The Isabella Health Home Program is a Care Management Program offered free of charge to individuals who are on Medicaid and who cope with chronic conditions.  The purpose of the Heath Home Program is to provide the right level of support so that an individual may be able to live as safely as possible in the community – and avoid unnecessary hospitalizations.

In collaboration with the Mount Sinai and New York Presbyterian, Lead Health Homes, the Isabella Health Home provides a comprehensive approach to managing care and is concerned with many aspects of a person’s life.

We provide:

  • Help understanding medical needs
  • Education and guidance
  • Coordination of health care appointments
  • Advocacy with health care providers
  • Social service support such as benefit entitlement, transportation, etc.
  • Mental health or addiction recovery services
  • Encouragement with weight loss, smoking cessation and/or exercise programs.

To qualify, the individual must be on or eligible for Medicaid, Medicaid & Medicare or participating in a Managed Care Plan. In addition, the individual must meet one of the following criteria:

  • Be coping with two or more chronic diseases such as asthma, heart disease, etc.
  • Have significant mental illness
  • Be living with HIV/AIDS

An Isabella Care Coordinator will meet with meet with the individual and his or her family or caregiver to assess each person’s needs and goals. The Care Coordinator will create, implement and oversee the plan of care and remain in contact with the individual, the doctor, other medical professionals and the family or caregiver.

Call and our staff will be happy to assist you in assessing the needs of the individual and determining if Isabella’s Health Home Program will provide the appropriate support that is needed.

For more information call (212) 342- 9514.

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