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Advocacy & Planning

    Results: 5

  • Advocacy (9)
    FP-0500

    Advocacy

    FP-0500

    Programs that intercede on behalf of individuals and/or groups to ensure that they receive the benefits and services for which they are eligible and that organizations within the established service delivery system meet the collective needs of the community; that attempt to marshal public support for a particular issue or cause; or that seek to influence legislation, local ordinances or administrative rulings in order to benefit specific interest groups or achieve specific social, political or environmental goals.
  • Case/Care Management (13)
    PH-1000

    Case/Care Management

    PH-1000

    Programs that develop plans for the evaluation, treatment and/or care of individuals who, because of age, illness, disability or other difficulties, need assistance in planning and arranging for services; which assess the individual's needs; coordinate the delivery of needed services; ensure that services are obtained in accordance with the case plan; and follow up and monitor progress to ensure that services are having a beneficial impact on the individual. Case management is a collaborative process characterized by communication, advocacy and resource management to promote high quality, cost-effective interventions and outcomes.
  • Individual Advocacy (2)
    FP-0500.3300

    Individual Advocacy

    FP-0500.3300

    Programs that intercede on behalf of individuals to help them establish eligibility for or obtain needed services when they have been denied benefits or services for which they are eligible, when they need assistance to communicate their needs to a service provider or to otherwise effectively represent themselves, or when they have a complaint about a service. Individual advocacy attempts to reach equitable settlements without resorting to litigation and seeks to meet individual needs without attempting to change social institutions.
  • Legislative Advocacy (5)
    FP-0500.4500

    Legislative Advocacy

    FP-0500.4500

    Programs that attempt to influence the introduction or review of pending bills, ordinances or administrative rulings with the objective of having an impact on the passage or defeat of such legislation or its content.
  • Medicare Information/Counseling (2)
    LH-3500.5000

    Medicare Information/Counseling

    LH-3500.5000

    Programs that offer information and guidance for older adults and people with disabilities regarding their health insurance options with the objective of empowering them to make informed choices. Included is information about benefits covered (and not covered); the payment process; the rights of beneficiaries; the process for eligibility determinations, coverage denials and appeals; consumer safeguards; and options for filling the gap in Medicare coverage (Medigap supplement insurance). Also available is information relating to an individual's eligibility for benefits and assistance with evaluating their options and enrolling in a Medicare plan (A, B, C, and/or D) that will best meet their needs. These programs also address coordination of benefits when beneficiaries have other types of health insurance in addition to Medicare (e.g. Medicaid, employer coverage or retiree insurance) and provide counseling and assistance regarding the subsidies that are available to low income beneficiaries enrolled in the Part D Prescription Drug Benefit (which help pay for Part D premiums and reduce the cost of prescriptions at the pharmacy) and the Medicare Savings Programs which help pay for Medicare out-of-pocket costs. They may also provide information about Medicaid and the linkages between the two programs, referrals to appropriate state and local agencies involved in the Medicaid program, information about other Medicare-related entities (such as peer review organizations, Medicare-approved prescription drug plans, Medicare administrative contractors), and assistance in completing related Medicare insurance forms.