What is Health Home for Children?

For many children, navigating the healthcare system can be a daunting and confusing experience. Health Home for Children is a program designed to provide coordinated care and support to children with complex medical, developmental, and behavioral health needs.

The program was created to help children and families receive the right care at the right time, with the goal of improving health outcomes and reducing healthcare costs.

What is Health Home?

Health Home is a program that provides care coordination and management services to individuals with complex medical, developmental, and behavioral health needs. The program is designed to help individuals receive the right care at the right time, with the goal of improving health outcomes and reducing healthcare costs. Health Home is available to individuals of all ages, including children.

What is Health Home for Children?

Health Home for Children is a specific program under the Health Home umbrella that is designed to provide coordinated care and support to children with complex medical, developmental, and behavioral health needs. The program is available to children up to the age of 21 who meet certain eligibility criteria.

Health Home for Children provides a range of services, including care coordination, health promotion, and family support services. The program is designed to be family-centered and aims to involve parents and caregivers in all aspects of care. Health Home for Children also connects families to community resources and other support services, such as education and housing.

What does a Children’s Health Home Do?

Children's Health Homes provide a variety of services to children with complex medical, developmental, and behavioral health needs. These services include:

Care Coordination Management

Care coordination and management, which involves creating personalized care plans for each child that address their unique needs and goals, with input from the family.

Health Promotion

Health promotion services, such as education on healthy behaviors and lifestyle choices, including nutrition counseling, physical activity programs, and substance abuse prevention.

Comprehensive Transitional Care

Comprehensive transitional care, which is designed to help children transition from one healthcare setting to another, such as from a hospital or residential treatment facility to home-based care. This helps ensure that children receive the right care in the right setting, at the right time. Health Home for Children also provides emotional and social support for families during the transition process.

Individual and Family Support

Family support services to help families navigate the healthcare system, including assistance with scheduling appointments, transportation to appointments, and finding community resources that can support the child's health and well-being.

Referral to Community and Social Support Services

Health Home for Children also provides referrals to community and social support services, such as education and housing.

These referrals can help ensure that children receive the services they need to remain healthy and safe, as well as access to resources that can promote their overall well-being.

Health Home for Children also offers advocacy services to ensure that children's rights and needs are represented in the healthcare system.

Overall, the goal of Children's Health Homes is to improve health outcomes for children with complex medical needs while reducing healthcare costs through coordinated care and support.

How Health Home for Children Works:

1. Referral: The process begins with a referral from a healthcare provider, school, or other community organization. A child may also self-refer.
2. Eligibility Determination: After the referral is made, the child's eligibility for the program is determined based on certain criteria, such as having complex medical, developmental, or behavioral health needs.
3. Assessment: Once eligibility is established, a care manager conducts an assessment to identify the child's needs and develop a care plan.
4. Care Plan Development: The care manager works with the family to develop a comprehensive care plan that addresses all of the child's needs. This plan includes goals and objectives that are specific to the child's health status and circumstances.
5. Service Coordination: The care manager coordinates all of the services and supports identified in the care plan, including medical and behavioral healthcare, education and vocational training, housing assistance, transportation services, and more.
6. Monitoring and Evaluation: The care manager regularly monitors the child's progress toward achieving their goals and evaluates whether any changes need to be made to the care plan.
7. Continued Support: Health Home for Children provides ongoing support to ensure that children continue to receive coordinated care and access to needed services as they grow older or their needs change.

Why is Health Home for Children important?

Children with complex medical, developmental, and behavioral health needs often require care from multiple providers and may struggle to navigate the healthcare system.

Health Home for Children provides a single point of contact for families, helping them to coordinate care and access the services they need. The program is designed to improve health outcomes and reduce healthcare costs by providing more effective and efficient care.

In addition to improving health outcomes, Health Home for Children can also provide significant cost savings for families and the healthcare system. By coordinating care and reducing unnecessary hospitalizations and emergency room visits, the program can help to reduce healthcare costs for families and insurers.

Eligibility Criteria for Health Home for Children

To be eligible for Health Home for Children, a child must meet certain criteria. These criteria include:

• Having a chronic medical condition, such as asthma or diabetes
• Having a serious emotional disturbance (SED)
• Having a developmental disability
• Being at risk for developmental delays
• Being in foster care
• Receiving Medicaid

If a child meets one or more of these criteria, they may be eligible for the Health Home for Children. Once enrolled in the program, the child will receive an initial assessment to determine their specific needs and develop a care plan tailored to those needs.

