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Provides and coordinates care management. 

  • Health Home services are provided through a network of community-based agencies that work with individuals with serious and complex physical health, mental health, and substance use disorders to achieve better health outcomes and reduce cost. 

Eligibility: Adult Medicaid recipients including managed care and dual-eligible Medicaid and Medicare. Receiving the majority of their care in Monroe County, and the following: Significant mental illness or serious emotional disturbance. HIV/AIDS. Complex trauma, if under 21. Two or more chronic health conditions (i.e. asthma, diabetes, heart disease, mental health condition, substance use disorder, etc.).

Application Process: Referral needed. Call, e-mail or visit website.

Required Documentation: Call for information.

Fees: No fee for services if Medicaid-eligible.

Coverage Note: Monroe County.

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