Departments within hospitals, HMOs and other health care institutions that provide for the spiritual care of patients with severe, chronic or terminal conditions, their families and staff, regardless of their religious traditions. Pastoral care workers work cooperatively with the health care team; listen, elicit and respond to individual religious/spiritual needs; identify and clarify ethical issues related to end-of-life treatment and care; provide bereavement support for family members, significant others and professional staff; and ensure that treatment addresses the whole person, not just his or her medical needs. The service is provided by licensed clergy or trained, accredited spiritual care volunteers.

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Programs that help people navigate through the maze of doctors' offices, clinics, hospitals, outpatient centres, insurance and payment systems, patient-support organizations and other components of the health care system with the objective of supporting timely delivery of quality care and ensuring that patients, survivors and families are satisfied with their encounters with the health care system. Personal health care advocates are trained health care workers, often nurses, or volunteers familiar with the health care system who work independently of any health care institution. They help patients identify specialists, coordinate appointments with providers to assure timely delivery of diagnostic and treatment services, provide "cheat sheets" of questions, and lay out the choices patients have in plain English. They may also ensure that appropriate medical records are available at scheduled appointments, accompany patients to medical appointments, arrange language translation or interpretation services, facilitate financial support and help with paperwork, negotiate insurance claims, arrange transportation and/or child/elder care, provide access to clinical trials and facilitate linkages to follow-up services. Some programs contract with employers to serve as personal advocates for employees who are ill; and others work exclusively with individuals who have specific illnesses, e.g., cancer.

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Programs that develop plans for the evaluation, treatment and/or care of individuals who, because of age, illness, disability or other difficulties, need assistance in planning and arranging for services; which assess the individual's needs; coordinate the delivery of needed services; ensure that services are obtained in accordance with the case plan; and follow up and monitor progress to ensure that services are having a beneficial impact on the individual. Case management is a collaborative process characterized by communication, advocacy and resource management to promote high quality, cost-effective interventions and outcomes.

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Programs that develop case plans for the evaluation, treatment and/or care of individuals who have mental, emotional or social problems and need assistance in arranging for services; which assess the individual's needs; coordinate the delivery of needed services; ensure that services are obtained in accordance with the case plan; and follow up and monitor progress to ensure that services are having a beneficial impact on the problem.

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