The Exceptional Needs Care Coordinator in the Oregon Health Plan

This report describes how the state of Oregon designed and implemented its Exceptional Needs Care Coordinator (ENCC) function, assesses the extent to which this role is meeting the state's objectives, and discusses design elements that support the state's objectives. In order to provide a background for the discussion, we first describe the context in which the ENCC program operates, including the Oregon Health Plan and the long-term care community case management system. We then discuss the state legislative background and objectives for the ENCC role. This is followed by an examination of how health plans implemented the ENCC role, focusing specifically on how the flexible program requirements led to significant variation in ENCC functions across plans. The authors also describe the state's approach to monitoring the services. The report concludes with a discussion of the lessons learned from the Oregon ENCC design and implementation that might be of interest to other state policy makers. [42 PDF pages]