HomeTeam's Coordination in Self-Directed Care Models

Introduction

With the healthcare landscape continuously evolving, self-directed care models present a transformative approach to service delivery, putting individuals at the center of their own care. Key players like HomeTeam are championing effective coordination methodologies within this framework, enhancing both autonomy and efficiency. This article delves into the complexities and benefits of HomeTeam's coordination efforts in self-directed care models, highlighting best practices, key roles, and strategic frameworks that facilitate this impactful paradigm.

The Essence of Self-Directed Care

What is an example of self-directed care?

An example of self-directed care is when an individual receiving Medicaid-funded home and community-based services takes charge of their own care planning and management. They have the authority to recruit, train, hire, and supervise their support workers, often with support from a financial management services agency or a dedicated broker.

These individuals develop a personal, customized service plan that aligns with their unique goals and preferences. They also oversee their service budget, managing how funds are allocated and ensuring that their care remains consistent with their needs.

Allowing individuals to choose their caregivers—sometimes including family members or community residents—empowers them to shape their support network. This model fosters a sense of control, independence, and satisfaction because the care is tailored specifically to what they value most.

Overall, self-directed care places the individual at the center of decision-making, helping them lead lives that better reflect their personal wishes and circumstances, while also encouraging greater engagement and fulfillment.

HomeTeam's Approach to Coordination

Implementation strategies by HomeTeam

HomeTeam employs a comprehensive approach to care coordination that emphasizes person-centered strategies and community integration. Their implementation includes training staff to understand social determinants of health, ensuring that coordinators can address non-medical factors affecting well-being. They collaborate with community organizations to fill service gaps and create seamless service pathways. Additionally, HomeTeam emphasizes continuous staff development to adapt to evolving client needs and leverage innovative technology tools for better management.

Coordination methodologies

At the core of HomeTeam's model is a multidisciplinary team approach. Coordinators advocate for clients, participate in assessments, and develop personalized community-based service plans. They facilitate communication among healthcare providers, social services, and families. Technology plays a pivotal role, with self-directed care software like HHAeXchange’s FMS Engine streamlining budget management, scheduling, and billing. This integration of methodologies ensures timely, efficient, and person-centered care delivery.

Integration with Medicaid HCBS programs

HomeTeam actively integrates its coordination efforts with Medicaid Home and Community-Based Services (HCBS). This aligns with federal and state efforts to promote independence and deinstitutionalization. Coordinators assist eligible individuals in navigating Medicaid waivers such as 1915(c) and 1915(j), supporting self-directed care options. They work closely with Medicaid Service Coordinators (MSCs) and Financial Management Services Agencies (FMSAs) to help participants develop individualized service plans and manage care budgets effectively. Such integration enhances access to tailored services, reinforcing the goal of enabling individuals to live in their homes with appropriate supports.

Examples of care models and collaboration

HomeTeam adopts various models of care coordination, including wraparound services, shared case management, and integrated health-social care approaches. They foster partnerships with healthcare providers, social workers, and community agencies to promote holistic support.

Final overview

The approach combines strategic implementation, innovative methodologies, and strong ties with Medicaid programs, creating a robust framework. This framework ensures that individuals receive coordinated, person-centered support promoting independence and quality of life.

Revolutionizing Care: The Role of LTS Coordinators

What is the role of Long Term Services and Supports (LTS) Coordinators in the 'One Care' program?

LTS Coordinators play a vital role within the 'One Care' program by acting as advocates and service planning experts for individuals eligible for both Medicare and Medicaid. They are involved in assessment processes, helping develop community-based service plans tailored to each person's needs and preferences.

Their responsibilities extend to coordinating various long-term services and supports (LTSS), ensuring that care is integrated and person-centered. This includes connecting individuals with community resources, healthcare providers, and social supports, all aimed at promoting independence and quality of life.

How do LTS Coordinators impact social determinants of health?

Participants reported feeling more supported and understood due to the dedicated attention of their LTS Coordinators. This personalized engagement helps reduce feelings of loneliness and isolation.

Furthermore, LTS Coordinators address social determinants of health—factors like housing, transportation, social inclusion, and access to community resources. They incorporate the Independent Living (IL) philosophy, emphasizing autonomy, community participation, and empowerment, which directly influences positive health outcomes.

What challenges do LTS Coordinators face, and what opportunities exist for improvement?

