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CHI Health Partners Network | CHI Health Creighton University Medical Center Bergan Mercy

Network of health providers offering the following services: patient care coordination, nursing home network and referrals, post-discharge medication review, coordinates home health services, provides medical equipment delivery, medication management, nutritional management, and social work services focused on financial, legal, housing, mental health, and family issues.

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Counseling Services | Cunningham Children's Home

Offers counseling and wellness services for youth, adults, and families in the community who are experiencing difficulty in relationships, socialization, physical or mental wellness and emotional concerns. Some services/counseling types include, individual and family counseling, group sessions, case management, child abuse, sex abuse, and neglect, domestic violence, major depressive disorder, bi-polar disorder, and other mood disorders, parent/child relational issues, and PTSD and other anxiety disorders.

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Intact Family Services | Catholic Charities - Diocese of Springfield

The goal is to keep troubled families together by offering them intense case management, education in parenting, and links to community resources. A caseworker will help the family to develop a short-term, agreed upon plan to make the changes that will help keep the children safe. Services such as counseling, domestic violence prevention, substance abuse treatment, mental health treatment, parenting coaching/classes, or housing can be provided.

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Community Health Representative Program | Meskwaki Nation

Provides outreach, health care services, and health promotion/disease prevention services.

Offers transportation to Marshalltown Dialysis Center and specialty clinics for patients referred by the Meskwaki Clinic.  

Sets up and delivers medication to patients who require assistance.  

Emergency Care case management and coordination after a hospital discharge. 

Monitors patient blood sugar levels, blood pressure, weight, and medications.  Home visits to diabetes patients and hospital discharge patients.  

Health promotion and disease prevention programs.  

Translates medical instructions to Meskwaki when needed.

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SASS (Screening, Assessment and Support Services) | Heritage Behavioral Health Center

SASS provides the following services for children and youth:

Crisis intervention

Short-term stabilization where a child is at risk of self-harm, or harming others

Individual and family psychotherapy/counseling

Mental health assessment

Case management and resource linkage assistance

Psychiatric services

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Intact Family Services | Catholic Charities - Diocese of Springfield

The goal is to keep troubled families together by offering them intense case management, education in parenting, and links to community resources. A caseworker will help the family to develop a short-term, agreed upon plan to make the changes that will help keep the children safe. Services such as counseling, domestic violence prevention, substance abuse treatment, mental health treatment, parenting coaching/classes, or housing can be provided.

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Pathway of Hope | Salvation Army - Des Moines

Offers case management services to any families that have a child or children in the household under the age of 18. Assessments are done to check if family would benefit from the case management services. Case management is offered to help families reach stability and get out of poverty. Participation is usually a 3 month commitment or longer. Goals created are client oriented, whether it's for housing, going back to school or help finding resources to help family meet the goal.

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Senior Services | York County Aging Services

Services and activities for senior citizens within York County to support their independence and community involvement.

Information and referral, including referrals for minor home repair, yard work, personal care, and homemaker services.

Counseling and case management.

Recreational activities.

Assistance with Medicare and medical insurance.

Friendly visiting.

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HealthWorks | Logan County Department of Public Health

The purpose of HealthWorks is to assure that DCFS wards who are in substitute care receive comprehensive quality health care services. By linking each child to a primary care physician, the child will receive higher quality and more consistent care, as well as reduce dependence on emergency room care.

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Community Health Representatives | Winnebago Public Health Department

The Community Health Representatives provide the following services:

-- Case Finding/Screenings

-- Case Management

-- Home visitation services

-- Blood Pressure and Blood Glucose Screenings

-- Patient Care Services and Other Patient Services

-- Consults (medication, medical orders, appointments)

-- Environmental Health

-- Homemaker Services

-- Community Development

-- Health Education

-- Local transportation

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Advocacy | Epilepsy Advocacy Network

Provides the following services

- Case coordination. 
- Advocacy. 
- Transportation resources. 
- Financial resources. 
- Medication assistance.
- Special care.
- Education outreach.
- Seizure response training.

