Case Management Forms
Welcome to the STAR Health Center (SHC) – Your Medical Home!
At SHC you can expect state-of-the art medical care with staff that will treat you with respect and kindness.
You may never need someone to act on your behalf, but it is always better to be prepared to ensure that you receive the care you want in the manner you want it.
For more information, speak to your health care provider, case manager, or counselor. You may also download and complete your case management forms; please fill them out, print them, and bring them back your case manager when you are ready:
- ADAP Application
- ADAP medical form
- DOH-Form_Physicians-Order
- Electronic Consent
- God’s love we deliver
- HIV HIPAA
- Intake Guidelines
- Intake Package
- M11Q
- Six Months Attestation
- WIC Form
Please read the following to learn what you can expect at SHC.
An introduction….
Health Care Team
A team of medical providers, nurses, case managers, adherence counselors, mental health counselors, a nutritionist and clerical staff will be working with you to provide your complete care at SHC. A medical provider and a case manager will be assigned to you, so please get to know their names and write down their phone numbers so you can reach them when needed.
Medical Information
You will be asked to sign a release of medical records form so we can get your medical information from other health care providers. This medical information is essential for continuity of care. Please let your case manager know if you are working with outside case managers and medical providers so we can communicate with them to ensure you receive all of the services you need.
Contact Information
The clerical staff will ask you for your contact information during the first visit and at EVERY visit. It is important that you always give us a working phone number, so that your medical provider can contact you for issues such as follow-up of test results and appointment reminders. Please make sure to let us know right away if you have changed your address or phone number.
Insurance
If you do not have medical insurance your case manager will work with you to get a suitable insurance. Please deliver the necessary papers needed for processing the insurance on time in order to avoid delay in getting medical care. It may be difficult to get some services and medications without medical insurance.
Languages and Special Needs
Staff in the SHC speak several languages including Spanish, French, and Haitian Creole as well as others. We have staff that can help you if you speak other languages or need special assistance for issues such as vision or hearing problems. Please let the clerk at the front desk know of any special needs when you register. We make every effort to accommodate special needs. If we feel we are unable to provide you with the best care, we will help you find a provider that is better able to provide you with the special services you need.
MetroCard
For your travel, a MetroCard is given on the days of your lab work, medical or mental health appointment. You will be given a paper slip, and you will go to the main registration window at the Clarkson Avenue entrance to get the MetroCard. The main registration closes at 4.30pm, so remember to collect your MetroCard before that area closes. The distribution of MetroCards is a special service of the SHC. Metrocards are not given for any other clinic visit or for prescription pick up.
Your ongoing care…..
Personal Health Plan
Your medical provider will develop an individual health plan for you with your input to keep you healthy. If needed s/he may refer you to see other specialists such as the cardiologist (heart), nephrologist (kidney), diabetes specialist, dentist, psychiatrist and mental health counselors. Please see these specialists in order to improve your health. Your provider will need to communicate with these specialists about your history and treatment in order to better understand the medical problem.
Medical Appointments
You will be seeing your medical provider at least 4 times a year. Depending on your health your provider can ask you to come more frequently. An appointment will be made according to your provider’s schedule. Let the clerical staff know if the appointment date is not convenient for you and it can be changed. You will receive a reminder call 2 days before your appointment. If you cannot come to your appointment please call the clinic and reschedule your appointment.
Lab/Blood Work
In order to make sure that you are in fine health and to see that the medications are working, you will be asked to come for blood test 2 weeks before your medical visit. It is very important that you keep this appointment.
Annual Comprehensive Visits
A comprehensive medical examination will be conducted once a year and that visit will be longer than your routine visit. You will be seeing the nurse, adherence counselor, case manager and the nutritionist, in addition to your medical provider. You will be told when you are due for your annual exam, so when you are scheduled for that appointment, please be prepared to spend 2 hours in the clinic.
Walk-In Service
You can come to the clinic if you have an urgent medical problem on the days when you don’t have a scheduled medical visit. Depending on the seriousness of your medical condition, you may be sent to the emergency room or be seen by a provider in the clinic. If your problem is not an emergency, you may have to wait until after the providers see their scheduled patients. If you have a medical problem that has been present for a long time, please do not come in as a walk-in. Schedule an appointment with your own provider who best knows your medical history.
