Webinar 1  |  Webinar 2  |  Webinar 3  |  Webinar 4  |  Webinar 5  |  Training

The project is supported by grant funding from the US Department of Health and Human Services’ Administration for Strategic Preparedness and Response, administered by the NYC Department of Health and Mental Hygiene, Office of Emergency Preparedness and Response (OEPR).

The home and community-based services sector is on the front lines when infectious disease threats emerge. The overall project is focused on providing access to the training, planning resources, and protective equipment that support a coordinated response to managing infectious diseases in home care settings.

The webinar series is designed to provide baseline knowledge of emerging infectious disease, novel and high-risk infections in the home care setting. Building on this knowledge, the webinars address planning, protocols, and best practices in prevention and control of these and other high risk and prevalent infections in the home and community-based services population.

Five one-hour webinars cover identification, prevention, agency integration, patient and family engagement, and interagency coordination and planning.

This is the first of five webinars that will address emerging infectious disease or novel influenza outbreak planning for a home care audience. The focus for this initial webinar is on the identification of these diseases, such as H5N1 and respiratory tract pathogens (Influenza, COVID, RSV) and their associated etiology, background and key facts, prevalence, and implications for the home and community-based services population.

Presenter: Teresa Lubowski, Pharm. D., B.S., CPHQ, Director, Medication Safety, IPRO
Date: February 27, 2026

The second webinar in the series is focused on the integration of planning into the home care agency’s overall scope, plans and protocols for infection prevention and control for these and other high risk and prevalent infections in the home and community based services population.

Presenter: Melanie Ronda, MSN, RN, LTC-CIP, CPHQ, Senior Director of Healthcare Quality Improvement and Infection Preventionist at IPRO
Date: March 20, 2026

The third webinar in the series is focused on best practice (interventions) in prevention and control that address emerging infectious diseases or novel influenza outbreaks and high-risk infection presented in Webinar 1 and 2 

Presenter: Melanie Ronda, MSN, RN, LTC-CIP, CPHQ, Senior Director of Healthcare Quality Improvement and Infection Preventionist at IPRO
Date: April 20, 2026

The fourth webinar in the series is focused on patient, family, caregiver, and/or household member engagement in prevention and control of infectious disease and outbreaks.

Presenter: Melanie Ronda, MSN, RN, LTC-CIP, CPHQ, Senior Director of Healthcare Quality Improvement and Infection Preventionist at IPRO
Date: May 29, 2026

The final webinar in the series is focused on Communication, Collaboration & Cross-Agency Coordination and explores best practices for HCBS agency coordination during emerging infectious disease outbreaks.

Presenters: Melanie Ronda, MSN, RN, LTC-CIP, CPHQ, Senior Director of Healthcare Quality Improvement and Infection Preventionist at IPRO and Sara Butterfield, RN, BSN, CPHQ, CCM, Assistant Vice President of Health Care Quality Improvement for IPRO and the Health System Lead and Engagement Lead for the Northeast Centers for Medicare & Medicaid Services (CMS) QIN-QIO (Region 1)

Clinical (in-person) training session:

 HCA E&R conducted two in-person clinical education programs focused on the early identification, control, and management of emerging infectious diseases, novel influenza, and other high-risk infections in the home and community-based services (HCBS) population.

The trainings offered a deep dive into strategies for prevention and mitigation of novel/high-risk infections especially prevalent and virulent in the (HCBS) population. The in-person trainings offered a complement to our five part webinar series introducing and broadly addressing these areas.

The trainings took place at the Conference Center in Manhattan and comprised a full morning and afternoon session.

Participants were educated in:

• Nursing bag protocol
• Hand hygiene (especially critical in infectious disease prevention/ mitigation)
• Related high-risk/high morbidity infections in HCBS, including UTIs, aspiration pneumonia, pressure injuries, cellulitis, and prevention and intervention for progression to sepsis
• Clinical assessment and interventions to support management and care coordination
• Clinical tools and resources for staff, patient, and caregiver education.

