One Care Implementation Council February 13 2018 WHAT IS THE ROLE OF THE LTSC 2 WHEN IS LTSC ACCESSED LTSCs part of Care Team During Initial assessment and reassessment throughout care experience ID: 716913
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Long Term Support Services- One Care Implementation Council
February 13, 2018Slide2
WHAT IS THE ROLE OF THE LTSC?
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WHEN IS LTSC ACCESSED?
LTSCs part
of Care Team
During Initial assessment
and reassessment,
throughout care experience
and u
pon member request
Work with members to find resources that support wellness, independence and recovery goals
When need identified by Care
Team
Educate Care Team on importance
of LTSS; p
ivotal role in Care Plan development
When receiving rehabilitation services from DMH or other
state agency
Come
from independent community organizations that are experts in independent living, recovery and aging
When being admitted to nursing facility, psychiatric hospital,
or other institutionSlide3
SERVICES LTSCs HELP IDENTIFY AND CONNECT MEMBERS TO (not an exhaustive list)
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Companion
PCA
Housing
Homemaker
Adult
Day Health
Food Stamps
Chore
Adult
Family Care
Job Placement
Laundry/Grocery
Group Adult Foster Care
Peer Support
Home-delivered
meals
Medical and Non-medical Transportation
Support Groups
Home Health
Aide
Personal Emergency Response
Systems
Community
activitiesSlide4
Michelle- Member controls the care plan
47 years old
LTSC and Care Partner supported her in accessing LTSS in the sequence and cadence that meets her specific needs
4Slide5
Sam- Leveraging LTSS to support housing stability
60 years old
At risk for eviction due to bed bug infestation. Team worked with him to introduce LTSS (heavy chore) to preserve housing
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