In July and August of 2019, Care Design NY held managed care focus groups in four regions throughout New York State (NYS), including Long Island, Manhattan, Hudson Valley and Capital District/ North Country.
The focus groups were facilitated by a neutral third-party contractor.
The goal of these focus groups was to offer individuals and families the opportunity to share with Care Design NY their thoughts, feelings, concerns, and questions about the anticipated roll-out of managed care in NYS for individuals with intellectual and/or developmental disabilities.
We would like to use the information learned in these sessions to produce meaningful education and outreach materials for individuals and families.
In the meantime, individuals and families should continue to build natural supports. The Care Design NY Care Manager will continue to assist with resources in the community i.e.; Guardianship, Special Needs Trust, and Supportive Decision Making
Given the long delay in circulating the revised application to the public, it is likely that NYS will host another public comment period.
Visit the New York State OPWDD and Department of Health (DOH) websites for information the agencies will post for individuals and families during the transition period. Information can be accessed from the following websites:
We will also keep individuals and families up to date through Care Design NY’s website, social media and other communications.
This will depend on the plan that the individual chooses to utilize.
We will be updating individuals and families on the plans that will be available and ensure they have all the information needed to make an informed decision about the managed care plan that is right for them. Your Care Manager will be able to assist you should you have any questions when reviewing the plans. This includes a review of the doctors, specialists, dentists, etc. in the plan’s Provider Network.
Each managed care plan will be expected to build a Provider Network, including dentists. Once we have the information for each managed care plan, we will ensure that the information is shared in a timely manner so that informed choices can be made.
We will not have the final details on this until the revised application is released by NYS.
Once we have the information for each managed care plan, we will ensure that the information is shared in a timely manner so that informed choices can be made.
You should reach out to your Care Manager to discuss this further. We will also add this topic to future webinars that we conduct for individuals and families throughout the year. Individuals and Families can also connect with Advocacy Groups i.e. Parent to Parent and Self Advocacy Association of New York State (SANYS).
However, Medicare doesn’t pay for OPWDD supports and services, only Medicaid. Therefore, when the OPWDD supports and services are included in the managed care benefit package, the expectation is that individuals will need to enroll in a managed care plan to receive those services once there is mandatory enrollment.
Also, similar to Medicare, private insurance does not pay for OPWDD supports and services. Therefore, when the OPWDD supports and services are included in the managed care benefit package, the expectation is that individuals will need to enroll in a managed care plan to receive those services once there is mandatory enrollment.
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8 Southwoods Blvd
Albany, NY 12211