For Providers
Referrals
To receive a copy of the Health Home Referral Form, please email us at CHHReferrals@urmc.rochester.edu. Referrals for the Children's Health Home can be submitted through eRecord, faxed to (585) 742-4228, or emailed to us.
A Health Home is a care management service model where all of an individual’s caregivers communicate with one another so that the patient’s needs are addressed in a comprehensive manner. This is done primarily through a care manager who 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. Health Home services are provided through a network of organizations—providers, health plans and community-based organizations. When all the services are considered collectively they become a virtual Health Home.
Role of the Care Managers
A Care Manager is a trained professional, who makes sure that the child (and the family) has the services they need such to care for the child; such as appointments, medications, a safe place to live, insurance to pay for the care, and transportation to their appointments. A Care Manager works to setup a care plan, listing all of the person’s specific needs and goals for achievement, and helps to determine what providers and services are required to reach those goals.
Eligibility
The child can be enrolled at any time and must be covered under Medicaid or a Managed Medicaid Insurance Company (MCO) and
- Have 1 single qualifying condition (HIV/AIDS, A Serious Emotional Disturbance or Complex Trauma); or
- Have 2 or more chronic conditions (Ex. Diabetes, Asthma, Obesity etc.)
- Have significant behavioral, medical or social risk factors (Ex. Death, Disability, Inadequate Housing)
Currently, we are not accepting children who are in a Waiver Program or have Early Intervention Services. If a child is in Foster Care, please include the name and contact information of the Department of Social Services caseworker who is currently working with the child.
A person can enroll in a Health Home at any time.
Please provide families with the Patient and Family Fact sheet to help them understand the program.