Virtual training designed for home care paraprofessional staff:

A special virtual training for paraprofessionals was offered June 16, 2026. The training, “Special Virtual HHA/PCA In-service Training in Emerging Infectious Diseases, Novel Influenza & Infections in the HCBS Population” attracted more than 90 participants and is available to view online at no-cost. 

HCANYS and IPRO conducted this 90-minute free virtual training for home health aides and personal care aides on the infections that affect their patients, the dangerous complications that can arise, and the precautions to be taken to protect both the caregiver and patients. This 90-minute program provides the knowledge and skills to help protect both the HHA/PCA and their patients from infectious diseases. Participants will learn how to recognize warning signs, apply infection control precautions in the home, and respond when a patient's condition changes. Case scenarios and Q&A are built into the session. 

This training is designed to correspond to the New York State Department of Health's regulatory criteria, which counts toward HHA/PCA annual in-service requirement in infection control.

The Home Care Association of New York State Education and Research E&R (HCA E&R), the Iroquois Healthcare Association (IHA), and IPRO, the state-federal regional quality improvement organization, partnered to develop and pilot Collaborative Models of Community Medicine and Paramedicine. 

This initiative involves a multiyear plan that is currently underway in seven rural and small community regions that have developed pilots across New York State:

1. Northern New York Region
2. St. Lawrence Region
3. Finger Lakes Region
4. Southern Tier Region
5. Mohawk Valley Region
6. Hudson Valley Region
7. Adirondack/Northeast Region

Core health sector partners and practitioners from local hospitals, home health agencies, physicians, clinics, and emergency medical service (EMS) organizations are working together to develop and implement collaborative models to strengthen care in their communities.

The service population focuses on individuals with complex, high-risk health conditions, those who face challenges accessing health care, those who have multiple chronic conditions, those who need help with activities of daily living, or those who are super utilizers of the hospital and/or local EMS/911 system.

Coordinating and optimizing the roles of all core partners in care delivery, particularly amid growing care complexity and shortage of resources, is critical to patient access, quality, and outcomes. The need for a coordinated response is exacerbated by the chronic and worsening health personnel shortages in the NYS healthcare system that impair access and continuity of care for medically, socio-economically, and mentally vulnerable individuals living in the community. 

To close these gaps, collaborative care by hospitals, physicians, home health agencies, EMS, and other core community partners is imperative. While emergency care is typically the focus of paramedics, they can have further invaluable roles in partnerships with patient care teams, as they are particularly knowledgeable of their community’s health needs, especially those who rely on EMS/911 to address their healthcare needs. Emergency medical technicians (EMTs) are frequently called into non-urgent medical situations, straining the already limited resources for when true emergencies arise. This puts a burden on emergency care teams and threatens to harm those in true need of emergency.

By leveraging collaboration between emergency services and other health sector partners, this burden can be reduced while also ensuring community members receive appropriate and efficient care.

Traditionally, developing programs of community medicine in NYS that include elements of paramedicine is a challenge. Instead of focusing solely on statutory change, this initiative draws upon collaboration. This program is highly community-centered and requires consistent collaboration among providers. Collaborative models aim to optimize already established community resources and work with all partners towards goals to support care transitions, continuity of patient service, and coordinated intervention with vulnerable populations or during vulnerable periods.

The seven pilot sites share similar goals, but each is tailored to the available community resources and the identified needs of the individuals living in each community.

The foundation of the success of the pilots thus far is attributable to continued education, communication, and trust-building across all core partners.

• Supports home care by serving as a bridge in critical points in care transitions between health care facilities and the home, while supplementing timely services.
• Improves communication, access, and continuity of care by flexibly choreographing the partnered assistance of core health system partners.
• Meets the health needs of the community, while simultaneously preventing potentially avoidable emergency department usage.
• Decreases 911 utilization and EMS transport for conditions able to be handled through preventive in-home support.

• Decreases emergency department visits by 61%
• Decreases hospital admissions by 78%
• Decreases EMS/911 calls without transport by 60%
• Decreases EMS/911 calls with transport by 50%

(Performance results 6 months prior and 6 months post program implementation. Data collected from 3 original pilot sites.)

