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Care Coordination

CARE COORDINATION

WellLife Network provides care coordination services to clients living in Queens, Brooklyn, Staten Island and Long Island. Our Care Management program establishes a person-centered, recovery-focused system of care for individuals with a mental illness and chronic medical conditions.

Best efforts are made to ensure that individuals have access to services within the first 24-hours following referral. The WellLife Network model assures cultural competency in service delivery and staff who are highly respectful of the privacy of individuals.

Our Approach

Six core functions of care coordination include:

• Comprehensive Care Coordination

• Care Management and Health Promotion

• Comprehensive Transition Care

• Patient and Family Support

• Referral to Community and Social Support Services

• Use of Health Information Technology

The WellLife Network partners with state-designated Lead Health Homes, each with a network of care coordination agencies and providers. Our partners include: Health and Hospitals Corporation, Northwell, Coordinated Behavioral Care, Southwest Brooklyn Health Home, Community Health Network and Hudson River Health Care. WellLife Network also has contracts to receive referrals from Single Point of Access (SPOA) for individuals who do not have Medicaid.

Care coordinators contact clients monthly in person and by phone or letter according to individual need. The program also conducts outreach efforts to engage clients from lists of potential clients received from the Department of Health via the Lead Health Homes, and from other referral sources in the community.

Outcome Expectations

Communication is essential to success and client recovery. WellLife Network caregivers communicate with one another regularly so that all of the client’s needs are addressed in a comprehensive manner. This is accomplished through a care coordinator who oversees and provides access to all of the services an individual needs. With a comprehensive plan in place, participants receive the supports necessary to stay healthy, out of the emergency room and out of the hospital.

For more information, call:

Care Coordination Services

New York CityTel. 917-563-3352

Long IslandTel. 631-920-8303

 

Our Impact
25,000
individuals and families served this year.
2,000
individuals and families served each day.
327
multi-service hubs, satellite offices, facilities, residences and off-site locations.
Give, so others can live well.

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