3.1 Organizational Context and Capacity

Factors related to organizational context and capacity may influence the potential effectiveness of a PCM program. These factors include the organization's physical setting, staffing capacity and skills, referral tracking capabilities, and the availability of, and access to, local referral sources.  

PCM may be implemented from a variety of institutional or community-based settings. A review of PCM programs suggests, however, that "stand-alone" PCM programs - those programs independent of other preventive, medical, or social services, for example, health care, substance abuse treatment, and residential housing - have had more difficulty recruiting and retaining PCM clients [Purcell, DeGroff, Wolitski, Submitted for Publication]. PCM programs that are well integrated within a larger continuum of drug treatment, STD treatment, health care, or other social services may be more effective in recruiting and retaining clients. Thus, agencies that provide a spectrum of services and have strong relationships and/or alliances with outside providers in the community may be well positioned to support a PCM program, whereas "stand-alone" programs - those independent from other preventive, medical, or social services - are discouraged from considering a PCM program.  

Second, the skills and capacity of staff are especially important for many of the services PCM programs provide. Prevention case managers require a broad array of sophisticated skills including assessment, prevention service planning, risk-reduction counseling, and crisis counseling. PCM targets those individuals with multiple, complex problems and risk-reduction needs; consequently, sophisticated skills are required of staff for some tasks (See Section 4.3 for more detail about staff qualifications).

Third, referral tracking systems, computerized or otherwise, should be implemented to evaluate the effectiveness of a PCM program's referral system. This implies a level of organizational capacity to establish and confidentially maintain such a system.

Finally, the case management literature suggests that giving consideration to the available network of community support programs is important (Rubin 1992). The effectiveness of case management in general is related to both the availability of referral sources in the community and to supportive structural factors in the agency itself and the larger community system (Rothman 1992). Therefore, agencies considering a PCM program should first assess the availability of community services relevant to the target population and then evaluate their ability to develop and implement referral systems.

All these factors should be considered in determining whether or not your agency and community has the capacity to effectively support a PCM program.

Go to 3.2 Developing an Organization's Program Plan for PCM