Care Coordination

Care Coordination A. Care Coordination aims to improve the quality of care of people with behavioral health conditions by ensuring that services are well-coordinated across different providers and settings. B. DMH/C and DMH/P providers must have implemented written policies and procedures which include the following care coordination activities/principles, in addition to other applicable care coordination activities as outlined elsewhere in the DMH Operational Standards: 1. Collaborative Care: Promoting collaboration among primary care providers, behavioral health care providers, and other service providers to ensure a holistic care approach. 2. Care Planning and Coordination: Addressing in service plans the unique needs and preferences of people being served and coordinating care across different providers and specialties. 3. Information Sharing: Ensuring appropriate and timely sharing of a person’s information among care team members while adhering to applicable informed consent, release of information, and privacy and confidentiality policies and laws, such as HIPAA. 4. Care Transition: Facilitating smooth transitions between different levels of care to prevent gaps in treatment and ensure continuity of care. 5. Quality Improvement and Performance Measurement: Monitoring and evaluating care coordination processes, outcomes, and persons’ experiences to identify areas for improvement.