State Designated Health Homes and Downstream Care Management Agencies

State Designated Health Homes and Downstream Care Management Agencies meeting Safety Net Criteria

State - Designated Health Homes and Downstream Care Management Agencies meeting Safety Net Criteria

Criteria Used to Identify Health Home Safety Net Providers for DSRIP A) Organization has more than $10,000 in Care Management claims billed to NYS Medicaid in 2013 (either directly or indirectly, criteria pending CMS approval) B) Organization meets Safety Net Designation based on NPI match. Providers may want to verify the Safety Net Status on alternate Safety Net lists.

Entity Name

ADIRONDACK HEALTH INSTITUTE INC AL JORDAN HEALTH CORPORATION/GRHHN BRONX LEBANON HOSPITAL CENTER/BRONX HEALTH HOME CATHOLIC CHARITIES OF BROOME COUNTY CENTRAL NEW YORK HEALTH HOME NETWORK CHAUTAUQUA COUNTY DEPARTMENT OF MH/HHUNY COMMUNITY CARE MANAGEMENT PARTNERS (CCMP)/VNSNY COMMUNITY HLTHCARE NETWORK (CHN)/QCCP COORDINATED BEHAVIORAL CARE INC FED EMPL & GLD SER MR MH/FEGS GREATER BUFFALO UNITED IPA/GBUAHN HEALTH HOME PARTNERS OF WNY LLC HERITAGE HEALTH AND HOUSING, INC HUDSON RIVER HEALTHCARE INC OPEN DOOR FAMILY MEDICAL CENTER/HVCC HUTHER-DOYLE MEM INSTITUTE/HHUNY INSTITUTE FOR COMMUNITY LIVING INSTITUTE FOR FAMILY HLTH LAKE SHORE BEHAVIORAL HLTH/HHUNY MAIMONIDES MEDICAL CENTER/SW BROOKLYN HEALTH HOME MARY IMOGENE BASSET HOSPITAL MONTEFIORE MEDICAL CENTER/BAHN NIAGARA FALLS MEM MED CTR NORTH SHORE UNIVERSITY HOSPITAL NY HOSPITAL JACOBI MEDICAL CENTER/HHC HEALTH HOME ONONDAGA CASE MANAGEMENT INC/HHUNY QUEENS COORDINATED CARE PARTNERS SOUTHWEST BROOKLYN HEALTH HOME LLC SAMARITAN HOSPITAL ST LUKES ROOSEVELT HSP CTR/DBA MT SINAI HEALTH HOME ST MARYS HOSP AMSTERDAM ST.JOSEPH'S HSP HLTH CTR UNITED HEALTH SERV HOSP INC VISITING NURS SVC/SCHTD & SAR CNTY VNSNY COMMUNITY HEALTH SERVICES

Safety Net Criteria Type

A A B A A A A A A A A A B B B A A B A B B A B A B B A A A B B B B B B B

Entity ID Provider MMIS ID Provider NPI

Health Home Type

E0333823 E0335892 E0251934 E0183473 E0344563 E0341782 E0350866 E0189629 E0345855 E0162796 E0338409 E0335619 E0314396 E0252206 E0252207 E0204306 E0296517 E0209381 E0232519 E0274050 E0268584 E0334974 E0263733 E0334635 E0274062 E0273834 E0028423 E0350743 03605176 E0036493 E0263685 E0264004 E0169412 E0238207 E0226952 E0004967

03449974 03467301 00476022 01164149 03549144 03520990 03606902 01102441 03559515 01371571 03489287 03465001 00509980 00473038 03003578 00954572 03129908 00903700 03005323 02998736 03000593 03460400 00354467 03457054 00243178 00246048 02994838 03785206 E0350202 02993713 00354967 03001310 02995893 03004639 02997684 02996041

1740557735 1740554229 1417027558 1689710154 1891045902 1477807097 1366780850 1952518078 1730451071 1912164120 1033484894 1760742548 1851414965 1619969458 1467487637 1073614533 1558598052 1295729408 1922210657 1093777492 1780600577 1831461847 1285717298 1932472107 1194832477 1679587679 1235184235 1215292305 1023354933 1043267727 1104982917 1811977796 1508815333 1518998699 1841360740 1528059805

Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home Health Home

1

State Designated Health Homes and Downstream Care Management Agencies meeting Safety Net Criteria

State - Designated Health Homes and Downstream Care Management Agencies meeting Safety Net Criteria

Criteria Used to Identify Health Home Safety Net Providers for DSRIP A) Organization has more than $10,000 in Care Management claims billed to NYS Medicaid in 2013 (either directly or indirectly, criteria pending CMS approval) B) Organization meets Safety Net Designation based on NPI match. Providers may want to verify the Safety Net Status on alternate Safety Net lists.

