Health Home Program (HHP) Mental Health & Substance Use Patient-Centered Medical Home Telehealth FOR PATIENTS LOCATIONS CONTACT THE NEWSROOM Call Us Health Home Program (HHP) View All Services The HHP provides six core services: Comprehensive care management Care coordination (physical health, behavioral health, community-based long-term services and supports "LTSS") Health promotion Comprehensive transitional care Individual and family support Referral to community and social support services, including housing What will you gain as a member of the HHP? You will have a personalized care team – including a Care Coordinator – that works together to help you get the care you need. Your care team and Care Coordinator will work with you to develop an individualized Health Action Plan (HAP). A HAP will help you to meet your goals and objectives in hopes of better overall health and wellness. You receive extra services at no cost as part of your Medi-Cal benefits, including help with: Making and following-through with appointments Transportation to-and-from doctors appointments Understanding your prescription medications Medication reminders Getting follow-up services after you leave the hospital Connecting to and applying for community programs and services, including food benefits and housing Who qualifies for the HHP? To be eligible for HHP services, patients must meet the following requirements Be enrolled in a Medi-Cal health plan Have certain chronic conditions that are determined by ICD-10 codes. Including at least 1 of the boxes below: At least 2 of the following: Chronic obstructive pulmonary disease (COPD), diabetes, traumatic brain injury, chronic or congestive heart failure, coronary artery disease, chronic liver disease, chronic kidney disease, dementia, or substance use disorders Hypertension (high blood pressure) and 1 of the following: COPD, diabetes, coronary artery disease, or chronic or congestive heart failure 1 of the following: Major depression disorders, bipolar disorder, or psychotic disorders (including schizophrenia) Asthma Meets at least one acuity or complexity criteria. The member can check at least 1 box below: Has 3 or more of the HHP-eligible chronic conditions Had at least 1 inpatient hospital stay in the last year Had 3 or more emergency department visits in the last year Is experiencing chronic homelessness For more general information regarding the Health Home Program, please view the following documents: English: HHP Member Toolkit Spanish: Caja De Herramientas Para El Miembro For more information regarding CNHF's Health Home Program, please contact Amanda Granados: (213)-610-5131. Thank you! Contact Us Today Follow Us (323) 234-5000 info@cnhfclinics.org Our Clinics Serving the Southern California community since 1967. Mon - Fri 8:00 am - 5:00 pm Sat - Sun Closed