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For most of that time, Dr. Hayne performed about 1,700 autopsies annually, more than four for every day of the year and nearly seven times the maximum caseload recommended by the National Association of Medical Examiners.
However, there is no stipulated maximum caseload.
– Each member of the team will follow a maximum caseload of 20 patients as a case manager.
The target for maximum caseload for each AID manager was 20 patients in active intervention treatment at any time.
Funding allowed three nurses to be employed to deliver the intervention, each with a maximum caseload of 25 mothers (in accordance with NSW Department of Health guidelines).
The number of women to participate in the study was limited to the maximum caseload of the intervention nurses and a matching number of comparison women.
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The findings were stark: 73% of county-operated defender systems, utilized in 27 states, were functioning above the maximum recommended caseload level.
This allowed a planned recruitment of 90 subjects per group whilst maintaining the maximum intervention caseload of 75, to allow for a proposed 15% loss to follow-up.
Key features of ACT are: assertive engagement, a small caseload (maximum of 10 patients per clinician); shared caseload (i.e. all clinicians collaborated closely on each patient using one treatment plan); and community-based and assertive services on a time-unlimited basis [ 5, 19].
"The best way to address a changing caseload is to ensure there is maximum flexibility for the states," complains Doug Howard, Michigan's welfare administrator.
In a September report on New York's indigent defense system, the NYCLU found that some public defenders carried overwhelming caseloads that were five times over the recommended maximum.
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