Case Management Adaptation in COVID-19

The steps in the case management process remain unchanged in COVID-19, but the approach for each step should be reviewed and adapted according to the context and location.

Remember that even if current access is not significantly impacted in your context, it is important to prepare in advance for the potential of limited access to children and families as a result of COVID-19.

The following section is taken from the Technical Note: Adaptation of Child protection Case Management to the COVID-19 Pandemic, it outlines some key considerations and priority areas for adapting case management services in COVID-19 for the safe continuity of services for the most vulnerable children.

The article presents key considerations for all open cases categorized by associated risk level as well as for new intakes.

Key Considerations for Adapting Case Management in COVID-19: Current Case Load

• Review the current caseload and assign new risk levels based on the COVID-19 situation.
• Give priority to high-risk cases.

Additional guidance:

• IRC remote case management decision tree
• TDH COVID-19 Decision Making on Essential Personal Interaction
• Lebanon Inter-Agency Guidance: COVID-19Preventative Safety Measures for Case Management

1) For All Cases:

Start with high-risk cases.

Guiding questions to focus the re-prioritization discussion:

• What is the current situation of the child? Have there been any minor or major changes that affect the child and/or their caregivers as a result of the pandemic?
• What is the likelihood that the child’s safety and wellbeing will worsen due to the current crisis? (Determine specific risks and document, if possible.)
• What type of support does the child require and how will caseworker and child safety be considered for each action prioritized? (Document in case plan, if possible.)

Considerations for adaptations to Case Management Services must be made either as preparedness measures or for immediate implementation depending on the stage of COVID-19.

Considerations for adaptation:

• Face-to-face: continue when safe and appropriate. Make available personal protective equipment (PPE) for face-face meetings. Call in advance to determine if any person in the household is experiencing COVID-19 symptoms or believes they have been exposed to the virus. Where caseworker cannot visit the home, establish an alternative safe place to meet, if possible outside or in a well-ventilated space.
• Phone communication and video meetings: if accessible to the child and/or caregiver use as a supplement to face-to-face or where appropriate to the risk level as an alternative to visits.
• Work with trusted community members or groups to provide follow-up if safe and relevant.
• Create or update safety plans for the child and/or caregiver/trusted adult.
• Determine and preposition the resources needed for adaptations (e.g., phone credit, PPE, psychosocial support materials, movement permits, referral service pocket cards, etc.).
• Allocate a backup caseworker to cover cases in case the primary caseworker falls ill or is unable to continue providing services,
• Document agreed adaption plans as an annex to the case management standard operating procedures (SOPs).

2) For high-risk cases :

• Maintain case management support for all high-risk cases. Where possible conduct face-to-face visits with the most urgent/life-threatening cases. Where restrictions are placed on movement, actors may need to advocate with authorities for permission to ensure continuity for high-risk cases.
• Introduce the backup caseworker to the child and/or trusted adult in case of temporary handover due to illness or COVID-19 restrictions impacting.

Document how the backup caseworker will safely access case information during the coverage period.

3) For medium and low-risk cases

• Review and prioritize based on assessed needs. Share caseworkers’ contact information with the child and/or caregiver/ trusted adult. Provide phone follow-up where face-face is not possible. Explore trusted community safe support options.

Key Considerations for Adapting Case Management in COVID-19: New Case Load

Adapt case management criteria to consider:

• Family/child directly impacted by COVID-19: increased distress, loss of livelihood, family separation and children isolated without appropriate care (alone at home due to caregivers’ illness and children in observation or treatment centers), orphans (death of parents/caregiver due to the illness), etc.
• Family/child indirectly impacted by COVID-19: domestic violence, sexual and gender-based violence, child marriage, adolescent pregnancy, trafficking, child labor, and enhanced risks for: children or caregivers with disabilities and/or chronic illnesses, children on the move, children living on the street or in residential care facilities, children associated with armed forces or armed groups, and children in detention.
• Establish clear protocols specific to the COVID-19 situation in each operational location for identification and intake of new cases (review and update the protocols regularly).

Remember that contextualization and adaptation will be needed to make sure that case management processes reflect in-country staff capacity, access to technology, and virus prevention and response measures in place at any given time.

Interested to read more? Check out the full COVID-19 Case Management Guidance from the Alliance for Child Protection in Humanitarian Action and the annex on Case Management by phone