CCSP

Community Care Settings Program

Since 2014, CCSP has helped over 190 aging and disabled people transition from long-term care facilities back into their own homes. By coordinating a wide range of resources – such as housing, medical, behavioral health, social, home-health, adult day care and transportation services – CCSP empowers participants to be fully engaged community members.

HPSM’s Program Partners

HPSM partners with San Francisco’s Institute on Aging (IOA) and the housing agency Brilliant Corners to provide eligible CCSP participants with the support they need to live independently.

  1. Brilliant Corners helps people find homes that best fit their situations
  2. IOA then manages their care
  3. HPSM works with IOA to make sure members have the resources they need to remain stable and live independently as active members of the community

Eligibility

Currently, CCSP is only available on a limited basis to members who meet specific criteria and are invited to participate by HPSM or IOA. HPSM plans to roll the most successful components of CSSP out more widely in the near future. Then more older and disabled adults, and their families, can benefit as well.

CCSP Member Stories

Conrado

ConradoConrado moved into a long-term care facility after hip replacement surgery left him unable to walk. When his health improved, Conrado no longer needed round-the-clock care, so his doctor recommended him for HPSM’s Community Care Settings Pilot. Through the program, Conrado got an apartment of his own in a senior housing complex and the kind of care he needed to live independently. Read more

Rafael

RafaelAfter suffering a stroke in 2012, Rafael could not walk without a walker. Medical bills left he and his wife Zenaida struggling financially, so they lived in a rented garage. HPSM’s Community Care Settings Pilot got them a furnished apartment in a subsidized senior community that was much more affordable. The program also provided Rafael with the support he needed to recover from his stroke. Read more

Rick

RickAfter being hospitalized for sepsis and a blood clot in his leg, Rick was diagnosed with several other chronic health conditions, including diabetes, Parkinson’s disease, glaucoma, an enlarged prostate and an atrial fibrillation. After moving into a long-term care facility, Rick enrolled in HPSM’s Community Care Settings Pilot. The program got him an affordable apartment of his own and mobilized resources to support his health. Read more

CCSP in the News

CHCS Profiles Community Care Settings Pilot Program

Many individuals with long-term services and supports (LTSS) needs either reside in institutions or are at risk for institutionalization. Rebalancing care to provide LTSS in the community is one goal of the federal Financial Alignment Initiative for Medicare-Medicaid enrollees. This profile details the experiences of the Health Plan of San Mateo (HPSM), a participant in California’s Cal MediConnect financial alignment demonstration, as it implements a pilot program to help dually eligible individuals in nursing facilities transition back to community living and those at risk of nursing home placement to remain in the community.

Lessons from this pilot may help other health plans, states, and providers develop approaches to serving dually eligible individuals with extensive LTSS needs. HPSM is a participant in Promoting Integrated Care for Dual Eligibles (PRIDE), a national initiative made possible by The Commonwealth Fund.