It's important to note that eligibility criteria may vary by state. Families should check with their state's Medicaid program to determine if their child is eligible for Health Home for Children.

The Role of Care Managers in the Health Home for Children Program

Care managers play a critical role in the Health Home for Children program, providing a range of services that benefit both children and families. These benefits include:

• Developing personalized care plans that meet the unique needs of each child and involving families in the decision-making process.
• Serving as a single point of contact for families, helping them navigate the healthcare system and access necessary services.
• Providing health promotion and education services to families, including information on managing their child's medical condition and connecting them with community resources.
• Helping to reduce unnecessary hospitalizations and emergency room visits by working with families to manage their child's condition at home and prevent complications.

Overall, care managers are an essential part of the Health Home for Children program, and their expertise and support can make a significant difference in the lives of children with complex medical, developmental, and behavioral health needs and their families.

Community Resources Available Through Health Home for Children

Health Home for Children is designed to connect families with community resources and support services that can help improve health outcomes and overall well-being. Some examples of community resources that Health Home for Children can connect families to include:

Support groups

For children and parents/caregivers, support groups can provide a safe space to share experiences, ask questions, and receive emotional support from others who are going through similar challenges.

Educational programs

From parenting classes to workshops on managing chronic conditions, educational programs can help families gain the knowledge and skills they need to manage their child's health effectively.

Transportation assistance

Getting to medical appointments or picking up medications can be a challenge for families without reliable transportation. Health Home for Children can connect families with transportation assistance programs in their community.

By connecting families with these types of resources, Health Home for Children aims to provide holistic support that addresses the unique needs of each child and family.

HCBS services

If determined eligible, based on information collected and assessments done by the care manager, the child may be eligible for Home and Community Based Services which may include planned or crisis respite, caregiver/family advocacy support services, prevocational services and more.

How to Enroll in Health Home for Children

Families who believe their child is eligible for the Health Home for Children program can enroll by following these steps:

1. Speak with your child's healthcare provider, school, or other community organization to request a referral to the program.
2. Once the referral is made, an intake specialist will contact you to schedule an eligibility determination meeting.
3. During this meeting, the intake specialist will review your child's medical history and determine if they meet the eligibility criteria for the program.
4. If your child is eligible, you will need to enroll in the program, providing consents and supporting documentation. 
5. Once enrolled, the care manager will schedule a time to come to your home for a first visit. 

It's important to note that families do not need to pay anything to enroll in Health Home for Children. The program is covered by Medicaid. Families should also be aware that eligibility criteria may vary by state, so it's essential to check with their state's Medicaid program for more information on how to enroll in Health Home for Children.

Summary

Health Home for Children is a program designed to provide coordinated care and support to children with complex medical, developmental, and behavioral health needs.

The program offers a range of services, including care coordination, health promotion, and family support services. Health Home for Children is available to children up to the age of 21 who meet certain eligibility criteria. The program aims to improve health outcomes and reduce healthcare costs by providing more effective and efficient care.

Children with chronic medical conditions, serious emotional disturbances (SED), developmental disabilities, at risk for developmental delays, in foster care and receiving Medicaid may be eligible for the program. Once enrolled in the program, the child will receive an initial assessment to determine their specific needs and develop a care plan tailored to those needs.

Care managers play a crucial role in the Health Home for Children program as they are responsible for working with families to develop a care plan that meets the unique needs of each child. Care managers also serve as a single point of contact for families and help them navigate the healthcare system while accessing required services.

Health Home for Children is designed to connect families with community resources and support services that can help improve health outcomes and overall well-being. Support groups, educational programs and transportation assistance are some examples of community resources that Health Home for Children can connect families with.

Sources

• New York State Department of Health. (2021). Health Homes Serving Children: Program Overview.
• Centers for Medicare & Medicaid Services. (2019). Health Homes Provider Information - Comprehensive Information on Health Homes, Including Guidance on Developing Your Health Home Infrastructure and Care Coordination Processes.
• National Council on Behavioral Health. (2015). The Role of Care Coordination in Improving Behavioral Health Outcomes: A Literature Review
• New York State Department of Health. (2021). Health Home for Children.
• New York State Department of Health. (n.d.). Health Homes Serving Children - Program Overview.
• Centers for Medicare & Medicaid Services. (2019). Health Homes Information Resource Center - Frequently Asked Questions (FAQs) - Technical Assistance Tool Series.
• National Council on Behavioral Health. (2021). What Is a Health Home?