Prime Care Coordination unifies NY providers, ensuring quality of services

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Five years ago, local service providers for people with intellectual and developmental disabilities came together as one to raise the system of care coordination to a higher level. The result was Rochester-based Prime Care Coordination.

Since then, case managers who have worked closely with those they serve have seen increases in the number and quality of services provided, said Kate Wagner, Prime Care Coordination’s executive director.

“It is our main priority to work with these individuals to support them in their community, achieving goals and impacting their everyday lives,” Wagner said.

Over the past five years, Prime Care Coordination staff throughout New York state have held more than 358,000 in-person meetings with individuals with intellectual and developmental disabilities, their families and caregivers, to coordinate services.

That accomplishment is just one of the many successes that has occurred since New York enacted the care coordination organizations in 2018.

The shift in services was designed to improve and enhance care coordination for individuals previously served under the Medicaid Service Coordination program, also seen as the first step in the shift to managed care.

Care coordination organizations – regulated by the New York State Office for People With Developmental Disabilities – provide health home care management services to over 100,000 New Yorkers with intellectual and developmental disabilities statewide.

Prime Care Coordination’s care managers and regional offices serve over 40 counties and have divided their service area into five regions – Western, Finger Lakes, Central, Mohawk Valley and Southern Tier.

An example of Prime Care Coordination’s effectiveness is that in the Finger Lakes region – the organization’s largest – the staff has completed nearly 87,000 life plans, Wagner noted.

Life plans are person-centered plans focused on supporting the individual to meet their needs and wants, to help them to live healthy and fulfilling lives in their communities.

Wagner said the number of plans is “a tangible way to demonstrate that the care coordination model Prime Care Coordination was created to implement is making an impact in the lives of the individuals it was created to serve.”

Coordinating one’s needs and navigating complex systems in areas such as human services and health care can be challenging for families, Wagner said, noting the organization’s care managers do “an amazing job connecting people.”

An example of this is the work Prime Care Coordination staff does by assisting youth and their families as they transition out of school. Prime Care has a liaison who works directly with school systems on this matter, Wagner noted.

The Prime Care Coordination regional offices and care managers are local and actively involved in their communities, she added.

The organization has openings for care managers, she said, noting the organization places an emphasis on job training and support which leads to strong job retention numbers.

Wagner took the helm of Prime Care Coordination in March 2020, at the onset of the COVID-19 pandemic.

She previously served as vice president of CDS Life Transitions, providing day to day direction and support to CDS Monarch, Unistel and Warrior Salute Veteran Services. Wagner began her career at CDS Monarch in 2012 as a registered nurse for the organization.

Wagner praised the work Prime Care Coordination has accomplished, especially given the challenges of a global pandemic, as well as a worker shortage industry-wide that impacts people receiving needed services.

Moving forward, Wagner said the organization would focus on expanding services to more rural areas, where there is an underserved population.

Richard Ferrari, Prime Care Coordination’s board chair, said he is proud of the organization’s milestone, noting its ability to deliver high-quality, person-centered care management to thousands of people across the state.

“We are dedicated to continuing to provide and enhance this high standard of service to our current individuals and look to expand our model into more rural areas of the state,” he said.

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