Health Homes Program

In 2018, the State of California began offering to Medi-Cal beneficiaries a new program called “Health Homes.” It provides a specific set of care coordination services at no cost to individuals with multiple chronic health conditions and/or a serious mental illness. The program’s primary benefit is the coordination of a full range of physical, health, behavioral health and community-based long-term services and supports (LTSS).

The program was rolled out regionally across the state and became available in Los Angeles County during the summer of 2019. Recognizing the importance of the program to County residents, Partners offered to become one of the supporting agencies. In a very short time, Partners was serving participants through a number of health providers including Molina Health, L.A. Care, Blue Shield of California, Anthem Blue Cross, and Health Net.

Partners staff addresses six core Health Homes services:

  • Comprehensive care management
  • Care coordination (physical health, behavioral health, community-based LTSS)
  • Health promotion
  • Comprehensive transitional care
  • Individual and family support
  • Referral to community and social support services, including housing

The Partners Team is currently managing approximately 30,000 individuals participating in this program.

In this program, Partners provides services to individuals from newborn to end-of-life. Typically, they are already in crisis when the referral to Partners is made, requiring our staff to work intensively with them to quickly arrange the help they need.