Despite their positive impact, LTS Coordinators face challenges such as unclear roles and responsibilities within care teams, which can hinder their effectiveness.

Inconsistent integration into healthcare teams and limited resources further restrict their ability to serve participants optimally. To maximize their potential, ongoing training, better role clarity, and increased resource allocation are necessary.

Looking ahead, the role of LTS Coordinators holds promise as an innovative model for other integrated care systems. Improving clarity around their functions and providing comprehensive support could expand their influence and enhance person-centered care across diverse settings.

Aspect	Details	Additional Notes
Main responsibilities	Advocacy, assessments, service planning	Focus on community and social supports
Impact on social health	Reduces loneliness, addresses social determinants	Incorporates IL philosophy
Challenges	Role ambiguity, resource constraints	Needs clearer roles, more support
Opportunities for improvement	Better training, clarified responsibilities, resources	Potential to serve as a scalable model

Participant-Directed Services: Structure and Policies

What are Medicaid waiver types and their functions?

Medicaid waivers are specific programs that allow states to offer tailored services beyond basic Medicaid requirements. These include 1915(c) Home and Community-Based Services (HCBS) waivers that fund long-term support in community settings, 1115 research and demonstration waivers to test new models, and 1915(b) managed care waivers that help coordinate services more effectively.

Another important waiver type is the 1915(j), which supports self-directed personal assistance services. This waiver enables beneficiaries to personally hire caregivers, manage their care budgets, and oversee their services. Together, these waivers expand the range of options for individuals needing long-term supports, emphasizing independence and personalized care.

Who is eligible, and what is the application process?

Eligibility for Medicaid waivers for self-direction generally requires beneficiaries to be Medicaid-eligible and meet specific state criteria, such as functional limitations or medical diagnoses. A critical step is assessing an applicant’s capacity to manage their care or having a trusted representative do so.

The application process typically involves completing a formal assessment of needs, submitting documentation, and working with state agencies or designated representatives like a Financial Management Services Agency (FMSA). The FMSA plays a vital role by managing care budgets, processing payroll for caregivers, and ensuring compliance with regulations.

What are the components of participant-directed services?

Participant-directed services encompass several core components. These include developing an individualized service plan aligned with personal goals, choosing and hiring preferred caregivers, managing budgets, and accessing necessary services. This approach promotes autonomy, enabling individuals to shape their care according to their preferences.

Supportive tools like self-direction software—such as HHAeXchange’s FMS Engine—assist in streamlining financial management, scheduling, and billing activities. These resources help participants maintain control and efficiency in managing their long-term care.

The overall goal of participant-directed services is to foster independence, respect individual choices, and ensure that supports are aligned with personal health and life goals. Incorporating these elements into Medicaid waivers makes long-term care more person-centered and adaptable to each individual’s unique needs.

Advocacy and Assessment: Core Responsibilities of Coordinators

Development of community-based service plans

LTS Coordinators play a vital role in creating personalized, community-focused service plans for individuals. These plans are rooted in person-centered approaches, ensuring each person’s strengths, preferences, and goals are prioritized. By thoroughly assessing individual needs—beyond medical conditions—they facilitate access to services that support social, emotional, and functional well-being.

Coordination and advocacy roles

A primary responsibility of LTS Coordinators is acting as advocates. They serve as liaisons among healthcare providers, social service agencies, and community organizations. Coordinators advocate for individuals to ensure they receive appropriate resources, understand their options, and are actively involved in decision-making processes. They participate in assessments, develop tailored service plans, and coordinate various supports to promote effective, integrated care.

Support for independent living

Supporting independent living is a core aspect of the coordinator’s work. Drawing from the Independent Living philosophy, coordinators assist individuals in maintaining or enhancing their ability to live in their communities. They address social determinants of health—such as housing, transportation, and social connections—and help fill gaps that might hinder independence. This approach fosters autonomy, dignity, and improved quality of life.

Overall, the role of the LTS Coordinator encompasses developing comprehensive community-based plans, advocating fiercely for individual needs, and empowering individuals to live independently within their communities.

Enhancing Coordination through Financial Management Services

Functions of Financial Management Services Agencies (FMSA)

Financial Management Services Agencies (FMSAs) play a vital role in self-directed care by managing various administrative and financial tasks. They handle care budgets, process payroll for caregivers, ensure compliance with state and federal regulations, and provide billing support. This support allows individuals to focus on their healthcare needs while trusting that their funds and paperwork are managed correctly.

Budgeting, scheduling, and compliance

One of the core responsibilities of FMSAs is managing care budgets. They help establish and monitor financial plans, ensuring funds are used appropriately for eligible services. FMSAs also assist with scheduling caregivers and services, making sure care plans are executed smoothly. Additionally, they ensure that all activities comply with legal and program-specific requirements, reducing the risk of errors or penalties.

Role of technology in service management

Advancements in technology have significantly enhanced the efficiency of FMSAs. Software tools like HHAeXchange’s FMS Engine streamline the management process by offering features such as budgeting, scheduling, billing, and compliance tracking. These digital platforms help individuals and their caregivers access real-time data, manage care plans remotely, and reduce administrative burdens. Overall, technology improves accuracy, transparency, and ease of access within self-directed care systems.

Promoting Independence: The Client's Role in Self-Directed Care

Responsibilities and autonomy of clients

In self-directed care, clients take on a central role in managing their services and supports. This approach empowers individuals to have control over their care, ensuring that services align precisely with their preferences and needs.

Clients are responsible for recruiting, hiring, training, and evaluating their caregivers. They act as employers, which involves handling employment tasks such as payroll and taxes. These responsibilities require clients to be proactive and organized to maintain effective support.

Additionally, clients make all health-related decisions. This includes managing medications, scheduling medical appointments, and communicating directly with healthcare providers. By doing so, they maintain autonomy over their healthcare journey.

Working closely with support brokers or case managers, clients coordinate various services to foster independence and community participation. They also utilize resources like financial management services, which help handle administrative tasks related to their care. Overall, clients are at the helm of designing and maintaining their care plans, ensuring they reflect their personal goals and lifestyle choices.

Person-Centered Planning: The Heart of Self-Directed Care

What is involved in identifying strengths and interests?

Person-centered planning begins with understanding each individual’s unique strengths, interests, and valued outcomes. This process encourages individuals to express what they enjoy and what helps them feel fulfilled. Recognizing these elements allows care teams to develop plans that truly resonate with the person’s preferences, fostering independence and engagement.

How are family members involved?

Family members often play a vital role in shaping person-centered plans. Their insights help articulate the individual’s history, preferences, and needs, ensuring the support provided aligns with personal and cultural values. Collaboration with families promotes a supportive environment where the individual feels understood and empowered.

What are the steps in creating an Individualized Service Plan (ISP)?

Developing an ISP involves a collaborative process where the individual, their family, and care coordinators work together. This plan specifies the services, supports, and goals tailored to the person’s needs. Active involvement ensures the plan reflects personal aspirations and promotes autonomy, making it a living document that can evolve as goals and circumstances change.

Additional insights on person-centered planning

Effective person-centered planning integrates these components into a comprehensive approach that drives self-directed care. It emphasizes respect, choice, and empowerment, helping individuals lead meaningful lives in community settings. This model not only personalizes care but also supports better health outcomes and increased satisfaction.

Operational Strategies for Effective Self-Directed Care Coordination

Best practices for care coordination

Efficient care coordination is essential for supporting individuals who self-direct their services. Best practices include developing person-centered plans that emphasize the individual’s strengths, interests, and personal goals. Involving the individual and their family actively in planning ensures their preferences are prioritized. Clear documentation of each person's needs and goals helps care coordinators tailor services appropriately. Regular communication among providers and continuous monitoring allow for timely adjustments, ensuring care remains aligned with evolving needs.

Effective care coordination also involves training staff to understand the nuances of self-directed care models. This includes familiarity with fiscal management, resource navigation, and advocacy. Employing culturally competent practices and respecting diverse backgrounds enhances engagement and trust. Additionally, utilizing technology such as specialized management software streamlines administrative tasks like budgeting, scheduling, and reporting, thereby reducing errors and increasing efficiency.

Systems integration and resource allocation

A crucial aspect of successful self-directed care is seamless integration across healthcare, social, and community systems. Building strong partnerships between Medicaid agencies, service providers, and community organizations ensures resource sharing and reduces service gaps.

States can foster integration by creating unified data systems, allowing real-time sharing of information about individual plans and service utilization. Resource allocation should prioritize flexible funding mechanisms that empower individuals to choose and manage supports, including hiring personal assistants or accessing community resources.

