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Medicaid Service Coordination for children and adults with intellectual and developmental disabilities (I/DD) is changing in New York City and all across NYS! As a person with a disability, or a family member/advocate for a person with a disability, there is some very important information that you need to know to either enroll in services or to ensure that services continue.
On July 1, 2018, Medicaid Service Coordination services that we know today will end and will be replaced by a new, more robust service called Care Management. This service will be provided through specialized Care Coordination Organizations (Health Home CCOs) that have been approved by NYS. There will be three CCOs in New York City, including Care Design New York, Advance Care Alliance of New York and Tri-County Care. The new service will be even better for people with I/DD because, in addition to providing the service coordination support that you already receive, it will coordinate and connect to more comprehensive services, including health, behavioral health, long-term care and all the Medicaid-funded services and supports that a person with I/DD might need.
The 105,000 individuals already in the OPWDD service system statewide, as well as children and young adults entering the OPWDD system (many of whom are transitioning from Department of Education programs), will all need to enroll in a CCO as part of this change. By July 1, all individuals with I/DD will need to be enrolled with one of the three new CCOs in New York City in order to receive or continue to receive a variety of Medicaid services funded by the New York State Office for People With Intellectual and Developmental Disabilities (OPWDD), including adult day habilitation, prevocational and employment programs; certified residential programs; in-home and community supports, including community habilitation and respite care. Individuals supported through self-direction will also have to be enrolled.
For those with existing Medicaid Service Coordinators, the current Medicaid Service Coordinator (MSC) will help with the transition and enrollment process with the goal of the MSC continuing as the person’s Care Manager in the new CCO, so that there is no disruption in the coordination of services, based upon individual choice. This process will begin around April 1, 2018, and the current MSC will be reaching out to each person they support to notify them of the process and choices involved. Medicaid Service Coordinators will most likely transition their employment to the CCO with whom their agency is affiliating. The goal is for you keep your current service coordinator if you enroll in the Health Home CCO. You will have the option to choose the CCO that the agency that provides your MSC services has joined. However, if an individual or the individual’s family want to join a different CCO, they will be able to select a different CCO in April or in the future should they change their mind.
Individuals who are new to OPWDD services will need to contact OPWDD’s “Front Door” to start the eligibility process. There, staff from OPWDD will inform you about available services and the requirements to enter the service system, including enrolling in Medicaid if the person has not already done so. You will also be given information about the three CCOs that will be providing care management and be asked to select one of them. . The benefit of completing the OPWDD eligibility process is receiving ongoing support services for your family member and family as whole that can be funded through Medicaid and requires no out-of-pocket costs to you.
To further understand these changes and the upcoming enrollment process, the most important thing you can to do is to get educated!
Care Design New York will be hosting a new round of Family Forums (with the most up-to-date information) in March and April of 2018 at locations throughout the five boroughs.
You can check out Care Design New York’s website at www.caredesignny.org for a listing of upcoming Family Forums (information sessions.) You can also access information about Care Coordination and OPWDD funded services on the OPWDD website at https://opwdd.ny.gov/.
If you have any questions about Care Design New York, you may call (518) 235-1888 or contact them via the web address above.
For information on accessing OPWDD’s Front Door, contact:
Bronx – (718) 430-0757
Brooklyn – (718) 642-8576
Manhattan – (646) 766-3220
Queens – (718) 217-6485
Staten Island – (718) 982-1913