Long-Term Services and Supports Care Management

Medicaid Long-Term Services and Supports (LTSS) serve individuals who are among North Carolina’s most vulnerable citizens. The populations using LTSS are extremely diverse and range in age from 0 to death in terms of individuals’ care needs, service utilization and spending. Care management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet an individual’s and family’s comprehensive health needs for North Carolinians. The NC Medicaid LTSS Care Management Program is intended to guide PHP development of care management practices for members with LTSS needs to foster high-quality, accessible services that enhance well-being and facilitate engagement in community life.

Care Management is a cornerstone for improving member access and quality of care. In partnership with PHPs and the Care Management team, the LTSS population will receive significant opportunities to improve care coordination, access to community-based services, and outcomes that address both medical and non-medical drivers of health for these vulnerable populations for years to come.  

Long-Term Services and Supports (LTSS), as defined by the Centers for Medicare and Medicaid services, include: care provided in the home, in community-based settings or in facilities, such as nursing homes; care for people of all ages with disabilities who need support because of age, physical, cognitive, developmental or chronic health conditions, or other functional limitations that restrict their abilities to care for themselves. Specific LTSS program areas can be accessed from the Medicaid Program and Services page.

Programmatic Guidance

• LTSS Care Management Program Guide  – April 2021

Policy Papers

• North Carolina's Vision for Long-Term Services and Supports under Managed Care - April 2018

Trainings

• LTSS Care Management  – March 2021
   

Additional Information 

• Medicaid's Long-Term Care page