Safety net frays with case manager decline


A year after state funding cuts caused Lynn Canal Counseling to fold into Southeast Alaska Regional Health Consortium, another Haines nonprofit is stretched thin from the blowback.

Margaret Sebens of Southeast Alaska Independent Living said her caseload has doubled since Lynn Canal Counseling merged with SEARHC in the fall of 2015.

SAIL is seeing a big increase in referrals and people needing case management, Sebens said.

“I have definitely been experiencing a big influx and at times wondering ‘What am I going to do? There’s no possible way I can serve all these people effectively,’” she said.

Sebens defined a case manager as someone who helps build a safety net of services for a person to function in daily life. Anyone with chronic or long-term challenges, including medical or psychological conditions or people in crisis, may need the assistance of a case manager.

But Sebens said the two-person Haines crew working for SAIL is not able to take over so many time-consuming and complicated cases.

Sebens is currently managing 22 active cases. At least half require extensive help with everything from applying for disability, social security, public assistance, Medicaid, supported living, supported employment and more.

As far as a solution, Sebens said she is toying with the idea of training at least one volunteer to assist in filling out time-consuming paperwork.

Sebens also refers some patients to a local family services case manager, Kelsey Taylor of Central Council Tlingit and Haida Indian Tribes of Alaska. Taylor was out of town this week.

Lynn Canal Counseling had employed case managers and SEARHC had employed one in its behavioral health function. But SEARHC now has no such position, said agency administrative assistant Heather Haack of Haines. Some cases with SEARHC have transferred to Taylor with Tlingit-Haida.

Haack and four SEARHC clinicians only can deal with short-term cases due to the vacant position. If it’s determined a case will take too much time away from clinicians, SEARHC staff will refer cases to the other two organizations.

“We don’t want to get in over our heads with case management,” Haack said.

New SEARHC administrator Pat Hefley said that because the clinical side of SEARHC deals heavily with medical cases that often require referring patients out of the community for care, long-term local case management is “not a function we could afford.”

Citing state budget cuts, Hefley said, “Piece by piece, the social networks that exist that are starting to fray at the edges.”

Kelly Williamson, who manages SEARHC outpatient facilities in Haines, Juneau and Sitka, said the agency intends to fill that case manager position again. She stressed that SEARHC is a patient-centered facility and will develop treatment around the person’s needs.

“If someone needs long-term (care), we’ll make that work,” she said.

Haines resident Lowana Drurey was one of the people directly affected by the fraying safety net.

Drurey, 52, was served by a case manager at Lynn Canal Counseling for about 16 years before the merger, when she had to manage on her own for about six months before being referred to SAIL this year.

Drurey said she has epilepsy, bipolar disorder and a developmental disability. The most difficult part of managing on her own was trying to find some emotional support.

“(SAIL) helps me live out there in the world,” she said. “It’s hard when you look fine on the outside but you’re sick on the inside. Sometimes it can be very hard to deal with and they help you cope with that.”

Sebens said from her experience in the social services network in Haines, there are good services here compared to many Alaskan communities and the Lower 48. But due to the “perfect storm” of even more looming budget cuts, more and more people are going into crisis and will need social services.

“That’s something we all feel like we need to be preparing ourselves for, but how to do that, I don’t know,” Sebens said.


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