Public and private insurers must recognize the value of these collaborative models and their applicability to health care. Ways to do that include:

• Coverage under private and commercial health plans.
• Medicaid coverage under the state’s 1115 Medicaid waiver.
• Bundled services coverage under new and evolving forms of federal, state, and private reimbursement.
• Coverage under other health plan models offered in NY.

A formal evaluation will be taking place in 2025-2026 to determine effectiveness, efficiencies, strengths, weaknesses, areas for improvement, outcomes, impact, and lessons learned across all seven pilot sites. A request for proposals (RFP) will be available soon.

Related Resources

Hospitals and home care providers have long worked in a coordinated fashion. Pre-acute home care helps prevent avoidable hospitalizations, while post-acute home care helps in the recovery process.

Together these efforts ensure that patients do not end up admitted or readmitted to the hospital unnecessarily, so that hospitals can dedicate resources where they are most needed for emergency, critical, surgical, trauma and/or other specialty care.

This is especially important during medical surges, like in the COVID-19 pandemic, which has placed enormous stresses on hospital capacity, further necessitating strong mutual support partnerships across settings. 

Under a grant from the Mother Cabrini Health Foundation, the Home Care Association of New York State Education & Research (HCA E&R) the Healthcare Association of New York State (HANYS) and the Iroquois Healthcare Association (IHA) have developed a Statewide Hospital-Home Care Collaborative.

The purpose of this program is to improve hospital-home care synchronization for front-end/pre-acute hospital care as well as far-end/post-hospital care, recovery, and long term support.

As part of this effort, IHA, HCA E&R, and HANYS have curated and hosted a series of webinars featuring prototypes of hospital and home care collaboration models that can be emulated by other providers statewide — working together, across settings.

HCA is also partnering with VNS Ithaca & Tompkins and Stonybrook/Gurwin to expand upon two collaborative models.

This initiative also includes a library of online resources and tools to assist hospital-home care collaborative development, provide technical assistance, and further education on identified collaboration needs and issues.

• Compendium of Statewide Hospital-Home Care. Home Care Association, Iroquois Health Association, HANYS, 2023.
• Two Innovative Models Address Healthcare Workforce Challenges. Home Care Association, Iroquois Health Association, HANYS, 2022.
• Blueprints for Collaboration - Two Innovative Models Address Healthcare Workforce Challenges. Home Care Association, Iroquois Health Association, HANYS, 2022.
• Innovative Hospital-Home Care-Mental Health Collaboration Models: A Primer Home Care Association, Iroquois Health Association, HANYS, 2023.
• 2022 Collaborative Prototypes & Lessons Learned During the COVID-19 Vaccine Rollout. Home Care Association, Iroquois Health Association, HANYS, 2023.
• Hospital and Home Care Partnerships with Aging Providers: Collaboration Models and Lessons Learned. Home Care Association, Iroquois Health Association, HANYS, 2023.
• Workforce Summit Summary, Home Care Association. Home Care Association, Iroquois Health Association, HANYS, 2022.

Univ. of Rochester Medical Center & UR Home Care: Models of Hospital-Home Care Collaboration Full Version 

Short version here.

St Mary's: Models of Hospital-Home Care Collaboration Full version

Short version here.

St. Peter's Health Partners-Models of Hospital-Home Care Collaboration Full Version

Short version here.

CROWN & CARES Program for Managing Acute and Chronic Needs of COVID
WATCH Webinar

Patients at Home
Northwell Health and Northwell Home Care | Related Resource:

• Ambulatory Management of Moderate to High Risk COVID-19 Patients: The Coronavirus Related Outpatient Work Navigators (CROWN) Protocol. Home Health Care Management and Practice. October 2020.

