Greater Rochester Health Home Network (GRHHN)
GRHHN was formed in January 2012 to establish a Health Home in order to serve the most vulnerable people in our community, especially those struggling with multiple medical and behavioral health conditions. GRHHN was developed through a collaborative process with community providers to learn new ways to integrate with care team partners across medical, mental health, substance abuse, and community-based service sectors. As a lead health home, GRHHN is responsible for managing and supporting a network of 22 Care Management Agencies in Monroe County.
Our goals are to:
Decrease Emergency Room and inpatient use
Support access to health care services
Link with community resources to provide comprehensive care.
Our goals are to:
Decrease Emergency Room and inpatient use
Support access to health care services
Link with community resources to provide comprehensive care.
Populations we serve
Counties Serving Adults: Allegany, Chemung, Genesee, Livingston, Monroe, Ontario, Steuben, Wayne
Counties Serving Children: Allegany, Cayuga, Chemung, Genesee, Livingston, Monroe, Ontario, Orleans, Seneca, Steuben, Wayne, Wyoming, Yates
Direct Care Management Team
The GRHHN Direct Care Management (DCM) team play a vital role in our effort to improve care among the most vulnerable population in our community. By supporting our own DCM Team, GRHHN offers a wide range of flexible services to both community organizations and primary care offices.
A DCM team member:
- Manages the needs of clients with high risk or complex medical and behavioral health needs through community and home-based visits as well as telephone support.
- Links clients to appropriate community resources and refers them to appropriate care services.
- Supports client self-management and communicates with providers to reduce barriers and improve health care outcomes.
Our DCM Team can assist agencies with outreach, enrollment or care management in ways that best suit the needs of each agency. We have the flexibility to embed a DCM or Outreach Worker at a facility to assist with outreach.
Partnership with FLPPS
In 2018 Finger Lakes Performing Provider System (FLPPS) acquired GRHHN. FLPPS is a partnership comprised of 19 hospitals, 6,700 healthcare providers and more than 600 healthcare and community-based organizations in a 13-county region (Allegany, Cayuga, Chemung, Genesee, Livingston, Monroe, Ontario, Orleans, Seneca, Steuben, Wayne, Wyoming and Yates counties).
This partnership works together to implement innovative system transformation using the NYS Delivery System Reform Incentive Payment (DSRIP) program to reform local Medicaid healthcare delivery.
Referrals can also be submitted to GRHHN via fax at 585-978-7714 or sent via secure email to [email protected]flpps.org
Patient consent is required (verbal consent is acceptable).