Entity Name

A C CENTER INC AIDS COMMUNITY RESOURCES AI AIDS COMMUNITY SER WNY AIDS COUNCIL OF NENY AI AIDS CTR OF QUEENS COUNTY INC AIDS SVC CTR MANHATTEN AI ALBANY CNTY DEPT/CHILD Y&F MH ALBANY COUNTY MH ALLEGANY CO COMMUNITY SVCS MH ALLEGANY REHAB ASSOC MH ARGUS COMMUNITY INC AI ASIAN & PACIFIC I C HIV/AIDS ASSOC/REHAB CASE MGNT HOU MH ASTOR HOME FOR CHILDREN FBT BAILEY HOUSE AI BEHAVIORAL HLTH SRVCS NORTH RISP CN BETH ISRAEL MEDICAL CTR ACT BRC HUMAN SERVICES CORP SCM BRONX AIDS SERVICE AI BRONX LEBANON HOSPITAL SCM BROOKLYN AIDS TASK FORCE AI C BROWNSVILLE FAM HLTH CTR AI BUFFALO FED NEIGHHD CTRS CAMBA INC CATH CHAR COMM & RES SVC AI M CATH CHAR NGHBHD SVCS INC MH CATHOLIC CHARITIES CORTLAND CATHOLIC CHARITIES OF WNY MH CATHOLIC CHARITIES/ALBANY AI CATHOLIC CHARITIES/OSWEGO CNTY MH CATTARAUGUS CO DEPT MH MH CATTARAUGUS REHAB CENTER MH CAYUGA CTY COMM MH CAYUGA HM FOR CHILDREN MH CENTRAL NASS GUID/COUN SVS MH CHAUTAUQUA COUNTY MH

Safety Net Criteria Type

B A B A A A A A A A A A A A A A B A A A A A A A A A A A A A A A A A A A

Entity ID Provider MMIS ID Provider NPI

Health Home Type

E0176804 E0172705 E0128886 E0157043 E0144842 E0151585 E0046990 E0183169 E0171131 E0170710 E0162867 E0025906 E0081360 E0144364 E0017904 E0001942 E0043328 E0142815 E0175552 E0142816 E0180257 E0171875 E0169571 E0144784 E0180827 E0185643 E0169421 E0084724 E0155944 E0283327 E0159164 E0165754 E0180672 E0083639 E0066319 E0091589

01230991 01272031 02995357 01429318 02996601 01484019 02531542 01167188 01287801 02977099 01370850 02997175 02187204 02994769 02822911 02996894 02994489 02995802 01243521 01571860 01196327 01280340 02994109 01552134 01190629 01142387 02995435 02998227 01440326 03014808 01408075 01341886 01192176 02997542 02337846 02997928

1861496358 1477672798 1356390918 1265625685 1629274972 1710109947 1043379159 1952460990 1316111636 1720004633 1659412849 1730303017 1649420092 1225009806 1083820583 1689621468 1174689665 1477684967 1669642211 1053481192 1548368756 1831395821 1114110848 1659594075 1902018971 1013050129 1366597171 1962596718 1104067024 1730345109 1245374214 1730352451 1922386101 1821272972 1073652855 1902897374

Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency

2

State Designated Health Homes and Downstream Care Management Agencies meeting Safety Net Criteria

State - Designated Health Homes and Downstream Care Management Agencies meeting Safety Net Criteria

Criteria Used to Identify Health Home Safety Net Providers for DSRIP A) Organization has more than $10,000 in Care Management claims billed to NYS Medicaid in 2013 (either directly or indirectly, criteria pending CMS approval) B) Organization meets Safety Net Designation based on NPI match. Providers may want to verify the Safety Net Status on alternate Safety Net lists.

Entity Name

CHENANGO COUNTY MH CHILD AND FAMILY SERVICES MH CHILD/ADOLESCENT TRT SER MH CHOICE OF NEW ROCHELLE MH CITIZEN ADVOCATES MR MH CITIZENS ADVICE BUREAU AI CLEARVIEW CENTER MH CLUBHOUSE OF SUFFOLK INC COLUMBIA CTY MH CTR MH COMMUNITY HEALTH ACTION OF SI COMM MHC GLEN FALLS MH CONEY ISLAND HOSPITAL SCM CONSUMER SER MADISON CNTY MH CRYSTAL RUN VILLAGE MH DENNELISSE CORP AI DEPAUL COMM SER MH DIASPORA COMMUNITY SERVICES AI DIRECTIONS IN INDEPENDENT LIV MH ECON OPP COUNCIL SUFFOLK AI ELLIS HOSPITAL MH ELMHURST HOSPITAL CTR MH ESSEX CO COMM SER MH FAM & CHILD SVCS NIAGARA MH FAMILIES FIRST IN ESSEX FAMILY SER OF CHEMUNG CNTY MH FAMILY SERVICE LEAGUE FAMILY SERVICES NETWORK NY AI FEDERATION OF ORGANIZATION MH FEDERATION OF ORGANIZATION MH FEDERATION OF ORGANIZATION MH FEDERATION OF ORGANIZATION MH FEDERATION OF ORGANIZATION MH FEDERATION OF ORGANIZATION MH FEDERATION OF ORGANIZATION MH FEDERATION OF ORGANIZATION MH FEGS

