Case loads are unrealistically high. Serious turn over in staff results in extra coverage cases, on top of already unrealistic number of cases. Quantity over quality atmosphere at the expense of case manager mental health, and client health and safety. Despite the increased reimbursement rate for case management services, recent job postings show a decrease in entry salary by several thousand dollars. Case managers voiced concerns about being over worked and the response was tacking on 1 extra floating holiday per year before turning around and accepting a new county contract for a different type of waiver that resulted in cutting the teams which were already short staffed and having difficulty hiring and retaining staff. Staff "life expectancy" at this job is less than 1 year. Upper management often commented that the case manager role was a "revolving door job" without any commitment to fix this. If you make it more than a year you've beat the system.