Health Home cuts likely to hurt those who need help

HUDSON–Health Home funding cuts, Recovery Services and temporary housing received attention at the Columbia County Community Services Board meeting Wednesday, March 28.

A state Health Department brochure described the Health Home program as “a group of health care and service providers working together to make sure” Medicaid-eligible individuals receive the care and services they need. Each person enrolled in a Health Home program gets a care manager who works with the person to set up a care plan and appointments for services like medical, substance abuse, housing, transportation and public assistance. Health Home is credited with reducing the amount spent in New York on in-patient care, emergency room care, and “preventable hospital re-admissions.”

To get Health Home care managers, the state contracts with Health Home organizations, which in turn contract with care management agencies. The Health Home organization serving Columbia and Greene counties is the Hudson River Health Care/Community Care Collaborative. It contracts with four management agencies: the county Department of Human Services (DHS), the Alliance for Positive Health, Catholic Charities and the Mental Health Association of Columbia and Greene Counties.

These agencies have a good relationship with each other, said John Lyons, supervisor of Adult Care Coordination for the DHS.

Mr. Lyons supervises a care management team of seven: four full-time care managers, one half-time care manager and two additional staffers. It currently serves about 200 clients, all from Columbia County, Mr. Lyons said.

But now, Mr. Lyons warned, the federal government has reduced its funding and the state might also reduce its funding for Health Home programs. “What’s not known is what would a funding cut would result in,” said Michael Cole, County Director of Human Services, who listed a some possibilities: “Mergers? Higher caseloads? Clients dropped?”

On April 2, Mr. Lyons indicated by phone April 2, the funding cut is “looking like” $20 million.

Already the number of clients Health Home Care Managers have has grown from 12 to 20, under “an old model,” and up to 50 clients in some places, including Columbia County, said Mr. Lyons. At the last month’s meeting, Cristy Tutt, county planner for the DHS, said that in some counties, care managers just try to contact clients by phone, talk to them briefly if they reach them, and consider their work with the clients done. Some policy makers “see abuse” in this, but what causes care Managers to work like this is “overbooking,” she said.

About 40% of Health Home clients are designated “low acuity,” and “there has been talk of eliminating low acuity” clients, Mr. Lyons added. But he continued, “What if they are low acuity now because they’re getting good care now? I don’t know if folks really understand what our Health Home Care Coordinators contribute. We have some very vulnerable people and some great success stories.”

Amanda Pierro, director of peer services for the Mental Health Association, said some people might perceive the state as paying twice: for both Health Home and Managed Care. But “telephonic managed care companies are not a viable alternative,” he said.

Beth Schuster, executive director of Twin County Recovery Services, Inc., which works with individuals to reduce chemical dependency, announced that her organization is seeking new locations for both its men’s residence and its administrative offices. Twin County’s residences serve as halfway house for individuals recovering from addiction. The men’s house current location, on Hudson’s Columbia Street, is “out of room. People are doubled up,” she said.

The women’s residence is in Catskill. The administrative offices are currently on Hudson’s Power Avenue, where Twin Counties has an outpatient clinic. The organization is looking to expand its offices and needs an additional location for them.

Ms. Schuster also indicated that starting next month, she will go to the Department of Social Services building in Hudson regularly to let its new clients know about additional services available to them.

Regarding temporary housing for individuals who are homeless, Sarah Sterling, Supervisor of Hudson’s First Ward, reported that the Galvan Civic Motel now under construction needs water improvements before it can open. She also said that a new proposal suggests using trailers at 51 Middle Road. These two sites, both in Greenport, would together bring the county up to 34 additional units for temporary housing.

The Community Service Board’s next meeting is Wednesday, April 25, at noon at 325 Columbia Street.

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