Intensive Preventive

Bridges to Health Healthcare Integration

Health Home Program





For referral and additional information please call (716) 828-9699






Care Management


Care coordination is "the deliberate organization of patient care activities between two or more participants involved in a patient's care to facilitate the appropriate delivery of health care services." The care coordinator is responsible for assessing the needs of the individual, developing a plan of care, and ensuring that necessary services are obtained. The care coordinator continues to monitor the individual's progress on identified goals and make adjustments to the plan of care as the individual's needs change. Currently, care coordination is available in a variety of different programs and to different populations. Currently, Baker Victory Services offers care coordination through the Preventive and Preventive Intensive services, Bridges to Health, and Medicaid Service Coordination.

In 2011, the NYS Department of Health established a goal of having virtually all Medicaid enrollees served in care management by April 2018. This initiative, deemed "Care Management for All", began in as a Medicaid Redesign Team (MRT) proposal. Since this time, NYS has embraced the Health Home care management model which allows for integration of behavioral and physical health services. This model allows for improved benefit coordination, quality of care, patient outcomes over the full range of health care; including mental health, substance abuse, developmental disability, and physical health care services.

As a long standing children's service provider committed to providing optimal care to children and families, Baker Victory Services will become a care management agency to provide Health Home services to Children when this program begins on December 1, 2016.