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Health Home Care Management for Adults

In April of 2013, significant changes were made to the New York State’s Supportive Case Management Program as part of the Governor’s Medicaid Redesign Taskforce. It moved oversight of Health Home Care Management (HHCM) from the New York State Office of Mental Health (NYSOMH) to the New York State Department of Health (NYSDOH). This change in oversight shifted our program in two ways:

  1. Expanded eligibility: Care management could now be accessed by people with physical health challenges in addition to our prior focus on mental illness; and
  2. Promoting whole health: A new focus on planned, person-centered coordination of mental health, substance abuse, physical healthcare services as well as social services.

As described by NYS Department of Health:

[A] Health Home is a care management service model whereby all of an individual’s caregivers communicate with one another so that all of a patient’s needs are addressed in a comprehensive manner… [A care manager] oversees and provides access to all of the services an individual needs to assure that they receive everything necessary to stay healthy, out of the emergency room and out of the hospital. Health records are shared among providers so that services are not duplicated or neglected.

Working in collaboration with lead Health Homes: Skyward Health and Northwell Health, MHAW helps eligible clients with serious mental illness, HIV/AIDS, or two or more other serious and chronic physical, psychiatric, or substance abuse health conditions. Based in Riverhead and Ronkonkoma, our HHCM program supports clients by way of a team approach. Each team consists of three to five staff members: a Master’s-level Team Leader/Supervisor and two to four Bachelor’s-level Care Managers. An additional team provides outreach and engagement services to people in hospitals, referred by community agencies, families, health and behavioral health providers, and other human and social services.

Our care managers connect with people in their homes, at community venues, and in facilities in communities across Suffolk County. The effectiveness and quality of services provided by our HHCM program are monitored by the NYSDOH.

Gina Fattibene, LCSW
Adult Care Management Program Director
631-471-7242 x1101

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