Fidelis Care, the non-profit Catholic health plan for New York State, announced the expansion of its Care at Home program last month to New York City and four counties in the Albany Diocese.

Now, patients with chronic illnesses or disabilities in the four counties - Albany, Rensselaer, Schenectady and Montgomery - can apply for the managed long-term care (MLTC) program as an alternative to nursing home placement.

Fidelis representatives say this will not only grant patients more independence, but also save taxpayers money by preventing the need for unnecessary emergency room visits or nursing home stays.

"It really gives [patients] the opportunity to live out their life the way they choose," said Elaine Morgan, assistant vice president for MLTC. "This is a great opportunity to be with family."

The change also means that patients without family, friends or neighbors to care for them have choices, and that the "sandwich generation" (caretakers of both children and elderly parents) can get a respite.

Nurse managers work with MLTC patients' support systems: physicians, service providers and family members. Services covered by the program include in-home nursing and health aides; physical, occupational and speech therapy; medical and social services; adult day care; medical equipment and supplies; podiatry, dental, audiology and optometry services; non-emergency transportation; and nutrition care.

Fidelis works with Catholic Charities, parish nurses, pastoral care workers and community organizations to find people eligible for its health services.

"They're often shut in at home. They don't have the services they need," said Michael Bucci, a Fidelis spokesman. "It allows them to feel a greater sense of dignity. They're treated as an individual with unique needs and with a lot of respect."

MLTC has been operating in Orange and Rockland Counties for four years. Last year, a state Medicaid redesign team recommended expanding use of such programs as part of reform efforts expected to save New York State $34.3 billion over the next five years, according to the state Department of Health website.

Home care management is "the wave of the future" for a rising population of aging adults, Ms. Morgan said. The Fidelis program also covers more "social and environmental supports" - for instance, air conditioners for patients with breathing issues or housecleaning for bedbug outbreaks - than fee-for-service Medicaid plans.

"It just gives us the latitude as times change," said Ms. Morgan.

Medicaid covers supplies like ramps and grab bars, she said, but Fidelis care managers streamline the ordering process. They can also check up on patients who forget to take their medications and supply them with programmable, talking medication-dispensing units. Fidelis intends to expand the Care at Home program across the state and expects Fidelis membership to rise. Representatives want to debunk myths that Fidelis only covers Catholics or that care management means nursing home placement.

Fidelis offers affordable health insurance in 59 counties. It was founded in 1993 "as a way for the Church to extend its mission to serve the needy," said Scott Averill, vice president of marketing.

"This is our core business," Mr. Averill said. Care at Home "just extends that mission to those who have challenging circumstances."