High Risk/High Need Patient Collaborative
Nathan Littauer Hospital, Community Health Care Center of St. Mary’s and Nathan Littauer Hospital
WATCH Webinar

Critical Illness Recovery Program
University of Rochester Medical Center, URMC Home Care
WATCH Webinar

eMOLST Physician-Hospital-Home Care Collaborative
Dr. Patricia Bomba, NYU Hospital, Visiting Nurse Service of New York
WATCH Webinar | Related Resources:

• CompassionAndSupport.org
• Video: Thoughtful MOLST Discussions in Hospital & Hospice Settings. CompassionAndSupport.org.
• Video: Thoughtful MOLST Discussions in the Nursing Home Setting. CompassionAndSupport.org.
• MOLST Form and related resources. MOLST.org.
• MOLST General Instructions for Adults. New York State Department of Health.
• 8-Step MOLST Protocol. MOLST.org.

Integrated Care and Care Management Collaborative
Gurwin Health Care System, Stony Brook Hospital, Stony Brook Physician Practice
WATCH Webinar

Pre-acute/Post-acute Collaborative
Mount Sinai South Nassau, South Nassau Home Care
WATCH Webinar

Population Health Collaborative and Analytics Partnership
Upstate Medical Center, Nascentia Health, Upstate Home Care
WATCH Webinar

Utilizing Strategic Design to Foster Homecare-Hospital Collaboration Initiatives
M.S. Hall & Associates 
WATCH Webinar

Statewide Summits

Registered attendees will need to use their login credentials to access recordings. If you did not attend the Summit or previously register, you can do so at the link to gain access to all recordings. 

Statewide Virtual Workforce Summit | May 26, 2022
Click Here To View The Workforce Summit Recording

Statewide Hospital Home-Care Collaboration Summit | December 2, 2021
Click Here To View The Summit Recording

Webinar Series

No login credentials needed to access recordings and handouts. If you did not attend or previously register, you can do so at the link to gain access to all recordings.

A Blueprint for a Collaboration Model
Early College for Aspiring Healthcare Workers in High School
M.S. Hall & Associates
December, 2022
Click here to view the recording
Click here to view the presentation

Models of Hospital-Homecare Electronic Health Record Integration 
Collaborative Organizations: Montefiore Hospital and Montefiore Home Care

EHR integration is critical to effective health care services delivery, quality and value. It is an imperative in the evolving health care system and is a major threshold for collaborating partners. This webinar shares successful roadmaps and provides invaluable assistance to providers strategically exploring and planning EHR integration, particularly Hospital EPIC-system integration, with home care and other partners. Representatives from two hospital-homecare models – one upstate and one downstate urban – will share their approaches and successful experiences integrating EPIC with their hospital, home care and other network partners, and address important technical, programmatic and buy-in elements.
Click here to view the recording
Click here to view the presentation 

Innovations in Care and Management through Hospital-Home Care Collaboration 
Collaborative Organizations: Catholic Health System and Catholic Home Care 

Collaboration is the pathway for innovating new models and solutions for patient care and for health system and population health goals. This webinar will present newest, cutting-edge designs for collaboratives being undertaken by a major hospital system and home health agency. It will delve into the newest areas and approaches employing collaborative strategies. Learn the latest from system leaders on how they are advancing the horizons of health program development and interventions through hospital-home care collaboration. 
Click here to view the recording
Click here to view the presentation

Collaboration of Care for patients with Mental Illness Across the Health System
Collaborative Organizations: Catholic Health System and Catholic Home Care 

Integration of physical and mental health services to at risk patients requires collaboration across the care continuum. Learn how one hospital and home care agency strove to move patients with mental illness seamlessly across acute care, outpatient and home care settings during the COVID-19 pandemic. A focus on telehealth greatly contributed to this collaborative model.
Click here to view the recording 
Click here to view the presentation

A Blueprint of a Collaboration Model  
Organization: M.S. Hall and Associates   

M.S. Hall, strategic consultants in healthcare, will present a plan developed from a past collaboration model presented in last year’s Collaborative webinar series. This plan or “blueprint” will illustrate the principles around strategic design thinking and will be a “how-to” on replication of a particular model in a local community. You will learn how to think about a collaborative model based on nine building blocks of a business model canvas. The webinar will also focus on how you can use this canvas with various stakeholders to build a collaboration.
Click here to view recording
Click here to view recording with Q&A
Click here to view presentation
Click here to view MS Hall – UR Collaboration Business Model
Click here to view MS Hall – UR Hospital and Home Care Collaboration Blueprint Narrative

