Following a hospital or facility admission, members should be seen by their providers within 30 days of discharge to evaluate new needs and complete a medication reconciliation.
Because this period following an admission can often be a difficult time of adjustment for members, L.A. Care offers additional post-discharge support to members identified to need it.
Members who experience a hospital or facility admission can be referred to the Transitional Care Services (TCS) Program for rapid assistance. Members will receive coordination and support from a TCS Care Manager or Community Health Worker to ensure all needed resources and services are received at home. Such resources and services include, but are not limited to assistance with:
- Transportation to medical appointments
- Access to Food
- Caregiver assistance
- Connecting member to longer term care management services, including Enhanced Care Management and Complex/High Risk Care Management
To refer members for TCS support within 30 days of discharge, contact the TCS Program:
- Phone: (888) 524-4832
- *Email the TCS team
*Note: Emails containing Member Personal Health Information (PHI) must be securely encrypted.