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LTSS COMMUNITY PARTNER SERVICES

Vinfen offers integrated care coordination services for MassHealth enrollees with intellectual and developmental disabilities, behavioral health challenges, and brain injuries.

Our multidisciplinary Care Teams partner with MassHealth enrollees to meet their health and wellness goals while working collaboratively with healthcare providers and community-based organizations to better support enrollee needs.

Vinfen offers community-based care coordination services as a member organization of LTSS Care Partners.

LTSS Community Partner Services Include

  • Health and wellness coaching, beginning with a comprehensive assessment of overall needs
  • Partnering with Care Teams to identify strengths and supports to develop a health and wellness map of goals for a LTSS Care Plan
  • Improved access to primary, specialty, and behavioral health care
  • Coordination of primary, specialty, and behavioral health care
  • Help scheduling and keeping health-related appointments including coordinating transportation
  • Getting medications and help following prescription orders
  • Connecting to social service supports including food stamps, fuel assistance, and meals on wheels.
  • Connecting to recovery supports
  • Arranging in-home services when needed, such as nursing or homemaking
  • Support for transitions of care such as stays in a hospital or rehabilitation facility within 3 days of discharge
  • Connecting to health and wellness activities such as smoking cessation and nutrition