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Health Partners Network | CHI Health Saint Francis

Network of health providers offering the following services: patient care coordination, nursing home network and referrals, post-discharge medication review, coordinates home health services, provides medical equipment delivery, medication management, nutritional management, and social work services focused on financial, legal, housing, mental health, and family issues.

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Public Health Nursing Programs | Shelby County Health Department

Offers immunizations, vaccines, family case management, pregnancy testing services, county school nursing, vision and hearing screenings, high-risk infant and maternal home visits, childhood lead poisoning prevention, Kid Care enrollment.

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Integrated Health Services | Pathways Behavioral Services

Provides care coordination and family support services to families whose child struggles at school or home due to behavioral health issues.  Also provides integrated health services to adults diagnosed with serious mental illness.

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Early Start Program | Brightpoint - Central Region

Home visitation program for pregnant parents and families with children up to age three. The program provides case management services, including individual needs assessments, the development of care plans, and the coordination of service delivery. Staff advocate for families, monitor progress, and ensure services are obtained to maximize child development and provide a foundation for school success. Services also include developmental screening to minimize potential learning barriers and interventions designed to prevent child abuse and neglect.

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Integrated Health Services | Pathways Behavioral Services

Provides care coordination and family support services to families whose child struggles at school or home due to behavioral health issues.  Also provides integrated health services to adults diagnosed with serious mental illness.

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Pharmacogenomics Testing - PGX | Western Community Health Resources

Provides pharmacogenomics testing to individuals who are experiencing behavioral health issues that may require prescription treatment.

The PGX testing includes a genetics profile identifying indicators for successful medication treatment options that match with individual genetic makeup. The testing process will include a patient/provider wraparound model to improve care coordination, close care quality gaps, achieve treatment goals, gain control of chronic conditions, reduce hospitalizations and readmissions.

Members of the team may include primary care providers, psychiatrists, mental health therapists, service coordinators and others essential to the positive outcome of the individual.

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Unite Nebraska | United Way of the Midlands

Provides a coordinated care network consisting of healthcare, government, nonprofit, and other organizations.

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Pathway of Hope | Salvation Army of Elgin

Offers comprehensive case management system that helps families identify barriers to self-sufficiency and connects them with community support organizations. Barriers could include unemployment, insecure housing, lack of job skills, lack of child care.

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Pharmacogenomics Testing - PGX | Western Community Health Resources

Provides pharmacogenomics testing to individuals who are experiencing behavioral health issues that may require prescription treatment.

The PGX testing includes a genetics profile identifying indicators for successful medication treatment options that match with individual genetic makeup. The testing process will include a patient/provider wraparound model to improve care coordination, close care quality gaps, achieve treatment goals, gain control of chronic conditions, reduce hospitalizations and readmissions.

Members of the team may include primary care providers, psychiatrists, mental health therapists, service coordinators and others essential to the positive outcome of the individual.

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Benefits Advocacy | Fifth Street Renaissance/SARA Center

Provides an advocacy and case management program designed to increase access to SSI/SSDI for eligible adults who are homeless or at risk of homelessness and have a mental illness and/or co-occurring substance use disorder or other medical impairments. Provides assistance with the SSI/SSDI application process.

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Community Support Teams | Trinity Services

Offers intensive, community-based therapeutic and case management services for individuals with mental illness.

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Pathway of Hope | Salvation Army of the Siouxland

Pathway of Hope assists families through crisis and instability, financial counseling and planning, goal setting with manageable action steps, job training, referrals and employment assistance, assistance with securing housing and child care, emotional and spiritual support.

Case workers meet with families weekly using the Strengths Model to focus on possibilities rather than problems and to establish goals.

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Integrated Health Services | Pathways Behavioral Services

Provides care coordination and family support services to families whose child struggles at school or home due to behavioral health issues.  Also provides integrated health services to adults diagnosed with serious mental illness.

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Willing Partner (Case Management/Social Work Services) | Heart Ministry Center

Navigators are available to meet with clients to discuss their situations and plan to help assist them with their move forward. Participants first attend orientation. Financial assistance, assistance with personal items, and other resources can be sought through an agency Navigator.


Emergency assistance not currently available.

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