Existing data on case management (CM) time were analyzed to investigate the impact of agitation and dementia-related behavior problems on the use of CM time by older clients (N = 242) in a Medicaid waiver-funded home and community-based services program. Among clients with dementia (n = 73), regression analysis revealed that having problem behaviors resulted in increased use of CM time. Among clients with behavior problems, those with greater functional ability consumed greater CM time. Content analysis revealed that most CM activity focused on service coordination rather than on direct attempts to manage problem behaviors. Implications for CM programs include the need to consider case mix when allocating caseload size and provision of specific training on interventions to address behavior problems.