Acute Care at Home Model Developed in the COVID-19 Surge
Collaborative organizations: Catholic Health System of Long Island and CHS Home Care 

This session describes an effective collaboration between Catholic Home Care and Primary Care, developed by Catholic Health leadership, designed to care for and manage patients at home during the COVID-19 surge. Employing a patient-centric focus model, the primary goal of the project was to decompress the patient volume within system hospitals to allow for the management of the most acutely ill individuals while not comprising patient care and outcomes.
Click here to view recording
Click here to view presentation

Point of Dispensing Collaborative to Reach Underserved Populations
Collaborative organizations: Mohawk Valley Health System (MVHS) and Mohawk Valley Home Care   

MVHS and Senior Network Health MLTC, part of MVHS’s Home Care Division, are using a Mobile point-of-dispensing (POD) team to reach underserved populations with COVID-19 vaccines. The Mobile PODs have already provided 1,325 vaccines while strengthening critical partnerships with local communities and community organizations. In this webinar, you’ll learn how to create a mobile team using all of your organizational assets and how to integrate this model into your community health improvement initiatives, particularly those that are addressing health disparities.   
Click here to view recording
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Home Asthma Management, A Collaborative Effort to Reduce the Burden of  Pediatric and  Young Adult Asthma 
Collaborative Organizations: St. Mary’s Home Care and New York-Presbyterian Queens 

A special-needs home care agency and a New York City academic medical center have joined forces in a unique collaboration to address the needs of young patients with complex and chronic medical conditions. In this webinar, you’ll learn how the organizations formed a long-term relationship that started with a small pilot program and grew to an expanded collaboration with a broader network of the medical center’s multi-specialty physicians, increasing the number of in-home visits, patients enrolled in remote patient monitoring, and supportive services to further enhance quality of life. 
Click here to view recording
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Complex Care Collaborative 
Collaborative Organizations:  St. Joseph’s Hospital, St. Joseph’s Health At Home, Trinity Health 

This Hospital-Homecare-Physician collaborative focuses on the care and management of highly complex patients over a six-county service area. The model integrates service teams of a hospital, home health agency and physician-led Accountable Care Organization (ACO) to provide comprehensive, coordinated care for complex patient conditions and needs. It manages the care, prevents avoidable hospitalizations, rehospitalizations and institutional placements, optimizes and facilitates hospital discharge and transition of very challenging cases, and promotes value, efficiency and cost savings. In this webinar, project leaders will show how hospitals, home care agencies and physicians can design and navigate a collaborative model for the care of these neediest of cases. 
Click here to view recording
Click here to view presentation

Emergency Department Diversion/Inpatient Admissions Collaborative Program for COVID-19 and Beyond 
Collaborative Organizations: St. Peter’s Hospital and Eddy Visiting Nurse and Rehab Association 

Preventable emergencies, ED visits and acute care admissions are systemic priorities. In this webinar, a major hospital and home care agency demonstrate how they partner for preventive intervention. The collaborative redirects emergency department and potential hospital admissions to patient-centered, appropriate and cost-effective care at home. The webinar will explain this win-win-win design, positive patient and system impacts, and key lessons for replication.
Click here to view recording
Click here to view the presentation

