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Care coordination plan

Develop a 4 page preliminary care coordination plan for an individual in your community with whom you choose to work (Individual Information will be provided). Identify and list available community resources for a safe and effective continuum of care.
• Identify a health concern as the focus of your care coordination plan.

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• Health concerns that this patient have ( you will see more below)

o Heart disease – high blood pressure (THIS WILL BE MAIN TOPIC FOR OUR PROJECT)
o Home safety -patient is currently homeless has no home, she stays at hotels
o Pain management – bone pain due to chemotherapy
o Mental health – suffers from depression and anxiety disorder
o Dental Problems – Infection due to extraction,
o Oncology – Patient suffers from Leukemia
o Others – Patient needs help with chemotherapy meds copays

• Identify available community resources for a safe and effective continuum of care.
Help with housing – Camillus House Shelter
Help with chemotherapy medication as Insurance will not cover current med – Organization
Help with meals- as the patient is disabled and lives on Social Security Income – Meals on Wheels

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