The Community Care Team is a formalized clinical and community based organization integration project. The Community Care Team (CCT) is made up of over 40 social service and health care providers in the Greater Waterbury community that come together weekly to provide intensive case management and coordinate care for the highest utilizers of our hospital Emergency Departments and most vulnerable residents. The CCT uses the data platform, Unite Us, to efficiently and securely track and send referrals to Partners that are enrolled in the system. The unique care coordination database called Unite Us allows GWHP to track linkages and measure progress of patients with outcome indicators. The CCT works to link patients with the care they need and coordinate services for any social determinants of health or barriers they may be facing. CCT interventions tend to be long-term with the goal of helping communities of color that are housing challenged achieve stability and independence.
The CCT project is primarily funded by the Connecticut Health Foundation, with additional support from GWHP Partners.
The CCT project is monitored by a CCT Oversight & Advisory Committee made up of key clinical partners who oversee the work of the CCT, strategize for sustainability and measure progress.