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Care Coordination
Care Coordination is a part of the Access
and Assistance system offered
through the Area Agency on Aging. It is a
process that includes the assessment, effective planning, arranging,
coordinating and follow-up on services that most appropriately meet the
identified needs as mutually defined by Area Agency on Aging access and
assistance staff, an older person, and/or a family member or other
caregiver. The aging network uses
local, state, and federal funds to provide this service to as many as
possible. Client referrals are accepted from any source.
The services provided through Care Coordination
are:
-
Care Coordination: It is a process
that includes assessing the needs of a client and effectively planning,
arranging, coordinating and follow-up on services that most appropriately meet
the identified needs of the client. -
Health Maintenance: The provision of
services, medications, and/or equipment which will prevent, alleviate, and/or
cure the onset of acute and /or chronic illness, increase awareness of special
health needs and/or improve the emotional well-being of an older
individual. -
Residential Repairs: Home repair
services consist of repair or modification of a client-occupied dwelling that
is essential for the health and safety of the
occupant(s). -
Income Support: A provision of aid
in the form of money or goods.
Care
coordination service is available to persons 60 years of age and older.
Services will be targeted to those eligible persons who will be able to
regain their independence by receiving short-term support services. Care plans are developed on an
individual basis with input by the client and/or caregiver. It is the estimation of this agency that
care plans will be no longer than three months and can be extended to six months
if necessary. The program is to
promote independence, not dependence.
Provision of services through the Care
Coordination program will be given to those
who:
-
Have recently been hospitalized or suffered a health
care crisis (recently has been defined as within the last 30
days); -
Have a mild to moderate impairment or a temporary
severe impairment (official impairment level determined during in-home
assessment by Care Coordinator); -
Are in great economic or social need, with particular
emphasis on low-income minority persons: -
Have a limited or no formal/informal support system;
and -
Reside in a rural
area.
For more information contact Bea Ramsey at 325-223-5704 or toll free
1-877-944-9666. E-mail address bea@cvcog.org.
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