A revised draft of New York State Medicaid Managed Care Organization I/DD System Transformation Requirements and Standards to Serve Individuals with Intellectual and/or Developmental Disabilities in Specialized I/DD Plans – Provider Led (SIPs-PL) is now posted online for comment.
DOH and OPWDD have undertaken a transition for people with intellectual and developmental disabilities (I/DD) to specialized managed care. Over the past two years, this process has been focused on two distinct areas: (1) improvement in care management processes using a home health model; and (2) creation of a policy framework for the implementation of provider-led managed care. This notice is published in order to update people we support, families, providers and other stake-holders on the progress we have made in these areas.
In July 2018, DOH and OPWDD launched an enhanced care management program to support individuals with developmental disabilities and their families. This program consolidated more than 350 agencies providing Medicaid Service Coordination into 7 regional Care Coordination Organizations (CCOs) providing Health Home Care Management. At the same time, we expanded the role of the new care managers, moving from OPWDD service-centric Individualized Support Plans (ISPs) to integrate and coordinate health and habilitative services through an expanded Life Plan. Approximately 100,000 individuals transitioned to this new model.
In August 2018, DOH and OPWDD released a draft version of the Qualification Document for stakeholder review and comment.
The draft document was revised based on the feedback received and the revised draft is being released for further public comment. Additional feedback to this revised Qualification Document received during the second opportunity for public comment will be used to better inform the State on how best to implement a transition to managed care.
Health Home Program
Division of Program Development & Management
To our Workforce, Members and Families:
We are excited to announce that it is now official, Care Design NY (CDNY), the largest Care Coordination Organization (CCO), has aligned with Partners Health Plan (PHP), which is currently the only provider-led managed care plan solely supporting individuals with intellectual and/or developmental disabilities in the Country.
Under the new alignment, Partnerships, the parent organization to PHP, will also become the parent to CDNY making PHP and CDNY “sister agencies”. This alignment is consistent with New York State’s vision for the move to managed care by developing strong, provider-led managed care plans built from the foundation CCOs have laid for comprehensive care coordination and the investments they are making for managed-care start-up costs.
The two organizations will be strengthened by supporting each other and sharing resources to be more effective and efficient. From a workforce perspective, this action will not result in anyone losing their job.
From the standpoint of our membership and their families, this alignment will only strengthen our ability in the long term to assist members in accessing the supports and services they need to achieve their life goals, while promoting good health and wellness.
We look forward to the future and making a difference in the lives of our members!
James Moran, CEO, Care Design NY
Kerry Delaney, CEO, Partners Health Plan
8 Southwoods Blvd
Albany, NY 12211