• Telehealth: Enhancing collaboration, improving care coordination: Nursing Management (lww.com)
• Using Telehealth to Improve Home-Based Care for Older Adults and Family Caregivers
• Patients in transition–improving hospital-home care collaboration through electronic messaging: providers’ perspectives – PubMed (nih.gov) 
• Age Friendly Health Systems. Institute for Healthcare Improvement.
• 5 ways Hospitals Can Boost Capacity Through Home Health. Advisory Board. 2020.
• Impact of Home Health Care on Health Care Resource Utilization Following Hospital Discharge: A Cohort Study. American Journal of Medicine. 2017.
• Innovative Home Care Models: Five Profiles in Cost Savings, Care Transitions. Simione Healthcare Consultants. 2012.
• Hospital-at-Home. American Hospital Association. 2022. Explore AHA’s growing repository of resources on hospital-at-home, including case studies and podcasts.
• How UVA Health’s Medicine HOME program reduces hospitalizations and readmissions | Healthcare IT News
• Collaborative Care Is Key to Reducing Hospitalizations
• Collaboration of Hospital Case Managers and Home Care Liaisons When Transitioning Patients: Professional Case Management (lww.com)
• Hospital and homecare nurses’ experiences of involvement of patients and families in transition between hospital and municipalities: A qualitative study – Petersen – Scandinavian Journal of Caring Sciences – Wiley Online Library
• How Collaboration Can Drastically Improve U.S. Health Care
• “Hospital at Home” Programs Improve Outcomes, Lower Costs, But Face Resistance from Providers and Payers

• Public Health Law Section 2805-x: the Hospital-Home Care-Physician Collaboration Law.
• 2805-x Implementation Guidancefrom the New York State Department of Health.

The Home Care Association of New York State Education & Research (HCA E&R) has been awarded funding from the Mother Cabrini Health Foundation to identify and address health disparities in populations receiving health care in homes and community-based services (HCBS) statewide.

This project includes a spectrum of components, including an assessment of disparities and potential interventions, a statewide diversity and cultural awareness education for all community based care organizations’ staff, a point of service translation pilot, a live-recorded training component for strategies and support for patients who have co-occurring behavioral health and physical health needs, a health literacy component for homebound individuals, a rural primary care collaborative, and engagement in Duke University’s “Population Care Coordinator Program” to train and certify clinicians in population care coordination.

Read more about each component and how you can get involved, below.

The initiative will pilot test the efficacy of providing virtual health literacy education and information to home care and hospice care recipients through the Virtual Senior Center (VSC), in partnership with Selfhelp Community Services, operator of the VSC. All home care, hospice, MLTC, FI/CDPAP and Waiver Program recipients encouraged to participate.

Health literacy has been defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” (Ratzan and Parker, 2000)

Health literacy is key to positive patient experience, outcomes, effective self-care, and partnership with care professionals. It is also critical in breaking through health disparities.

Your participation in this type of initiative will help equip you and your organization for advancement, and most importantly, will support your efforts to promote quality care and patient quality of experience, quality of life, independence and dignity.

Watch this compelling example of a VSC participant:

How to Enroll

The VSC contains an accessible menu of informational and educational material to support health literacy for recipients that can be directly accessed by the individual once they are enrolled. Individuals you identify, and who wish to enroll, will just need your help to be signed into the VSC.

Once enrolled, the individual (solo or with the assistance of their caregiver or family members) can access the elements of health literacy on the VSC. There is no limit to access; recipients can sign-in according to a schedule that works best for them.

There are no requirements other than to enroll, and to agree to provide feedback on the experience and benefit. Participating providers and organizations will be similarly asked to provide feedback and recommendations that HCA and the Mother Cabrini Foundation can use to evaluate and consider long-term support for the program.

At this link, you can enroll your client immediately by creating an account for them. The VSC team will keep HCA apprised (de-identified, no PHI) of the number of enrollees by organization and region.

Mental Health Training

HCA E&R in partnership with the New York State Office of Mental Health and the Finger Lakes Geriatric Education Center of the University of Rochester provided special training and educational curriculum for staff of home care agencies, hospice, MLTC and community mental health provider agencies to advance the skills and knowledge of provider staff, and inform the agencies’ organizational practices and strategies for the care and support of patients who have co-occurring mental health and physical health interdisciplinary needs.

Recordings are now available on HCA E&R Learning Center for this specially developed curriculum:

Session One: Introduction to Mental Health and Accessing Services

• The 3 D’s: Dementia, Delirium, & Depression
• Accessing Mental Health Services for Additional Support

Session Two: Understanding Health and Mental Health

• Overview of Serious Mental Illness (SMI)
• Psychotropic Medications

Session Three: Improving Communication and Addressing Crisis

• Communication Approaches for Clients with SMI
• Crisis Intervention

A New Tool Available To Help you Understand Delirium, Dementia, and Depression!

