Health Homes Care Coordination Services

Western New York Independent Living is a peer-centered family of agencies that provides programs and services for people with disabilities, as well as care coordination through Health Homes. Care coordination services are free.

What is a Health Home?

A Health Home is not a physical location. Instead, it’s a network of healthcare and service providers that work together to ensure individuals receive the care and support they need to stay healthy.

Who is Eligible?

To qualify, individuals must:

• Be enrolled in Medicaid
• Have two (2) or more chronic conditions; or
• Have HIV/AIDS; or
• Have a sserious mental illness (SMI).

Core Services Provided:

• Comprehensive care management
• Care coordination and health promotion
• Comprehensive transitional care (e.g., from hospital to home)
• Patient and family support
• Referral to community and support services
• Use of health information technology to link services

Goals of the Program:

• Reduce emergency room visits and hospitalizations.
• Improve health outcomes.
• Enhance access to services likes housing, transportation, and behavioral health.
• Provide person-centered, integrated care.

How it Works:

Once enrolled, each member is assigned a care manager who:

• Works with the individual to create a personalized care plan.
• Coordinate services across medical, behavioral, and social domains.
• Helps navigate the healthcare system and access needed supports.

Contact

To take the next step, contact your local office.

• Buffalo Area
  3108 Main Street, Buffalo, NY 14214
  716-836-0822
• Niagara County
  746 Portage Rd., Niagara Falls, NY 14301
  716-284-4131
• Genesee and Orleans Counties
  319 West Main St., Batavia, NY 14020
  585-815-8501