What is the role of STAR Kids Service Coordinators?Texas Children's Health Plan
A Service Coordinator is the central contact between Texas Children’s Health Plan and a member’s providers and family members. The purpose of a Service Coordinator is to maximize a Member’s health, wellbeing and independence. The Service Coordinator must work with the Member’s PCP to coordinate all of a member’s health services. The STAR Kids Service Coordinator also engages as an advocate and intervenes on behalf of the member if approved by the member.
The Service Coordinator will perform an overall evaluation of the member’s needs through use of the STAR Kids Assessment Instrument (SAI) and other valid assessment tools, which identify strengths, preferences, and individual needs. The STAR Kids SAI assists in:
- Determining eligibility for Medicaid-funded community long term services and supports (LTSS)
- Identifying individuals’ support needs and informing their service and support planning (e.g., plan of care).
- Identifying the potential need for nursing services, behavioral health, physical therapy, occupational therapy and speech therapy services.
Service Coordinators may assist in specific areas:
- STAR Kids service coordinators will become advocates to ensure that members find qualified providers to care for their complex healthcare needs.
- A service coordinator will connect members to covered and non-covered services necessary to meet their identified needs.
Plan of care
- Service coordinators will work with the member and the member’s LAR and other caretakers in the design of an Individual Service Plan (ISP).
- The service coordinator will provide a person-centered evaluation of the members needs and preferences. The evaluation will take place at least once a year and with additional telephone contacts, depending on the need level of a person.
- A service coordinator will connect with a member’s primary care provider and any other providers that are important in the member’s care to make sure everyone understands the care goals and preferences.
- The service coordinator will follow rules about keeping a member’s health information private.
- The service coordinator will contact a member after discharge to ensure access to covered services is timely and appropriate.
- The service coordinator will make sure a member understands their health issues.
Transition to adulthood
- The service coordinator will assist teens and young adults with transition planning for adulthood.
Providers can access the Service Coordination department for STAR Kids members at Texas Children’s Health Plan by calling 346-232-4923 or 1-800-659-5764. The Member’s assigned Service Coordinator will be notified to contact the provider.
Leave a Reply