Programs

Care Management Program

Hudson Valley

Care Management links, supports and oversees access to community services a child and family may need to improve overall health.  Your family works with a single care coordinator who brings together the best quality services needed to build a brighter future for your child.  We facilitate communication between you, medical staff and social workers assisting in navigating the healthcare and human service maze. We provide compassionate and individualized care for your family while combining all your services into one clear and simple plan. Your care coordinator is your family’s constant ally in your efforts to achieve lasting wellbeing, prevent health crises and pave the way for success.

Astor’s Heath Homes Care Coordination program provides Care Management services to children in 9 Hudson Valley Counties (Putnam, Rockland, Dutchess, Orange, Columbia, Sullivan, Greene, Delaware), and the Bronx.

Referral Criteria

  • Active Medicaid
  • Enrolled in a Health Home

What is a Health Home?

A Care Coordinator will oversee and provide 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 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.”

Who is Eligible to be in a Health Home?

Children from birth to age 21 must be enrolled in Medicaid AND meet have the following:

  • Two or more chronic conditions (ex. hypertension, obesity, diabetes, asthma)

OR

  • One of the following single qualifying conditions:
    • HIV/AIDS, or
    • Serious Mental Illness (SMI) (Adults 18+), or
    • Serious Emotional Disturbance (SED) (Children), or
    • Complex Trauma (Children)

 

Contact Us:

For more information or to make a referral to this program, contact:

Denise Brown, LMSW
Tel: 845-452-2372 x 120
Email: Please use our Program Contact Form »

More Information:

Program brochure (PDF file)

Folleto del programa (archivo PDF)

Learn about Astor's other Hudson Valley Community-based programs: