The Community Health Worker Resource Hub

Topic Areas

Behavioral health, Chronic disease, Social determinants of health

Priority Population

Individuals with special healthcare needs, Racial/ethnic minorities, Low income populations

Setting

Healthcare

The Health Home Program within the Patient Navigation Center at NYU Langone Hospital – Brooklyn utilizes Care Managers and CHWs who use Motivational Interviewing to promote behavior change within high-risk, underserved populations on Medicaid. In addition, the Health Home team helps this population navigate care across the care continuum and address social determinants of health (SDOH) to ultimately improve health outcomes. Patients often suffer from complex medical and/or psychiatric co-morbid conditions, as well as substance use, and face SDOH challenges commonly faced by underserved communities.

Topic Areas

Behavioral health, Chronic disease, Social determinants of health

Priority Population

Individuals with special healthcare needs, Racial/ethnic minorities, Low income populations

Setting

Healthcare

Years

2011-present

Principal Investigator or Program Director

Jason Hyde

Download a .zip file of all documents in this Project (12 files, 1.17 MB)

Resource Title	Resource Type	Topic Area	Language
Health Home Community Case Management	Study protocols	Mental illness, Substance use disorder, Cardiovascular disease, Diabetes, Hypertension, Obesity, HIV/AIDS, Asthma, Social determinants of health	English
Health Home Home Visits Protocol	Study protocols	Mental illness, Substance use disorder, Cardiovascular disease, Diabetes, Hypertension, Obesity, HIV/AIDS, Asthma, Social determinants of health	English
Health Home Interview Questions Manager	Applicant interview guides	Mental illness, Substance use disorder, Cardiovascular disease, Diabetes, Hypertension, Obesity, HIV/AIDS, Asthma, Social determinants of health	English
Health Home Job Description CHW	Job descriptions	Mental illness, Substance use disorder, Cardiovascular disease, Diabetes, Hypertension, Obesity, HIV/AIDS, Asthma, Social determinants of health	English
Health Home Patient Satisfaction Survey	Surveys	Mental illness, Substance use disorder, Cardiovascular disease, Diabetes, Hypertension, Obesity, HIV/AIDS, Asthma, Social determinants of health	English
Health Home Job Description Care Manager	Job descriptions	Mental illness, Substance use disorder, Cardiovascular disease, Diabetes, Hypertension, Obesity, HIV/AIDS, Asthma, Social determinants of health	English
Health Home Writing Sample Care Manager	Applicant interview guides	Mental illness, Substance use disorder, Cardiovascular disease, Diabetes, Hypertension, Obesity, HIV/AIDS, Asthma, Social determinants of health	English
Health Home Checklist for Community Case Management	Training guides	Mental illness, Substance use disorder, Cardiovascular disease, Diabetes, Hypertension, Obesity, HIV/AIDS, Asthma, Social determinants of health	English
Health Home Chronic Disease Management Tip Sheets	Study protocols	Mental illness, Substance use disorder, Cardiovascular disease, Diabetes, Hypertension, Obesity, HIV/AIDS, Asthma, Social determinants of health	English
Health Home Job Description Community Case Manager	Job descriptions	Mental illness, Substance use disorder, Cardiovascular disease, Diabetes, Hypertension, Obesity, HIV/AIDS, Asthma, Social determinants of health	English
Health Home Job Description Manager Care Coordination	Job descriptions	Mental illness, Substance use disorder, Cardiovascular disease, Diabetes, Hypertension, Obesity, HIV/AIDS, Asthma, Social determinants of health	English
Health Home Job Description Manager Care Coordination Quality	Job descriptions	Mental illness, Substance use disorder, Cardiovascular disease, Diabetes, Hypertension, Obesity, HIV/AIDS, Asthma, Social determinants of health	English

Patient Navigation Center - Health Home

12 Resources in this Project