Prescriptions
Your provider will prescribe medications if needed. Make sure that you take these medications as directed to improve your health. Prescriptions for your medications will be given to you by your provider during your visit with refills. Please make sure that you read the medication bottle and understand how many refills are left. If you have refills you can call the pharmacy directly for your next month supply. We do not fax prescriptions. Our turn-around to write a new prescription is 3 days. If you want to enroll with one of the 3 pharmacies with whom we have established agreements, the pharmacy will pick up your prescription in the SHC and the medication will be delivered to your home. If you have any questions about your prescription you can talk to your provider or the adherence team.
Pain Management
Your medical provider will check you and find out the cause of pain. Simple pain medicines will be given to you (Tylenol, Motrin). Your provider will send you to pain management clinic if your pain does not go away with the above medicines. The specialists in the pain management clinic will then take care of your pain. You will have to see the specialists in order to get pain medicines.
Mental Health Care
Your health care team will periodically ask you questions about how you are feeling emotionally and whether you are using alcohol or drugs to help you deal with your problems. If you are feeling particularly sad, irritable, worried, have difficulty sleeping, or lack of appetite you may benefit from talking to a counselor who will help you work through these issues and get the help you need. Please ask your provider to refer you to one of these mental health or substance abuse professionals.
Case Management
You personal case manager will help you get the services you need, so talk to your SHC case manager about what you need to improve your life situation. The case manager will refer you to other to organizations for services such as housing and legal counseling as well as many others. Your case manager will also help you fill out forms for benefits, but it sometimes takes a little time to complete. There is a wait time of 5 business days for non urgent forms & 2 business days for urgent forms.
Peer Services
People who understand what you are going through can be a big help in developing a plan to keep you healthy. Our trained peer educators would be glad to talk to you if you feel you would benefit from their experience. If you would like to talk to someone about how you can play a bigger role in developing your own health care plan or if you need help with all of your medications please ask to speak with a Peer Leader.
Support Groups
SHC has a variety of groups to support your health care such as acupuncture, relapse prevention, nutritional education, and medication education. Please talk to your provider, case manager or counselor for information on current groups.
Clinical Research / Trials
SHC offers the opportunity to participate in clinical research. Ask your medical provider regarding your eligibility to participate in the trials.
Policies of the SHC you need to know….
Confidentiality
At SHC we strive to maintain your privacy and confidentiality. When we call you for appointment reminders or abnormal test result or for any other reasons, we will be discreet and will only mention your doctor’s office. We will not divulge any other information. We will not talk to any family members unless you have given permission.
Waiting Room
A waiting room is provided for your comfort. There is water, juice, coffee and tea in the mornings in the waiting room. Please respect other clients’ privacy and space and do not engage in loud cell phone conversation or act in a rude manner. There is also a computer in the waiting room for clients of SHC. We request that you do not use the computer for more than 20 minutes so as to allow others an opportunity to use it.
Lateness Policy
If you are late by more than 30 minutes to your appointment you may not be seen that day but you will be given another appointment. In order to avoid not being seen please call the clinic at 718-270-3745 to inform us that you are running late.
Grounds for Discharge
At SHC we treat our patients with respect and dignity and hope that our patients will treat us and other patients the same way. We want to provide the very best care in a safe environment. If specific actions or new situations render us unable to provide excellent care, we will discharge you from the SHC and work with you to find another health care provider who can meet your needs. Below are reasons you may be discharged from the SHC.
- Threatening or violent behavior towards any person in the clinic
- Coming to the clinic under the influence of alcohol or illegal drugs
- Carrying weapons of any kind
- Stealing from the clinic, staff or another patient.
- Repeated rude behavior
- Insurance fraud
- Misusing medicines given to you for your care
- Not following the plan of care your provider gives you.
- Getting care from another primary care clinic at the same time
- If SHC is unable to provide the specific type of care you need
Filing a Complaint.
If you feel that any of the SHC staff has not treated you well you can ask to speak to their supervisor. If the supervisor is not available you can ask to speak with the Administrative Director or the Behavioral Health Director of the clinic. You can also file a complaint with Patient Relations. Your complaint will be taken seriously and you will get a verbal or a written response.
Thank you for choosing STAR Health Center for your care. We hope to be your partner in your medical care so you get the most benefit from our services.