Santa Clara Family Health Plan is a participating health plan in California’s new Coordinated Care Initiative (CCI), with the goal of providing long-term services and supports (LTSS) in a coordinated manner. To do this, LTSS benefits will be managed by Medi-Cal managed care plans beginning July 1, 2014. For beneficiaries with both Medicare and Medi-Cal, their LTSS benefits will be part of new Cal MediConnect plans starting January 1, 2015. LTSS includes a range of home and community-based services that support people living independently in the community, as well as services provided in a nursing facility.

The CA Department of Health Care Services (DHCS) requires all Primary Care Providers (PCPs) who treat patients covered by Medi-Cal managed care plans to complete training on Long-Term Services and Supports. Click here to go to the LTSS training module.

An example of a potential LTSS member is a patient with multiple chronic conditions and functional limitations that make it hard to live independently and safely at home without assistance. Long-term services and supports for this member may include:

• Nursing care in the home
• Personal care (help with dressing, bathing, grooming or feeding)
• Help preparing or receiving meals, grocery shopping
• Housekeeping
• Case management, including linkage to resources
• Community day health care with physical therapy, occupational therapy, socialization, nutritionist
• Transportation services