Community and LTSS Care Partners

About

LTSS Care Partners

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Long Term Services and Supports (LTSS) CP is a collaboration of seven community-based providers that offers care coordination services to MassHealth enrollees ages 3 to 64 with complex LTSS needs, with complex LTSS needs, such as children and adults with physical disabilities, developmental disabilities, and brain injuries..

Our LTSS Care Coordinators partner with enrollees to promote their health and wellness goals through integrated long term services and supports. We work side by side with healthcare providers and community based organizations in this effort. Member Organizations Bay Cove Human Services, Justice Resource InstituteVinfen, Mystic Valley Elder Services, Somerville-Cambridge Elder Services, Boston Center for Independent Living, and Boston Senior Home Care are leaders in their local communities and fields of service.

What We Do:

  • Engage enrollees in their health and wellness, beginning with a comprehensive assessment of their overall needs. 
  • Partner with the enrollee and the Care Team to identify strengths and supports to develop a health and wellness map of goals for a LTSS Care Plan. 
  • Address barriers and promote improved access to primary, specialty, and behavioral health care. 
  • Assist enrollees in scheduling and keeping their health-related appointments including coordinating transportation as needed. 
  • Support enrollees in accessing their medication, understanding their medications and taking their medications as prescribed. 
  • Serve as your point of contact to coordinate and collaborate with the Care Team about LTSS services.
  • Assist the enrollee in accessing LTSS services when medically necessary and appropriate.
  • Connect an enrollee to social services supports. Examples include food stamps, fuel assistance, and meals on wheels.
  • Connect an enrollee to recovery supports. 
  • Arrange in home services and supports for an enrollee. 
  • Support transitions of care by meeting with the enrollee within three days of discharge.
  • Connect an enrollee with health and wellness activities such as smoking cessation and nutrition.

For more information about our services, check out our flyers available for Health Care Providers or MassHealth Enrollees.

LTSS CP has a presence, provides services,  supports, and community connections in the following service areas:

  • Greater Boston: Boston, Revere, Somerville and Quincy
  • North: Malden
  • South: Brockton
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