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InterboroughDevelopmental&ConsultationCenter
1623King'sHighway
Brooklyn,N.Y.11229
HCBS/HARP
Homeand Community Based Services at Interborough:
Empowerment Services- Peer Support: This service uses trauma-informed non-clinical
assistance to archive long-term recovery from SUD and Mental health issues. Including advocacy,
outreach and engagement,companionship, raising awareness of existing services in the
community, interim home visits after hospitalization. Peer will be assisting and helping selecting
and utilizing self-directed recovery tools, helping recognize your sense of passion, purpose and
meaning in life. Connect to natural supports that enhance the quality and security of life.
Family support and Training: This service includes instructions about treatment regiments,
elements, recovery support options, recovery concepts, medication education specific for the
individual to safely maintain the participant at home and in the community. The family will also
benefit with this service by enhancing their skills when helping the participant.
Habitation: This service is provided on a 1-1 basis, it is designed to assist participants in
acquiring, retaining and improving skills such as communication,self-help, domestic, health care,
self-care, socialization, motor skills, mobility, personal adjustments, relationship development,
use of community sources, it will allow the participants with the developing skills necessary for
community living and if applicable, to continue the process of recovery.
Psychosocial Rehabilitation (PRS): This service is a consumer choice and the active
involvement of persons in their rehabilitation. PRS practice is guided by the basic philosophy of
rehabilitation which holds that people with disabilities need opportunities to identify and choose
for themselves their desired roles in the community with regard to living, learning, working
and/or participating in social environments. PSR support focuses on four main areas of recovery:
basic living skills development, psychosocial skills training, therapeutic socialization, and
supported employment.
For more information please call or email:
Rosario at 718-375-1200 X335
rrodriguez@interborough.org
InterboroughDevelopmental&ConsultationCenter
1623King'sHighway
Brooklyn,N.Y.11229
Home and Community Based Service Referral -HARP Eligible
 1 or more of the following:
 2 or more chronic medical conditions
 a Serious Mental Illness diagnosis –Major depression,Bipolar,Schizophrenia,or Schizoaffective
 HIV/AIDS
For more information abouteligibility,pleasecontactRosario Rodriguez atInterborough (718) 375 1200 ext. 335,
or email me at rrodriguez@interborough.org
Please Print clearly and Fill out all the information below about the person you are referring in
order to process the individual:
Name: __________________________ Phone Number: _______________________
Date of Birth: _____________ Gender: ____________ Cell Number ____________________
Medicaid Managed Care Insurance ID: ____________________ Medicaid ID Number: _____________
Address: _______________________________________________________________________________
Apartment Number: ____________ Borough: ___________ Zip Code: ______________________
Diagnoses:
Medical: _____________________________________________________________________________
_____________________________________________________________________________________________
Mental Health: _______________________________________________________________________
______________________________________________________________________
Please check which services apply to this particular participant:
Psychosocial Rehabilitation (PRS) __________ Family Support: ____________________
Habitation: ______________ Empowerment Services-Peer Support: ___________
All of the above: _______
Name of Person Making Referral: ______________________ Phone Number: ______________________
Email Address: _________________________________ Date: __________________
InterboroughDevelopmental&ConsultationCenter
1623King'sHighway
Brooklyn,N.Y.11229

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referral for HCBS

  • 1. InterboroughDevelopmental&ConsultationCenter 1623King'sHighway Brooklyn,N.Y.11229 HCBS/HARP Homeand Community Based Services at Interborough: Empowerment Services- Peer Support: This service uses trauma-informed non-clinical assistance to archive long-term recovery from SUD and Mental health issues. Including advocacy, outreach and engagement,companionship, raising awareness of existing services in the community, interim home visits after hospitalization. Peer will be assisting and helping selecting and utilizing self-directed recovery tools, helping recognize your sense of passion, purpose and meaning in life. Connect to natural supports that enhance the quality and security of life. Family support and Training: This service includes instructions about treatment regiments, elements, recovery support options, recovery concepts, medication education specific for the individual to safely maintain the participant at home and in the community. The family will also benefit with this service by enhancing their skills when helping the participant. Habitation: This service is provided on a 1-1 basis, it is designed to assist participants in acquiring, retaining and improving skills such as communication,self-help, domestic, health care, self-care, socialization, motor skills, mobility, personal adjustments, relationship development, use of community sources, it will allow the participants with the developing skills necessary for community living and if applicable, to continue the process of recovery. Psychosocial Rehabilitation (PRS): This service is a consumer choice and the active involvement of persons in their rehabilitation. PRS practice is guided by the basic philosophy of rehabilitation which holds that people with disabilities need opportunities to identify and choose for themselves their desired roles in the community with regard to living, learning, working and/or participating in social environments. PSR support focuses on four main areas of recovery: basic living skills development, psychosocial skills training, therapeutic socialization, and supported employment. For more information please call or email: Rosario at 718-375-1200 X335 rrodriguez@interborough.org
  • 2. InterboroughDevelopmental&ConsultationCenter 1623King'sHighway Brooklyn,N.Y.11229 Home and Community Based Service Referral -HARP Eligible  1 or more of the following:  2 or more chronic medical conditions  a Serious Mental Illness diagnosis –Major depression,Bipolar,Schizophrenia,or Schizoaffective  HIV/AIDS For more information abouteligibility,pleasecontactRosario Rodriguez atInterborough (718) 375 1200 ext. 335, or email me at rrodriguez@interborough.org Please Print clearly and Fill out all the information below about the person you are referring in order to process the individual: Name: __________________________ Phone Number: _______________________ Date of Birth: _____________ Gender: ____________ Cell Number ____________________ Medicaid Managed Care Insurance ID: ____________________ Medicaid ID Number: _____________ Address: _______________________________________________________________________________ Apartment Number: ____________ Borough: ___________ Zip Code: ______________________ Diagnoses: Medical: _____________________________________________________________________________ _____________________________________________________________________________________________ Mental Health: _______________________________________________________________________ ______________________________________________________________________ Please check which services apply to this particular participant: Psychosocial Rehabilitation (PRS) __________ Family Support: ____________________ Habitation: ______________ Empowerment Services-Peer Support: ___________ All of the above: _______ Name of Person Making Referral: ______________________ Phone Number: ______________________ Email Address: _________________________________ Date: __________________