Care Coordination
Long Term Care Coordination is a consumer-directed, team approach to the integration of care, services and support for optimizing health and social outcomes.
Those outcomes include:
- Care coordination[1] must allow people to maintain control to the greatest extent possible.
- Care coordination and activities of care coordination[2] must recognize people may require different levels of support based upon individual strengths and/or desires.
- Care coordination must allow people to change care coordinators upon request.
- Care coordination provides tools and supports for people to take increased levels of personal responsibility.
- Care coordination encompasses person centered care[3], self-determination[4] and consumer direction[5].
Value Message
Care coordination results in people who are managing their lives with the services and supports needed to successfully live in the community or setting of their choice.
Ask Message
Help us remind policy makers and service professionals that people who receive care coordination are the most knowledgeable partners regarding their needs.
Barrier Message
Unless the needs of the people served are the first priority, no cost savings will ever be realized. When care coordination represents the self-determined needs of the person, cost savings will follow -- naturally.
Vision Message
The best care coordination outcome is when a person gets what they need when they need it … No hoops to jump through, just action.
[1] Care coordination is the facilitation on behalf of the person to obtain or retain medical and non-medical services to meet their goals and needs.
[2] Activities include finding providers, scheduling appointments, helping problem solve to mitigate any barriers such as transportation, copays, assisting with applications, redeterminations, prior authorizations, appeals processes and all ancillary care. It provides referrals to resources to assist the person in meeting their other life needs and goals, including offering referrals to advocacy organizations and peer-to-peer support
[3] Person Centered care focuses on the preferences, strengths, capacities, needs and desired outcomes or goals expressed by the person. Any planning process, regardless of the person’s choice of service delivery must be an interactive process that supports and enhances the individual’s stated preferences. Any discussion related to an individual or event supporting an individual must focus on the Person-Centered approach and should utilize the values of Self-Determination.
[4] Freedom to decide how one wants to live his or her life; Authority over a targeted amount of dollars; Supports to organize resources in ways that are life enhancing and meaningful to the person; Responsibility for the wise use of public dollars; Recognition of the contribution individuals across Disability and aging can make to their communities and Confirmation of the important roles that individuals must play in the newly designed system”
[5] People with disabilities assess their own needs and make choices about what services would best meet those needs. It makes a statement that consumers can and should have options:
- to choose the personnel or provider entities that deliver their services,
- manage the how, when, and where of delivery of services, and
- monitor the quality of services.
Choice is guaranteed including the choice not to direct and to direct to the extent desired.
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