A Managed Care Solution

Partners in Community Care is a specialized Managed Long Term Care Plan for persons with chronic illness or disability who require long term care services and who might otherwise be in need of nursing home care. Enrollment is voluntary. Members of the Plan receive individual attention and flexible care planning, to help them live as independently as possible in their own homes and communities for as long as possible. A Nurse care manager keeps in regular touch with members and their families and other caregivers in order to arrange the specific services which are needed.

Flexibility in Care Planning

Partners in Community Care Nurse care managers and subcontracted providers make sure members get health and long term care services that will help them maintain their health and independence. We work with each member and his/her caregivers to identify needs and to develop a plan of care. We recognize that everyone is different and that what is appropriate for one member may not be best for another, even if they have similar medical conditions.

Individual Care Management

Every member's individualized care plan is overseen by that member's own Nurse care manager. This ensures that the member receives the right service at the right time, from the appropriate provider. The Nurse care manager encourages collaboration among all those involved with the member's medical and social support system including the physician, the service providers, the member, and the member's family, as this is key to providing the best health care results possible.

Choice of Primary Care Physician

At Partners in Community Care, the right to a choice is taken seriously. Every member may continue using the primary care physician with whom he or she has an established relationship, if the physician is willing to collaborate with the Plan. If a member does not have a physician, the Plan can help the member select one.

Access

The broad range of specialized services and facilities associated with Partners in Community Care, LLC offers members convenient access to trusted health care providers within its network throughout the Rockland and Orange County communities. In addition, members can continue to use their Medicare and/or Medicaid cards for services the Plan itself does not cover.

Covered Services

Partners in Community Care recognizes that members’ needs differ; therefore, the Plan offers a wide range of services available to suit individuals and their circumstances. Not every member will require every service. Member, physician, and care manager decide on the appropriateness and eligibility for any particular service

Individuals who are 21 years of age and older may apply for enrollment in Partners in Community Care if they:

• are eligible for Medicaid.
• reside in Orange or Rockland County.
• are assessed by the program to be capable, as of the time of enrollment, of remaining
• safely in their home and community.
• are eligible for nursing home level of care, for example, assistance with dressing, bathing and other activities of daily living, as assessed by the Plan.
• require the long term care services offered by the Plan for 120 days or more from date of enrollment.

Partners In Community Care, LLC’s staff will be pleased to discuss services and eligibility in more detail. For additional information, please call Partners at:
1 (800) 688-PICC (7422)

PARTNERS IN COMMUNITY CARE, LLC

Partners In Community Care was chosen by the New York State Department of Health as one of the original sites in New York State to offer this category of managed care program.

It is a voluntary program, with individuals free to decide on their own whether to enroll in the program if they meet eligibility requirements. Individuals may also request at any time to disenroll from the program.

Partners In Community Care makes every effort to be responsive to cultural diversity and to individuals’ communication needs. Translation and communication assistance services are available from the Plan free of charge.