So… that was entertaining.

My first day at my new job was eventful, to say the least. By 10, one of the clients had assaulted two staff members, broken an office window, and smashed another staff member’s windshield. She left in an ambulance very shortly thereafter to go to the hospital for an assessment, and likely won’t be coming back, as this is the third time she’s destroyed property. She was on my caseload, so we’ll see how that goes.

I read charts to familiarize myself with the clients who live there. This is a residential treatment facility, and primarily adult foster care. My job will be the local case manager, who works with the client’s county of origin and their case manager there, if they have one. A couple clients don’t, so I’ll be their primary case manager. I’ll also be in charge of the handful of clients that live in monitored apartments on campus. (Most of the clients live in cottages, which house four clients each.) I’ll make sure they have ID and food stamps and all those things they need to function in the community. I’m excited about doing it, and I don’t have a productivity requirement, as we do not bill insurance for their care. I just have to show up and help people. Only working 16 hours a week, I’m pretty sure I’ll find plenty to do, and I might be able to plead a case for developing a means to bill a client’s insurance for case management services, though I don’t know if any sort of framework exists for that at this agency. I don’t have a clue what the billing codes are for Michigan, but overall it looks like it’s very, very similar to Ohio, based on notes and treatment plans I saw in the chart that were from the client’s agency.

I only have four charts left to read, as the campus is only about half-full at the moment, so there are only 24 clients total. I’ll have a caseload of eight, it looks like, though only four of them will have me as their primary case manager, and the other four have a case manager in their county of origin.

It feels SO GOOD to be using clinical terms again, though I’m quickly discovering I’m rusty as all hell in using them. I had forgotten so many medication names in particular. The clients are all very low functioning, and upon reading charts, I noticed most, if not all, have developmental disabilities, and those remaining had a head injury that led to disability. I’m not even kidding; a good fourth of the clients have head injuries from various things. Two have English as a second language, so communication with them is difficult. All of them have extensive histories of abuse and most were in foster care for good chunks of their childhood. All have been unsuccessful in any placement other than a hospital before ending up at my agency. I wish I’d had access to an agency like this down in Ohio, because I’d have the entire place full to capacity with clients who could benefit from the 24/7 staffing and extensive rehabilitation available. It’s the group home my coworkers and I always threatened to create, where our clients who had been unsuccessful at every other group home in the city of Cincinnati could live. Basically, I am now working with the problem children of other people’s caseloads, from all over the state of Michigan.

I couldn’t be more excited about doing this if I tried.

It’s amazing how much I missed working with mentally ill folks, but so far I’m happy as a clam. I have an office, I get to use professional clinical language, I get to wear business casual again. It’s wonderful and feels like a dream come true.

Now if I could only make it into a full-time job, either because I’ve found a way to argue for a full-time schedule, or I’ve found another job on campus. Then it would be absolutely perfect in every way. ❤


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