Medicaid waivers, such as 1915(c) and 1915(j), support tailored services and self-direction, providing the financial framework needed for personalized care. Investing in infrastructure, such as self-direction software and FMSA (Financial Management Services Agency) support, optimizes resource distribution and compliance.

Workforce development and diversity

A well-trained, diverse workforce is vital for delivering quality self-directed care. Programs should focus on providing ongoing education related to person-centered planning, cultural competence, and disability awareness.

Expanding workforce diversity ensures service providers can effectively serve varied populations, fostering trust and engagement. States like Oregon and Rhode Island are pioneering initiatives, such as licensure alternatives and Medicaid reimbursement for family caregivers, to strengthen and diversify their care teams.

Supporting family members as paid care coordinators not only bolsters the workforce but also enhances continuity of care. Additionally, utilizing community health workers and employing innovative training approaches ensures that the workforce is adaptable and prepared to meet individual needs.

Strategy	Implementation Examples	Expected Outcomes
Person-centered planning	Family involvement, strength assessments	Increased satisfaction and personalized care
Data and technology utilization	Self-direction software, real-time data sharing	Enhanced efficiency and accuracy
Workforce diversity initiatives	Family care reimbursements, licensure pathways	Broader reach and cultural competence

By adopting these operational strategies, programs can deliver more responsive, equitable, and sustainable self-directed care that truly meets the needs of individuals.

Navigating Challenges: Role Clarification and Resource Needs

LTS Coordinators within the 'One Care' program play a vital role in supporting individuals with dual Medicare and Medicaid eligibility. They advocate for participants, develop community-based service plans, and help coordinate long-term services. However, they face several challenges that can hinder their effectiveness.

One major issue is the unclear definition of their roles and responsibilities. Without a clear understanding, coordinators may struggle to prioritize tasks or collaborate effectively within care teams. This ambiguity can lead to gaps in service delivery and affect the quality of support provided.

Additionally, inconsistent integration of LTS Coordinators into care teams often results in fragmented care. Some teams incorporate these coordinators well, while others do not, which can leave participants feeling unsupported and isolated.

To address these issues, there is a pressing need for improved clarity through detailed role descriptions and standardized procedures. Enhanced training programs are essential to equip coordinators with the skills they need to navigate complex care landscapes effectively.

Resource allocation is also a critical concern. LTS Coordinators require adequate staffing, technological tools, and ongoing professional development to perform their duties optimally. Without sufficient resources, their capacity to advocate and coordinate becomes limited, ultimately affecting participant outcomes.

Overall, strengthening role clarity, investing in training, and providing adequate resources are vital steps toward maximizing the positive impact of LTS Coordinators within integrated care models like 'One Care'.

Leveraging Technology for Enhanced Care Coordination

Integration of self-direction software

Self-directed care has gained momentum as an empowering way for individuals to manage their long-term services and supports. Central to this approach are software tools such as HHAeXchange’s FMS Engine, which streamline various administrative tasks. These platforms help users manage budgets, schedule services, process billing, and maintain compliance with regulations. By automating these functions, technology reduces administrative burdens and enables individuals and care teams to focus more on personal care and health goals.

Role of technology in improving service delivery

Advances in digital tools have transformed how care is delivered within programs like One Care. Care coordinators and service providers now use integrated platforms that facilitate real-time information sharing and communication. This enhances coordination among medical, community, and behavioral health providers. Moreover, telehealth innovations—accelerated by pandemic responses—allow for remote consultations, follow-ups, and therapy, making services more accessible, especially for those in rural or underserved areas.

Innovations in care management systems

Emerging care management systems incorporate data analytics, machine learning, and other advanced technologies to tailor interventions and predict individual needs. These systems enable proactive care planning by identifying risk factors early and suggesting targeted supports. Additionally, they support culturally competent care by providing insights into diverse populations' preferences and barriers. As technology continues to evolve, its integration into care coordination promises more personalized, efficient, and equitable services, ensuring all individuals receive the right care at the right time.

Technology Feature	Benefits	Example Tools
Digital care management platforms	Streamlined workflows, improved communication	HHAeXchange FMS Engine, Epic
Telehealth services	Increased access, convenience, reduced travel barriers	Telemedicine platforms, Doxy.me
Data analytics and AI	Predictive care, personalized interventions	CareData, IBM Watson Health
Culturally sensitive tech tools	Better understanding of diverse needs	Culturally tailored apps

Technology plays a vital role in modernizing care coordination, enabling people-centered, efficient, and equitable services that are adaptable to individual needs.

