Care Coordination
Strengthening children, youth & families.
FOR MORE INFORMATION
Call: 917-642-8168
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The healthcare and social service systems are complex, and navigating them can be challenging – particularly for caregivers of children and young people who have emotional and behavioral health needs, chronic health needs, or who are dealing with trauma.
Sometimes managing appointments and processes can feel like a full-time job – that’s where our Care Coordination team comes in. We partner with families and caregivers of children (up to age 21), to assist with scheduling, engage with providers to ensure care is integrated, and advocate for patients. Together, we help reduce the risk of emergency room visits, inpatient hospitalizations, and other types of out-of-home placements.
Care Coordination Services are built around six core functions that support all aspects of care:
- Comprehensive Care Coordination
- Care Management and Health Promotion
- Comprehensive Transition Care
- Patient and Family Support
- Referral to Community and Social Support Services
- Use of Health Information Technology to link services
We serve Medicaid-enrolled individuals residing within the five boroughs of NYC, and services are available in English, Spanish, Cantonese, Mandarin & French. Every case is different, and we work on a short- or long-term basis, depending on what each family needs.
We are dedicated to supporting children, youth and families on the path to wellness, and have built strong collaborations with our communities for 27 years. Our Care Coordinators are highly trained, experienced, multilingual professionals who bring person-centered, strengths-based, trauma-informed perspectives to this work. Under the Health Home Network, we are the first Care Management agency to offer Triple P – Positive Parenting, a multi-family evidence-based intervention. We are certified by the New York State Department of Health and Mental Hygiene.