Information for Health Homes, Care Coordination Organizations, & Care Management Agencies
Health Homes, Care Coordination Organizations, and Care Management Agencies play a key role in connecting members to HRSN services available through the SCN.
The New York State Department of Health encourages Health Homes, Care Coordination Organizations, and Care Management Agencies to partner with Social Care Networks (SCNs) to help members access Health-Related Social Needs (HRSN) services. As part of their partnership with SCN Lead Entities, Health Homes, Care Coordination Organizations, and Care Management Agencies can be reimbursed for time spent working with members to access services and can receive Capacity Building funding to support scale-up.
Not sure which Lead Entity represents your region? Visit this list (XLSX) to learn more.
| Lead Entities | Map Color | Counties |
|---|---|---|
| Care Compass Collaborative | Broome, Chenango, Delaware, Otsego, Tioga, Tompkins | |
| Forward Leading IPA | Allegany, Cayuga, Chemung, Genesee, Livingston,Monroe, Ontario, Orleans, Schuyler, Seneca, Steuben, Wayne, Wyoming, Yates | |
| Health Equity Alliance of Long Island | Nassau, Suffolk | |
| Healthy Alliance Foundation Inc. | 1 |
Albany, Columbia, Greene, Rensselaer, Montgomery, Saratoga, Schenectady, Schoharie |
2 |
Cortland, Herkimer, Madison, Oneida, Onondaga, Oswego | |
3 |
Clinton, Essex, Franklin, Fulton, Hamilton, Jefferson, Lewis, St. Lawrence, Warren, Washington | |
| Hudson Valley Care Coalition, Inc. | Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, Westchester | |
| Public Health Solutions | Kings (Brooklyn), New York (Manhattan), Queens | |
| Staten Island Performing Provider System | Richmond (Staten Island) | |
 |
Select zip codes in Kings (Brooklyn) and Queens in partnership with Public Health Solutions1 | |
| Somos Healthcare Providers, Inc. | Bronx | |
| Western New York Integrated Care Collaborative Inc. | Cattaraugus, Chautauqua, Erie, Niagara |
Details on SCNs in each region
Operational guidance for Health Homes, Care Coordination Organizations, and Care Management Agencies
- Guidance memo on partnering with SCNs
- Overview of SCN Program for HH and CMA Care Managers (PDF)
Additional information on funding
Other information
- Frequently Asked Questions for HHs and CMAs about the SCN program (from the NY Health Home Coalition)
- NYS Dept. of Health’s SCN page
How can you join a Social Care Network?
To learn more about becoming a SCN partner, reach out to the SCN Lead Entity in your region. If you provide services in more than one region, you may collaborate and/or contract with multiple SCNs. SCN Lead Entities will also be able to share more detailed operational guidance as you get started, including specific processes for your region.
__________________________
1. Kings (Brooklyn) zip codes: 11209, 11219, 11220, 11228 and Queens zip codes: 11355, 11368, 11373, 11377 1
