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Crossroads Community Inc.

Health Home

Where Care Of Mind & Body Meet To Promote Overall Health

What is Health Home?

Crossroads Community’s Health Home Program offers individually focused care. It empowers participants to manage and prevent chronic conditions, with a goal of improving overall health and reducing avoidable hospital visits. This is a community-based approach, not a residential program. Health Home integrates physical and behavioral health services for individuals with chronic conditions. We offer participants enhanced care-coordination services, working with participants’ primary care providers, specialists and behavioral health providers. There is not an actual referral form for this service. When an individual starts Crossroads’ Psychiatric Rehabilitation Program (PRP), Health Home will be available as an adjunct service.

Health Home Services

  • Comprehensive Care Management.  We create a treatment plan, set health and wellness goals, and address any challenges to physical and behavioral health needs.
  • Health Promotion.  We provide individuals with the knowledge and guidance to improve their overall wellness. Training, information and support are tailored to each person’s unique health challenges. We offer health education on chronic conditions, sexuality and family planning, development of a self-management plan, medication use, nutritional and physical activity counseling, smoking cessation and more.
  • Care Coordination. We help people get the care they need, make appointments and connections with primary care providers and specialists. We request and review participants’ medical records, consult about their status or needs with medical providers, help schedule medical appointments, provide referrals to specialists and track immunizations.
  • Comprehensive Transitional Care. We help in transitions to a different level of care if an individual is hospitalized or needs treatment in an outpatient facility. We review discharge statements, facilitate transfers, review medication changes, update care plans and schedule follow-up care.
  • Individual Family Support. We help participants and their caregivers find pharmacies, counseling and other services, assisting with overall health management. We offer support with scheduling, health literacy, medication adherence and advocacy for both participants and caregivers.
  • Referral to Community and Social Support. We provide connections to other community programs and support, including information or assistance with Medicaid eligibility, disability benefits, social services, NA/AA, housing, legal services, peer support, life skills, education and vocational training.

Eligibility

In order to participate in the Health Home Program, the individual must:

  • Have a serious and persistent mental illness and be receiving PRP services (adults)
  • Have a serious emotional disturbance and be receiving PRP services (youth)

Health Home services are available to both children and adults.

Locations

Services are provided in the following counties: Queen Anne's, Kent, Talbot, Caroline & Dorchester.

Administrative Offices &
Queen Anne’s County Program Services

120 Banjo Lane
Centreville, MD 21617
Phone: 410-758-3050
Fax: 410-758-1223

Kent County Services
937 Gateway Dr.
Chestertown, MD 21620

Dorchester Services
404 LeCompte Street
Cambridge, MD 21613