Capital District Health Home Network
The Children’s Health Home of the Capital District is a new Health Home that offers comprehensive Care Management services to New York State Medicaid recipient children in Albany, Rensselaer and Schenectady counties.
The goal of the New York State Department of Health Children’s Health Home program is to make sure children with Medicaid who have complex physical and/or behavioral health conditions get access to the care and services they need in order to be healthy.
The Health Home partners with other children’s service agencies that provide Care Management to enrolled children.
A dedicated Care Manager is assigned to the child and is responsible for coordinating all of their medical and behavioral health services. The Care Manager helps the child and family understand their chronic condition and manage their symptoms and ensures that all of the treatment team partners involved with the child are working together.
View Our Brochure for Children View Our Brochure for Adults Who Is EligibleComprehensive Care Management
Comprehensive Care Management offers clients access to more timely and appropriate care based on a comprehensive assessment of medical, behavioral, rehabilitative and social needs.
Care Coordination & Health Promotion
Care Coordination is about working with treating clinicians to ensure that client services are provided and changes in treatment or medical conditions are addressed as needed.
Comprehensive Transitional Care
Transitional Care is follow-up care. It can include working with hospitals and ERs to facilitate care prior to discharge into the community, as well as working in residential/rehabilitative settings, following up with Care Teams and assessing goals.
Member & Family Support
Care Management facilitates collaboration between providers, clients, family and support members to establish a continuing plan of care, including referrals to additional support services based on client need.
Referral and Community & Social Support Services
Care Management also identifies resources within the community and helps the client receive services as needed. This can be clinical and require a referral, or a non-clinical service such as housing, transportation, etc.
Care Management Agencies
BERKSHIRE FARM CENTER AND SERVICES FOR YOUTH
ST. CATHERINE’S CENTER FOR CHILDREN
VANDERHEYDEN HALL
