Funding and Advocacy

How can a medical home afford a care coordinator? Approaches to funding a care coordinator may include:

• Utilization of care coordination codes
  • See CMS Chronic Care Management Services Changes for 2017 ( 521 KB)
  • See Coding and Reimbursement Health Care Transition Tipsheet 2017 ( 925 KB)
• Coding and billing for physician services related to care coordination (the links above include relevant information)
• Leveraging existing staff to identify skills and opportunities
• Creating partnerships with large organizations, such as hospital systems or insurance companies, that will support care coordination activities
• Seeking grants and foundation funding

A care coordinator may act as an advocate for the needs of the child and family. While being an advocate sounds like you need an advanced degree, in the health care realm it has various connotations and is often part of the work you are already doing.

What is an Advocate? An advocate is defined as "one who pleads the cause of another." Advocacy can be for an individual or on behalf of a group of individuals.

Who is an Advocate? Any individual or group can be an advocate. Examples of advocates include parents, physicians, nurses, clergy, social worker and anyone that meets the definition. In the Medical Home Model, all team members act as the child’s and family’s advocate.

Examples:

• Advocacy for an Individual

• Completing a Letter of Medical Necessity for a child to obtain an insurance authorization for needed equipment or procedure, see Medical Necessity, part 1 ( 71 KB) and Medical Necessity, Part 2 ( 173 KB)
• Participating in Individualized Education Program (IEP) meetings at a child's school
• Parent Advocates within the Medical Home reaching out to touch base with a parent of a child with special health care needs

• Advocacy for a Group

• Providing community presentations at schools, community centers, or committee meetings
• Participating in creating or supporting legislation that improves services or benefits for CYSHCN, see State Government Links
• Sharing information about programs that encourage the health and safety of children, such as Healthy Child Care America and Prevent Child Abuse America