HCA E&R in partnership with the Finger Lakes Geriatric Education Center held an educational webinar to provide an overview of Dementia, Delirium, and Depression, and introduced a new point-of-care tool to help you better understand the differences between the 3 D’s.

The recorded webinar, 3D’s Tool, and a mobile phone friendly version of the tool can be accessed on HCA E&R Learning Center.

Simply sign up for the “course” and you will have access to the associated materials.

Translation Services

HCA E&R in partnership with Nascentia Health and several pilot agencies conducted a point-of-care translation service for English language-challenged and non-English speaking individuals receiving home care. The pilot utilized LanguageLine Solutions to provide real-time translation service right in the home over the phone. In addition to supporting the healthcare of individuals in their home, the program informed potential statewide replicability and next steps.

Additionally, HCA E&R and Nascentia Health received feedback from several member agencies on what zone tools and patient educational materials would be helpful to have translated into additional languages. Partnering with LanguageLine Solutions again, HCA E&R and Nascentia Health translated several resources and tools for providers and patients into various languages. Each tool has been made available in several of the listed languages.

Resources and Tools

• Adult Sepsis Zone Tool
• Pediatric Sepsis Zone Tool
• Maternal Sepsis Zone Tool
• Call for Help Tool
• COPD Action Plan
• General Health Booklet
• HF Symptom Tracker
• Respiratory Zone Tool

Languages

• Arabic
• Burmese
• Bengali
• Chinese Simplified
• Chinese Traditional
• Farsi
• Haitian Creole
• Italian
• Korean
• Karen
• Russian
• Spanish
• Somali
• Tagalog
• Vietnamese

These items are available on HCA E&R’s Learning Center. Simply create a login to access the ‘course’ and each of the materials are labeled and available for download for free.  

The “General Health Booklet” is available to be branded by your organization. Please reach out to This email address is being protected from spambots. You need JavaScript enabled to view it. if you’re interested.  

Population Care Coordination

HCA has engaged Duke University’s “Population Care Coordinator Program” to train and certify clinicians in population care coordination focused at the community, organizational and patient level. This initiative is currently piloted in 10 agencies across NYS serving as the basis for evaluation and potential expansion for broader availability. 

Twenty two clinicians across NYS were engaged and certified upon completion of this training program.

Public Health CBO-Home Health Collaborative Pilot

Hospital-Homecare-Physician Collaborative Models Addressing Health Disparities

A new NYS law was passed and signed in 2023 (Chapter 697 of Laws of 2023) to authorize “Hospital-Homecare-Physician Collaborative Models Addressing Health Disparities.”

This new opportunity leverages the state’s Hospital-Homecare-Physician Collaborative Program (public health law 2805-x) in providing regulatory and procedural waivers, reimbursement flexibility, grants (subject to funding in the state budget, and other policy and program supports for initiatives to address disparities in health care access, treatment and/or conditions of higher prevalence in certain populations such as racial and ethnic minority groups; persons with disabilities; women; the poor; and persons, living in rural and other medically unserved and underserved geographic areas.

The program harnesses core partners within the continuum of care for coordinated, multilevel disparities intervention. The program also fully syncs the goals of the state’s new 1115 federal Medicaid waiver for improved access and mitigation of disparities in health care.

Providers can review the NYS Public Health Law 2805-x provisions for the health disparities collaboratives here, and can access the NYS Department of Health administrative guidance for applying under this law for state support of this type of collaborative here.

By authorizing programs of collaboration between hospitals, home care agencies, physicians, and other partners targeted at disparities, this program opportunity encourages health care innovations designed to improve health outcomes for underserved persons and reduce health care costs within the state. Within these partnerships, home health providers are especially and uniquely positioned to provide culturally competent and person-center interventions in the homes, neighborhoods and communities where people truly spend their lives, and experience the social determinants.