Encompass Health Home


In 2018, Catholic Charities administration took several steps to improve services for members and develop a stronger program.

Changes that were implemented to strengthen the program and provide staff with the tools they need included:

  • A care manager specific training program (including shadowing and field work prior to any new cases)
  • Retreats and team building days to plan and elicit input from each team on ideas to improve the program
  • A Wellness Committee to address the health and wellness needs of staff members

Throughout 2018 there was a large push from DOH, OMH and the Lead Health Homes for all Care Management Agencies to conduct the Community Health Assessment for Health and Recovery Plan (HARP) enrolled behavioral health members who are eligible to receive additional home and community based services (HCBS). Staff were required to conduct a specific additional assessment and subsequent plan of care for those members who chose to enroll in this new array of services. This has now been added into the regular work flow and initial training done with care managers who are able to readily incorporate into their daily responsibilities.

In 2018, caseload size was decreased from 40 to 35. This has allowed care managers to provide better quality services.

Bernard: Before working with Encompass, life was unbearable for Bernard. On drugs and unemployed, he was always in and out of the hospital and never made his appointments. After getting out of jail, Bernard found help from his Care Manager, Ngozi, who stepped in to help fulfill his basic needs, such as housing, clothing, and proper medication. Ngozi also helped Bernard get established with a doctor and therapist, and makes sure he attends his appointments. While hesitant to accept her help at first, Bernard now realizes the impact that she has had on his life and is thankful to have her checking in on him. Bernard says that what sets Encompass apart is that the people actually care about you and want to see you do good.


The staff spent the 2018 year focusing on improving the quality of services and practicing best documentation procedures. Additional Health Information Technology tools were implemented to allow care managers to access more real time behavioral health information, enabling them to better perform their job.

Staff also continued to educate community providers and families on the goal and purpose of Health Home services and established greater collaborations with local community providers. Collaboration around the SPOA process also continued to evolve throughout 2018 and referrals are reviewed regularly for care management services.

Staff continued to attend numerous trainings and implement policy changes throughout the year which presented a challenge in developing new work-flow processes with each change. Despite numerous challenges, the staff were able to minimize any negative impact on the youth and their families and they achieved a 97% satisfaction rating at the end of 2018.

Catholic Charities Family Care Management continued to expand its services through its second full year of operation as a Health Home care management agency. They served 165 children and families, 151 through enrollment and an additional 14 in outreach. This was done through the caring services of eight care managers and a supervisor. They carry on average 19 individuals on a caseload of youth/families with varying needs.


Jack Balinsky, Diocesan Director of Catholic Charities of the Diocese of Rochester

Vincent Colonno, CEO Catholic Charities of the Diocese of Albany

Michael Lawler, Director of Catholic Charities, NYS Catholic Conference

Michael Melara, CEO Catholic Charities of the Diocese of Syracuse, Chair

Dennis Walczyk, President and CEO Catholic Charities of the Diocese of Buffalo


Reanna: Growing up in an unstable home environment, Reanna found herself getting roped into trouble with her parents and having problems at school. Since working with Encompass, she has transferred to a new school and has found activities to participate in that give her an outlet for her energy. Reanna is hopeful for the future and is thankful for her care managers’ constant support.

Antonio: Antonio used to go days without attending school, instead staying home to play video games. Since working with Encompass, Antonio’s mother has learned better ways to provide structure to support her son in going to school. Forming a plan to take away his game’s power cord on certain days, Antonio’s school attendance has greatly improved. He continues to make progress, and has even started to participate in after-school activities.

Tyler: Tyler received a wake-up call on his latest birthday that if he didn’t get his act together, his reckless attitude would ruin his life. His violent behavior and feelings of entitlement have changed since working with Encompass. He has learned how to master his emotions and has become active in school. Tyler now realizes that life should be more about helping other people and he hopes to do this after graduating from High School this June.