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Medicaid Service Coordination » Upcoming Changes in Medicaid Service Coordination

Upcoming Changes in Medicaid Service Coordination

Dear Service Recipients and Family Members, 


I would like to share some information with you about upcoming changes in Medicaid Service Coordination (MSC) for people with I/DD in New York State (NYS), as well as DDI’s role in the process. 

 

What is changing about MSC?


OPWDD is changing the way MSC services are delivered and reimbursed. Beginning July 2018, MSC will become “Health Home Care Management”. Care Management services will be delivered by a new type of organization, called a Care Coordination Organization/Health Home (CCO/HH). CCOs are organizations that were formed by existing developmental disability service providers like DDI. These new organizations will be staffed by Care Managers with training and experience in the field of developmental disabilities (our former MSCs). The CCO/HH that DDI partnered with is Advance Care Alliance of NY (ACANY). 

 

What is Advance Care Alliance of NY?


ACANY is a not-for-profit alliance of existing OPWDD provider agencies with decades of experience offering high quality community-based programs to people with I/DD and their families in NYC, Long Island, and the Lower Hudson Valley. ACANY is one of several organizations throughout New York State that have received initial designation letters from OPWDD that will allow them to begin operating as CCO/HHs on July 1, 2018.  Click here to learn more about ACANY.

 

How will I know which CCO is better for me?

 

CCO/HHs will be formed by agencies that currently provide OPWDD services and will deliver care management. In most cases, an individual will likely opt to maintain the relationship with his or her current MSC provider once the transition to CCO/HH care coordination takes place and start in the CCO/HH that his or her MSC provider joined. However, an individual is free to choose any CCO/HH in his or her region. CCO/HHs will work to explain the benefits of their programs to you.

 

Why is MSC becoming Care Management?

 

The new Health Home Care Management is an improved type of service coordination that will better support people, including those with complex needs. It will allow for better information sharing across service systems, resulting in more flexible and comprehensive service planning. The purpose is to make sure that all the services and supports received are high quality and reflect yours, and/or your family member’s personal goals and preferences.

 

Will this transition impact other OPWDD services?

 

This transition will NOT impact any of the other OPWDD-funded services a person may currently receive, such as living in a certified residence, day habilitation, respite, community habilitation, supported employment, etc.

 

What can I expect over the next year?


July 1, 2018 through June 30, 2019 will be a one-year period focused on relaunching MSC services as Care Management under a designated CCO/HH. ACANY will work very closely with DDI to support the current MSC staff and team that currently provides you with MSC services as they take on the new role of Care Managers. ACANY will be training these existing MSC employees in the months leading up to July 2018 to help prepare them for their new roles. To assist in this transition and to minimize changes and any disruptions, your current MSC team will remain employed by DDI, as Care Managers, until the following year (July 2019). During this “transition year”, ACANY will reimburse DDI for our services and will also provide technical resources, special training and other supports to ensure their success.


Based on federal government rules, CCO/HHs must directly employ all Care Managers (MSCs) no later than July 1, 2019. ACANY will seamlessly hire our MSC team at that time, and we anticipate that they will continue to work at or very near their current location(s) into the future.

 

What do I need to do?


In the coming weeks, your current MSC will contact you to review more information about the transition and ask you to sign consent forms for this new level of service. Click here for additional information from OPWDD about the CCO/HH transition.


As OPWDD transitions to new, more comprehensive coordination of services, we will support your transition each step of the way. We look forward to working together to ensure a seamless process.


Sincerely, 
John Lessard
Executive Director