We describe in this article the appreciation of case managers of the first months of implementation of a new integrated services network in Quebec City for elderly people. The case management has been mainly assumed by social workers affiliated in CLSCs. The results show that the case managers have met some difficulties in the application of their role and mandate, particularly in terms of organizational and operational barriers related to the implementation of these new integrated services network. These difficulties have not only a direct impact on clinicians and their collaborators, but also on the elderly people receiving their services. The decision makers are now seriously questioned the case management model that they have been initially retained.