Safety Net Criteria Type

A A A A A A A A A A B A A A A A A A A A A A A A A A A A A A A A A A A A

Entity ID Provider MMIS ID Provider NPI

Health Home Type

E0182018 E0035531 E0079813 E0084777 E0184363 E0168368 E0144346 E0001941 E0166443 E0158183 E0177645 E0142046 E0086001 E0085094 E0154978 E0081118 E0038721 E0005578 E0131708 E0179188 E0079158 E0086515 E0183472 E0086758 E0086000 E0026490 E0129904 E0084563 E0084563 E0084563 E0084563 E0084563 E0084563 E0084563 E0084563 E0295547

01178716 02646344 02202711 02152981 01155215 01315695 02995811 02996261 02996885 01417909 02997753 01579588 02140710 02149815 01449994 02189628 02614368 02971126 01683114 01207038 02209272 02996789 01164158 02997428 02996569 02996069 01701179 03010428 03010455 03010446 03010400 03010419 03010437 02155122 03010395 03121506

1588694749 1285801316 1851557656 1619161585 1730391012 1053504456 1477695021 1578516738 1689618977 1528283959 1871606764 1336368836 1275683203 1134407760 1043340474 1942374368 1386858538 1871889915 1619119237 1497949622 1174642649 1659485480 1447398755 1811190663 1619922432 1528093242 1326264672 1881765618 1922173962 1922173954 1649345687 1679648604 1881856136 1457513798 1497814149 1013143353

Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency

3

State Designated Health Homes and Downstream Care Management Agencies meeting Safety Net Criteria

State - Designated Health Homes and Downstream Care Management Agencies meeting Safety Net Criteria

Criteria Used to Identify Health Home Safety Net Providers for DSRIP A) Organization has more than $10,000 in Care Management claims billed to NYS Medicaid in 2013 (either directly or indirectly, criteria pending CMS approval) B) Organization meets Safety Net Designation based on NPI match. Providers may want to verify the Safety Net Status on alternate Safety Net lists.

Entity Name

GATEWAY LONGVIEW GAY MENS HLTH CRISIS AIDS AI GENESEE CTY MH GREEN COUNTY MENTAL HLTH MH HARLEM HOSPITAL CENTER HARLEM UNITED COM AIDS CTR AI HEARTSHARE HUMAN SVCS MR AI HELP/PSI AIDS ADHCP HHC BELLEVUE HSP CTR COBRA AI HHC ELMHURST HSP CTR COBRA AI HHC KINGS CO HSP CTR COBRA AI HHC METROPOLITAN HSP COBRA AI HHC WOODHULL MED CTR COBRA AI HHC/BELIEVUE HSP CTR SCM HONOR EHG INC HORIZON HEALTH SERVICES MH HOUSING WORKS INC AI HUDSON HEALTH PLAN INC HUMAN DEV SER WESTCHESTER MH INSTITUTE/COMMUNITY LIVING MH JAWONIO MH JEWISH BD FAM/CHILD SVCS MH JEWISH CHILD CARE ASSOC MH L I ASSOC FOR AIDS CARE AI LAKEVIEW MENTAL HEALTH ICM MH LEXINGTON CTR FOR MH SERVICES LIBERTY RESOURCES INC LINCOLN MED MENTAL HLTH CTR AI LIVING OPP OF DEPAUL MH LIVINGSTON CO MH ICM LONG BEACH MED CTR CNSLG MH MENTAL HEALTH ASSOC ESSEX MH MENTAL HEALTH ASSOC/NASSAU MH MENTAL HEALTH ASSOCIATION IN MENTAL HLTH ASSOC MH MENTAL HLTH ASSOC ROCKLAN CO

Safety Net Criteria Type

A A A A B A A B A A A A A A A B A A A A A A A A A A A A A A A A A A A A

Entity ID Provider MMIS ID Provider NPI

Health Home Type

E0263549 E0157693 E0183386 E0071970 E0273828 E0124369 E0158344 E0133280 E0104467 E0113807 E0104468 E0104464 E0104466 E0140308 E0343146 E0079490 E0164894 E0251866 E0084749 E0074490 E0002091 E0156343 E0179492 E0125681 E0148197 E0263421 E0001939 E0026664 E0085356 E0133795 E0039733 E0144960 E0063906 E0029044 E0085999 E0024190

