FAQ: Health Homes Care Management

What is the Health Home Program?

In New York State, many people get their health benefits through the Medicaid Program. Most people are generally healthy. However, others may have chronic health problems and can’t find providers and services. Without the right providers and services, it is hard for people to get well and stay healthy. New York State’s Health Home program was created with these people in mind. The goal of the Health Home program is to make sure its members get the care and services needed. This may mean fewer trips to the emergency room or, less time spent in the hospital. It could mean getting regular care and services from doctors and providers. Or, finding a safe place to live, and a way to get to medical appointments.

How do I enroll in a Health Home?

You can talk to your current service provider or you can contact a Health Home at any time to find out if you are eligible to enroll.
You also may be referred to a Health Home by Medicaid, based on care and services you have already received. Or, you can be referred by your Managed Care plan, doctor, specialist, hospital emergency room or discharge planner, or Social Service District. .

Is a Health Home right for you?

If you are a Medicaid recipient or believe you may qualify for Medicaid, think about the following questions:
  • Do you have chronic or mental health conditions for which you need regular doctors care ?
  • Do you have a doctor you can see when you need to ?
  • How many times have you been in the emergency room or hospital in the past six months ? Twelve months?
  • Do you have a safe place to live ?
  • Do you have someone in your life to help you whenever you need help?
  • Do you have difficulty keeping medical appointments?

Does it cost me anything to enroll?

No. Enrollment in the Health Home program is provided free of charge to you, if you are on Medicaid.
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What are the Roles & Responsibilities of TruCare Connections?

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  • Promote Consumer independence.
  • Serve as the fiscal intermediary between the Consumer and Medicaid by billing Medicaid based on the Consumer’s authorization.
  • Administer a comprehensive wage and benefits program for Personal Assistants.
  • Provide a variety of ancillary services including: compliance monitoring, recruitment assistance, emergency preparedness.

What are the Roles & Responsibilities of the Managed Care plan?

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  • Determine if the Consumer is eligible to participate in CDPAS.
  • Notify all Medicaid-eligible long-term care service recipients of the chance to participate in CDPAS.
  • Define the level and amount of services required for each Consumer through their locally-approved home care authorization procedure. Authorize reimbursement for PA services as prescribed by the New York State DSS.
  • Terminate services for any Consumer deemed not appropriate for CDPAS, and if suitable, transfer Consumer to another program.
  • Provide Consumer with a fair hearing notice. 

What are the Roles & Responsibilities of a Personal Assistant?

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  • Provide TruCare with all employment documents prior to hire, and get an initial physical exam and an annual physical exam while employed.
  • Complete all designated assignments of the Consumer (or the Self-Designated Other of the Consumer) to enhance the Consumer’s ability to live independently.
  • Complete a timesheet with actual hours worked at the end of each day.
  • Respect the Consumer’s health, well-being, privacy, and property.
  • Comply with the policies and regulations of TruCare Connections, Inc.
  • Report to TruCare any possible instances of Medicaid fraud.
  • Notify TruCare when a Consumer gets admitted to the hospital, long-term care facility or is on vacation.  

How do I become a Personal Assistant?

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A Personal Assistant must be hired by TruCare Connections:
  • Determine if the Consumer is eligible to participate in CDPAS.
  • Notify all Medicaid-eligible long-term care service recipients of the chance to participate in CDPAS.
  • Define the level and amount of services required for each Consumer through their locally-approved home care authorization procedure. Authorize reimbursement for PA services as prescribed by the New York State DSS.
  • Terminate services for any Consumer deemed not appropriate for CDPAS, and if suitable, transfer Consumer to another program.
  • Provide Consumer with a fair hearing notice.