Building a Supportive Framework: Policies and Practices

How do regulatory frameworks support self-direction in Medicaid?

State Medicaid programs utilize various waivers and policies to enable self-directed care, allowing individuals more control over their services. For instance, 1915(c) waivers provide home and community-based services, while 1915(j) waivers focus on personal assistance. These frameworks often include requirements for financial management, such as using a Financial Management Services Agency (FMSA), to handle budgets and compliance.

What policies does HomeTeam incorporate to promote effective coordination?

HomeTeam’s policies emphasize person-centered, team-based care that aligns with national standards for care coordination. They promote active involvement of consumers and require on-site coordinators like social workers or health coaches. The policies foster collaboration across medical, social, and developmental systems, leveraging health data and technology to streamline communication and support.

How are practices tailored to meet individual needs?

Practices are customized by focusing on individual strengths, goals, and preferences. The use of assessments and person-centered planning enables care teams to develop flexible, community-based service plans. Incorporating culturally competent approaches and family involvement ensures that care remains relevant and respectful of each person’s unique circumstances.

Policy/Practice Area	Examples	Description
Regulatory Support	Medicaid waivers, state policies	Enable self-direction, provide legal and financial frameworks
Care Coordination Practices	On-site coordinators, community links	Foster person-centered, integrated support
Individualized Approaches	Person-centered planning, cultural competence	Ensure tailored, respectful, and effective care

These strategies collectively create a flexible, empowering environment that enhances independence and quality of life for Medicaid recipients.

Expanding Access and Equity in Self-Directed Care

Ensuring health equity and access

Equity in self-directed care means making sure everyone can access personalized services regardless of their background or circumstances. Medicaid programs have increasingly focused on reducing disparities by offering tailored supports that meet diverse needs. This involves removing barriers related to language, culture, or socioeconomic status, ensuring all individuals can participate fully in designing and managing their care plans.

States are implementing policies that promote equity by providing caregiver support, simplifying enrollment processes, and offering culturally appropriate resources. These efforts help marginalized groups, including racial and ethnic minorities and those with disabilities, to achieve better health outcomes and maintain independence in their communities.

Innovations from the pandemic era

The COVID-19 pandemic spurred numerous innovations in self-directed care, notably expanding telehealth and remote management tools. Technologies like online portals and mobile apps improve access, allowing individuals to manage budgets, schedule services, and communicate with providers from home.

For example, software solutions such as HHAeXchange’s FMS Engine streamline administrative tasks, making it easier for participants to control their care remotely. These innovations not only support safety during public health crises but also pave the way for more flexible, person-centered service models that extend beyond emergencies.

Culturally competent services and CLAS standards

Providing culturally competent care is essential for equitable self-direction. The National Standards for Culturally and Linguistically Appropriate Services (CLAS) emphasize respecting diverse cultural health beliefs, languages, and communication preferences.

In practice, this involves training care coordinators and providers to understand cultural nuances and applying language assistance services. By aligning services with CLAS standards, programs can foster trust, improve engagement, and ensure that care plans resonate with individuals' cultural values, ultimately promoting better health and greater satisfaction.

Aspect	Description	Implementation Examples
Access	Removing barriers to care	Multilingual support, flexible scheduling
Technology	Leveraging remote tools	Telehealth, online care management portals
Cultural Competence	Respecting diverse backgrounds	Staff training, culturally tailored materials

Enhancing equity in self-directed care involves a continuous commitment to inclusive policies, embracing technological innovations, and fostering culturally sensitive practices. These strategies help ensure all individuals can effectively direct their own care and achieve their health goals.

Case Study: Integrating Care Coordination across Systems

Examples from State Implementations

States like Oregon and Rhode Island have pioneered innovative approaches to improve care coordination for individuals needing long-term services and supports (LTSS). Oregon has implemented asset mapping strategies that identify community resources to better tailor services to individual needs. Rhode Island has introduced Medicaid reimbursements for family caregivers, enabling a formal recognition of their role in care teams and fostering a more comprehensive support system.

These efforts highlight the diverse methods states use to promote seamless integration of services, ensuring individuals receive personalized and continuous care. Such initiatives demonstrate how local settings adapt overarching standards to meet unique community needs.

Cross-System Coordination and Communication

Effective care depends on robust communication and coordination across various sectors, including medical, behavioral health, social, educational, and residential systems. Programs like the PCMH+ emphasize organizing activities and information sharing among healthcare providers, community supports, and families.

Care coordinators, whether they are community health workers, nurses, or social workers, play a vital role in facilitating this exchange. They organize wellness activities, develop treatment plans, and leverage validated screening tools to enhance care quality. Culturally competent practices are emphasized to ensure services are accessible and respectful of diverse populations.

Adapting Successful Strategies across Regions

Adopting successful strategies across different regions involves several shared themes. Building strong partnerships among state agencies, healthcare providers, and community organizations is foundational. Utilizing health data to identify gaps and streamline access helps tailor interventions locally.

Support for workforce development, including training and diversifying care teams, is essential for sustaining improvements. Innovative licensure pathways and Medicaid reimbursements for family caregivers exemplify flexibility in building a sustainable and capable care coordination workforce.

These practices collectively support broader efforts to improve regional and national systems, ensuring that all individuals, especially those with complex needs, receive high-quality, comprehensive support.

Aspect	Examples	Additional Details
State Initiatives	Oregon’s asset mapping; Rhode Island’s caregiver reimbursement	Customized resource mapping and caregiver support models
Communication Methods	Shared care plans, team meetings, electronic health records	Ensure seamless information exchange among providers
Workforce Strategies	Training programs, caregiver reimbursements	Enhance workforce capacity and diversity
Goals	Improve access, integrate services, ensure cultural competence	Promote equity and patient-centered care

This interconnected approach exemplifies how lessons learned from one region can be adapted to improve care coordination elsewhere, ultimately leading to more efficient and equitable systems of support.

Future Directions: Sustainability and Innovation in Self-Directed Care

Opportunities for innovation and improvement

As self-directed care continues to evolve, embracing technological advancements and innovative practices can enhance its effectiveness. For example, expanding the use of software tools like HHAeXchange’s FMS Engine can streamline budget management, scheduling, and billing. These tools help make self-direction more accessible and efficient for individuals and caregivers.

Additionally, integrating new training modules for service coordinators and support staff can improve understanding of diverse needs, including cultural competence and disability-specific strategies. Developing tailored support programs can also address gaps in existing services, ensuring everyone benefits from personalized, flexible care options.

Aligning funding and measurement with care models

To sustain the growth of self-directed programs, it’s essential to align funding sources and measurement systems with care models that prioritize person-centered outcomes. States and federal programs are encouraged to explore flexible funding mechanisms that support innovation while maintaining accountability.

Concrete metrics focused on quality of life, level of autonomy, and satisfaction should be adopted to evaluate success. Combining quantitative data with personal feedback can help refine programs and demonstrate their value.

Increasing family and community engagement

Family members play a crucial role in self-directed care, and increasing their involvement can improve outcomes. Supporting family caregivers through training, resources, and recognition fosters a more engaged and capable support system.

Community engagement initiatives, such as local support groups and outreach programs, can empower individuals to participate actively in their care planning. Strengthening partnerships between service providers, families, and community organizations encourages a more integrated, responsive approach.

Together, these strategies — leveraging technology, aligning resources, and engaging families — are vital for advancing self-directed care as a sustainable and innovative model, capable of adapting to future healthcare challenges and needs.

Conclusion

As the need for personalized and effective healthcare solutions grows, self-directed care models provide a robust framework for empowering individuals to actively participate in their care decisions. HomeTeam's coordination approaches stand at the forefront of these innovations, demonstrating effective strategies that improve autonomy while maintaining high standards of care. Through effective coordination, resource management, and the use of technology, these models not only address current challenges but also set the stage for future advancements in personal healthcare. By continually refining these systems, we can ensure a more inclusive, responsive, and dignified healthcare experience for all.

References

• Explorations of the Long Term Supports Coordinator Role in ...
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• Self-Directed Services in Medicaid Home- and Community-Based ...
• [PDF] Looking into Service Coordination | Healthy Transitions
• [PDF] PCMH+ Enhanced Care Coordination Activities Guide - CT.gov
• National Care Coordination Standards for Children and Youth with ...
• Self-Directed Care: A Complete Guide to Roles - MyCIL.org
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• Learn More About Self-Direction | ACES - MyCIL.org
• Self-Directed Services | Medicaid