Lynne A. Valenti
Cabinet Secretary

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Health Home Program

Health home recipients are required to receive non-emergent services from their Health Home Provider (HHP). They are also required to have a referral from their HPP for non-emergent specialty and hospital services. They can receive certain services called Health Home Exempt Services from other providers without a referral from their HPP.

Health Homes Forms

Health Home recipients wishing to select or change their health home provider should submit the Health Home Selection and Change Form. Health Home recipients have the right to say no to the Health Home Program. If recipients do not wish to participate should submit the following form. Decline to participate form.

Providers wanting to propose new members to Health Homes should complete the Manual Tiering Document and fax it to 605.773.5246 with the required supporting documentation.

Health Homes are responsible for assuring that their members receive all medically necessary care, including primaryspecialty and behavioral health care. If the recipient sees another provider, they will need a referral. Community Mental Health Center Health Homes can use the CMHC Health Home Referral Form to send their recipients to another provider, they can use their electronic health record or communicate the referral telephonically. The Primary Care Provider Health Homes can use the Health Home Referral Form to send their recipients to another provider, they can use their electronic health record or communicate the referral telephonically. In all instances the referral should be documented in the recipients Electronic Health Record.