"Case Management ​is a collaborative, client-driven process for the provision of quality health and support services through the effective and efficient use of resources. 
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​​Case Management supports the clients’ achievement of safe, realistic, and reasonable goals within a complex health, social, and fiscal environment."

​(National Case Management Network of Canada, 2009)

When people and their families experience sudden catastrophic injuries or complex health conditions and disabilities, they often find themselves struggling to find and navigate various health and social care systems to ensure their needs are met. It is at this time that a case manager can be of greatest assistance to ensure that the client's medical, therapy, personal care, social care and developmental needs are met, and that a well-coordinated, collaborative planning process can begin.    

Focus Rehabilitation Consulting's case managers have particular expertise in providing clinical case management services to individuals who have experienced traumatic neurological injuries (particularly brain injury and spinal cord injury), polytraumatic injuries, psychological injuries. We also support individuals and families who have complex needs related to childhood developmental disabilities and those who experience complex health challenges related to aging. 

As social workers,  Focus Rehabilitation Consulting's case managers are able to identify and assist with complex cases where co-existing social issues impact outcomes (e.g. poverty, homelessness, addictions, discrimination/inequality, involvement in the justice system, limited access to care, etc.).

Case Managers at Focus Rehabilitation Consulting, together with their medical care providers and other allied health care providers, assist clients to establish goals and action plans that will help them achieve their maximum potential.  Effective, collaborative, well-coordinated community-based therapy teams are established, and comprehensive care programs are implemented premised upon the following core values:

• recognition of the client's right to self-determination and choice, as well as, the need for informed decision making

• use of outcome-oriented and evidence-informed practice principles  

​Focus Rehabilitation Consulting Case Managers have extensive knowledge of the Ontario public health, developmental, and social care systems, accident benefits insurance, and legal systems.  This ensures that clients receive the help, benefits, and services they need so that they can focus on their recovery and the achievement of their rehabilitation goals. ​

It is our ultimate goal to empower our clients and families to "self-manage" their health, therapy, ancillary, and social care needs to their fullest potential - throughout the stages of human development, recovery from traumatic injury, and beyond.  

"The Life Care Plan is a dynamic document based upon published standards of practice, comprehensive assessment, data analysis, and research, which provides an organized, concise plan for current and future needs with associated costs for individuals who have experienced catastrophic injury or have chronic health care needs (IALCP, 1998).  It is a way to plan for the lifetime needs of an individual with a disability."

Focus Rehabilitation Consulting has been providing comprehensive Life Care Planning (LCP) assessments and reports (commonly referred to as "Future Cost of Care" reports) since 2007.   These reports are usually completed by regulated health professionals who have achieved, and continue to maintain, credentialization as a Canadian Certified Life Care Planner (CCLCP). 

When completing a life care plan, Focus Rehabilitation Consulting experts follow the required methodological standards and ethical practice principles established by the International Academy of Life Care Planners (IALCP) and the International Association of Rehabilitation Professionals (IARP).  In doing so, we rely on objective, evidence-informed principles to develop life care plans that are valid, reliable, and defendable. 

Although the specialization of Life Care Planning developed in the U.S.A. to assist private health insurers and families to make informed decisions concerning the costs and future care requirements of individuals who experience life-long, and often complex, health challenges - in Ontario, the primary purpose of Life Care Plans (LCPs) has historically centred around the role and duty of the Life Care Planner as an "expert witness".  ​In this role, the Life Care Planner's primary responsibility is to "educate the court" concerning what, on the balance of probabilities, an individual's lifetime needs may encompass.  The assessment process reviews the need for items that are inclusive of (but not necessarily limited to) the following:

• medical and rehabilitation services

• attendant care services

• caregiver support

• medication

• medical supplies and equipment

• housing and vehicle modifications

• transportation

• housekeeping, home maintenance, and other ancillary services

• financial support costs

The costs for the recommended goods and services are subsequently researched and presented as lifetime annual amounts that can be forwarded for present value analysis.  

Although Focus Rehabilitation Consulting LCP reports are primarily commissioned by a client's legal representative to assist with the claims process, it is our hope that the clients and their families (whose strengths, challenges, and future care needs are meticulously and thoughtfully detailed in our LCP documents) will also be able to use our reports to help guide and plan for their future. 

"Loss of Service" assessment and analysis reports can also completed upon request.

"The scope of practice of the profession of social work means the assessment, diagnosis, treatment and evaluation of individual, interpersonal and societal problems through the use of social work knowledge, skills, interventions and strategies, to assist individuals, dyads, families, groups, organizations and communities to achieve optimum psychosocial and social functioning."

(OCSWSSW, 2008)

As social workers, we are experts at system navigation and often partner with other sectors (e.g. mental health and addiction services, criminal justice, public health, child welfare, social services, education system, charitable organizations, etc.) to ensure our client's needs are met. 

We understand that addressing the social determinants of health are as important as addressing the physical issues in fostering positive outcomes.   Our social work training, knowledge and expertise are indispensable and valued in situations where the injured person has limited family support, and/or a number of co-occurring psychological, social, or economic difficulties.

Social work services often encompasses the following:

• completion of a biopsychosocial needs evaluation, which generates recommendations for “next steps” for therapy or rehabilitation planning

• referrals to community partners and connection to government/community-based resources to reduce barriers to the rehabilitation process and ensure that needs are met (e.g. through addressing issues related to housing, income, transportation, employment, education, healthcare, and other social determinants of health, etc.)

• solution-focused counselling with attention on supporting clients and families how to become better self-managers of their health care needs and to navigate the health and social care systems

• counselling services for individuals and their families who have been impacted by the experience of a traumatic brain injury through the use of the Brain Injury Family Intervention (BIFI) model/approach

We recognize that funding is often limited; therefore, we aim to be as efficient as possible with our service delivery.  We help clients make informed decisions about funding availability. 

Please note, FRC staff do NOT currently provide services which fall under the controlled act of “psychotherapy” which came into force on December 1, 2017.  However, FRC social workers DO provide counselling and related services as defined and outlined within the broader social work scope of practice.