Care Coordination/Care Management

Connecticut provides care coordination and care management services to Medicare, Medicaid, and Husky Plan enrollees through programs such as the Connecticut Home-Care Program for the Elderly (Medicare),1 the Program of All-Inclusive Care for the Elderly (Medicaid),2 the Medicaid and Medicare Dually Eligible Pilot Program,3 the Primary Care Case Management Pilot Program (HUSKY), 4 and the Child Health Quality Improvement Plan (HUSKY). 5

The Connecticut Commissioner of Social Services (1) may obtain care coordination and care management services for Medicaid enrollees by contracting with care coordination and care management organizations; 6 (2) must offer community treatment teams and community support services to Medicaid beneficiaries with severe psychiatric disabilities;7 and (3) must establish a preventive health service plan, for children covered under the HUSKY Plan, which includes care coordination and chronic disease management.8

Many Connecticut pilot programs and demonstration projects utilize care coordination and care management including: (1) a demonstration project for providing long-term, coordinated care to chronically disabled and dependent patients;9 (2) a demonstration project for improving the care of uninsured pregnant women; 10 (3) a “medical home pilot program” to improve children’s health outcomes;11 and (4) a “pediatric asthma pilot program” that will provide children with referrals to appropriate health care providers.12

Connecticut permits licensed pharmacists and physicians to enter drug therapy management agreements that allow pharmacists to manage the drug therapy of an individual patient.13 The Commissioner of Consumer Protection must create a pilot program that will provide drug therapy management to Medicaid beneficiaries with specified conditions.14

Connecticut requires the establishment of standards for hospital discharge planning services.15 Hospitals that recommend a patient receive home health care services must include a minimum of two home health care agency options in that patient’s discharge plan.16 Hospitals must also create protocols for referring patients to substance abuse programs.17

Connecticut requires facilities that treat persons with psychiatric disabilities18 and assisted living service agencies19 to create personalized treatment plans.

The Department of Health must administer a program that will screen women for breast and cervical cancer and refer them for treatment.20