Although case management is a recognized technique to organize and coordinate human services, its use with high-risk children is relatively new. This article describes the development of a case management program for children at the Center for the Vulnerable Child at Children's Hospital, Oakland, California, a health care setting that brings together health, social work, and child welfare services. Case management was introduced into multidisciplinary clinical programs for foster children, drug-exposed infants, and adolescent mothers and their infants. Case management activities differed in each of the clinical programs in relation to the unique characteristics of each population and the different obstacles encountered. A time management analysis indicated consequent differences in case management time allocations. The implications of these findings are discussed.

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