00356538 01422811 02996358 02994907 00246108 01756596 01416297 02995339 01955884 01862353 01955875 01955917 01955893 01596987 03533319 02993786 01350509 03112810 02996349 02256077 02941082 01436328 01203974 01743457 02993680 03358656 02994810 02735239 02997726 02996321 02604240 01550370 02362009 02997313 02140738 02995191

1710158134 1992903389 1588602064 1255360046 1033124961 1609087790 1528289642 1346464989 1730213042 1033237193 1548382732 1336261460 1619195377 1659490076 1881957678 1043387152 1538379573 1053545814 1578761359 1164549812 1609150416 1972788594 1992824189 1154446557 1033155833 1659351021 1225254881 1114048543 1861564221 1578656302 1669654794 1487940870 1912128224 1780882373 1881760197 1326105446

Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency

4

State Designated Health Homes and Downstream Care Management Agencies meeting Safety Net Criteria

State - Designated Health Homes and Downstream Care Management Agencies meeting Safety Net Criteria

Criteria Used to Identify Health Home Safety Net Providers for DSRIP A) Organization has more than $10,000 in Care Management claims billed to NYS Medicaid in 2013 (either directly or indirectly, criteria pending CMS approval) B) Organization meets Safety Net Designation based on NPI match. Providers may want to verify the Safety Net Status on alternate Safety Net lists.

Entity Name

MENTAL HLTH ASSOC/DUTCHESS MH MENTAL HLTH PROV/W QUEENS MH MH SVC ERIE NORTHWEST COR-SCM MHA OF COLUMBIA-GREENE MH MHA OF WESTCHESTER MID ERIE MENTAL HEALTH SVC MID HUDSON VALLEY/ARCS AI MONTEFIORE MEDICAL CTR AI MORRIS HEIGHTS HLTH CTR AI MOUNT VERNON HOSPITAL NARCO FREEDOM CN AI NATIONAL ASSOCIATION ON DRUG ABUSE NEW DIRECTIONS YOUTH/FAMILY SER MH NEW HORIZON COUNSELING CTR MH NORTH COUNTRY TRAN LI SER MH OCCUPATIONS INC MH MR OFFICE MENTAL HEALTH MH OPTIONS FOR COMM LIVING AI ORLEANS COUNTY COMM SVC MH OSWEGO HOSPITAL OTSEGO COUNTY COMM SRV MH OUTREACH DEVELOPMENT CORP PARK RIDGE MENTAL HLTH CTR MH PARSONS CHILD AND FAMILY CTR PEDERSON KRAG CENTER INC PHELPS MEMORIAL HSP ASSOC POSTGRADUATE CTR FOR MH MH PROJECT HOSPITALITY INC AI PSCH INC MH PUERTO RICAN FAMILY INST MH PUTNAM FAMILY & COMM SER MH REHABILITATION SUPP SVCS C RENSSELAER CNTY UNIFIED MH RESOURCE CTR INDEP LIV MH RICHMOND HOME NEED SVCS AI ROCHESTER MENTAL HLTH CTR MH

Safety Net Criteria Type

A A A A A A A B A A A A A A A A A A A B A A A A A B A A A A A A A A A A

Entity ID Provider MMIS ID Provider NPI

Health Home Type

E0067615 E0078340 E0144351 E0084746 E0169407 E0086760 E0170375 E0175558 E0158243 E0062602 E0177676 E0332696 E0184612 E0026358 E0086513 E0180988 E0186155 E0150830 E0186041 E0028320 E0183392 E0200318 E0162715 E0332598 E0028444 E0271655 E0081112 E0125471 E0081115 E0157553 E0092737 E0165585 E0185771 E0170246 E0172300 E0162708

02324885 02995820 02996876 02996990 02998103 02994796 01295394 02998167 01417303 03171166 01222191 03439925 01152721 02738301 02996087 01189019 01137237 01491574 02993759 02997771 01164956 00994803 01372403 02998034 02993575 03356681 02189682 01745555 02189655 01424217 02995857 02998070 01141102 01296684 01276080 02994030

1023173820 1477699791 1679698286 1700938560 1942306873 1225095201 1841339728 1952476988 1265651020 1326374810 1245272772 1295006526 1083771505 1336347251 1538294699 1124213277 1609933142 1497827182 1043345713 1871678458 1528008257 1083717326 1235287525 1922171305 1013964170 1720185267 1710036546 1598882284 1386817906 1588873327 1497737167 1922293745 1942597232 1891989794 1689729782 1093812729

Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency Care Management Agency

5

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