution of the relinquishment/consent paperwork
• Arranging or preparing the birth mother for court (if needed)
• Reviewing any conflicts between state laws
• Reviewing any ICWA issues
• Preparing ICPC
• Consult with attorneys regarding any conflicts which may arise between interstate adoptions. This step can be extremely complex because many state laws conflict and thus require the adoption to be legally handled differently.
• Notify the adoptive family of the adoption and all circumstances surrounding it.
• Distribute living and medical expenses needed by the birth mother
• Itemize fees and collect the fees when they are due.
• Verify all home study and other supporting documents are gathered for the adoption.

As you can see, without an organization to help with this step the adoptive family will often be left wondering how their potential situation is moving along.

Facilitator - They offer no case management services. The family must arrange and find organization(s) who will handle all parts of the case management. In each state, the family must find and pay for a different case manager. This means if your first birth mother comes from Arizona, you will have to locate organization(s) in Arizona who will handle the case management. If that birth mother does not place and your next birth mother comes from Nevada, you will have to find different case manager(s) from Nevada. Without significant financial risk and high costs, it is remarkably difficult to find an organization that will handle or arrange all parts of the case management. This means you will often have two or three organizations to handle your case management in each state. Having multiple organizations involved leads to communication problems and errors. It should be noted that most case management fees are at risk like counseling fees.

Attorneys - Law offices often handle all case management from their offices. They often use unqualified personnel and each family is billed hourly for case management. This can be extremely costly at $150 to $250 an hour. Since a law office will often spend 30-100 hours on each case, the financial risk for case management can be significant.

Small agency - Small agencies usually handle the case management but most do not work across state lines. While his helps reduce the difficulties involved in case management, it limits a family's adoption opportunities. Small agencies often charge a lower hourly rate for case management than law offices. They usually bill at $65 - $100 and hour.

Medium sized - Most medium sized agencies bill hourly and the expenses are at risk. They usually bill at a higher hourly rate than small agencies but they often service a larger geographic area.

Larger agencies - Most larger agencies do not bill for case management because it is included in their agency fees. This is significant difference from all other professionals in this category, because little if any of the case management expenses with each potential adoption is at risk.

See example below:

Case management	Hours	Large agency	Other professionals
Conference calls	4 hours	No extra charge	hourly
Meetings	3 hours	No extra charge	hourly
Preparing clients	10 hours	No extra charge	hourly
Reviewing state laws	3 hours	No extra charge	hourly
ICWA review	1 hour	No extra charge	hourly
ICPC	4 hours	Varies	hourly
Prepare attorneys	3 hours	No extra charge	hourly
Arrange doctor visits	2 hours	No extra charge	hourly
Distribute living expenses	1 hour	No extra charge	hourly
Verify supporting docs	3 hours	No extra charge	hourly
Family correspondence	3 hours	No extra charge	hourly
Totals	37 hours

Other Professionals
Small agency at $65 X 37 hours	$2,405 at risk
Medium agency at $100 X 37 hours	$3,700 at risk
Attorneys at $250 X 37 hours	$9,250 at risk
Large agency
Large agency at $0 X 37 hours	$0 at risk

With large agencies, you only pay for case management upon a successful adoption and it is often included in a fixed placement fee. If the adoption does not work out, then you pay nothing for their case management. With other professionals, in this case, you will pay for 37 case management hours at their hourly rate. If the adoption does not work out, you will still pay for their case management.

Below is an itemization of typical and actual expenses the average family will incur in their pursuit of adopting a child. This example explains what it would look like working with 10 birth mothers throughout the process, with one leading to a successful placement.

	LARGE AGENCY	ATTORNEY	SMALL AGENCY	MEDIUM AGENCY	FACILITATOR
Birth mother #1 Worked case for 1 hour	No charge	$200 an hour	$80 an hour	$100 an hour	Must use another hourly professional
Birth mother #2 Worked case for 3 hours	No charge	$600	$240	$300	$300
Birth mother #3 Worked case for 1 hour	No charge	$200	$80	$100	$100
Birth mother #4 Worked case for 8 hours	No charge	$1,600	$640	$800	$800
Birth mother #5 Worked case for 37 hours	No charge	$7,400	$2,960	$3,700	$3,700
Birth mother #6 Worked case for 1 hour	No charge	$200	$80	$100	$100
Birth mother #7 Worked case for 1 hour	No charge	$200	$80	$100	$100
Birth mother #8 Worked case for 22 hours	No charge	$4,400	$1,760	$2,200	$2,200
Birth mother #9 Worked case for 1 hour	No charge	$200	$80	$100	$100
Birth mother #10 Worked successful adoption 45 hours	Agency fees range from $12,000-$18,000	$9,000	$3,600	$4,500	$4,500
Legal work	$3,000-$7,000	$3,000-$7,000	$3,000-$7,000	$3,000-$7,000	$3,000-$7,000
Advertising costs	Included in above amount	$8,000-10,000	$8,000-10,000	$8,000-9,000	$8,000-9,000
Total costs paid to professional for all services rendered excluding medical and living expenses if needed	$15,000-$25,000	$34,000-$38,000	$19,600-$23,600	$22,000-$26,000	$22,000-$26,000

With large agencies, families have an insurance policy or fixed cost regardless of how many birth mothers the large agency works with. With other professionals, it seems one of three things happen.

1. Most families pay for the professional to work with approximately ten birth mothers before a successful placement occurs.
2. Some families either get lucky on the first few birth mothers and thus their total costs are lower than with larger agencies.
3. Some families grow tired of losing money on unsuccessful placements and stop their adoption plan or join an agency that burdens the risk.

With all other professionals, besides large agencies, families should understand not only are the hourly counseling and case management fees at risk but so is the advertising fees. With large agencies, none of those items are usually at risk.

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