New York switching to CCO model for disability services

Starting July 1st, New York is changing how people with disabilities receive their services as the Medicaid Service Coordination program is replaced with Health Home Care Management, a new and improved service coordination program.

Adults and children with intellectual and development disabilities enrolled in Medicaid Service Coordination must enroll with a Care Coordination Organization (CCO), which are new entities formed by existing providers of developmental disability services. The CCOs will coordinate the Health Home Care Management services.

The Office for People with Developmental Disabilities (OPWDD) serves 105,000 people across the state, who will need to switch to the Health Home Care Management program in order to continue to receive Medicare services.

“Over the past several years, OPWDD has worked to offer New Yorkers with developmental disabilities and their families more control, flexibility and opportunities for innovative supports customized to their abilities and needs,” said OPWDD Acting Commissioner Kerry A. Delaney in a press release. “People First Care Coordination provided through the Health Home Care Management program will help New York better address people with more complex needs, provide consistency in planning and allow for better information sharing across service systems, resulting in more holistic service planning and improving services overall.”

Seven CCOs have been announced across the state:

The CCOs will coordinate and connect enrollees with more comprehensive services, such as physical and behavioral health care, long-term care, while continuing to provide existing service coordination support that was provided through the Medicaid Service Coordination model.

HeartShare Human Services, a member of Care Design NY, has been working to ensure a smooth transition for enrollees.

“At HeartShare, we anticipated this major change in service delivery and due to that foresight, we are prepared to help individuals with disabilities and their families start services or transition without disruption,” said Linda Tempel, Executive Director of Developmental Disabilities Services at HeartShare Human Services of New York. “Care coordination is the beginning of the transition into managed care for all, which will take place over the next five years, and we hope our work developing CCOs like Care Design NY will serve as a model to other states working to do the same.”

In order to reduce potential disruption, many of the existing Medicaid Service Coordinators will be given the opportunity to transition into new roles as Care Managers in the new CCOs. The goal is for enrollees to keep their current service coordinators under the new system as often as possible. Case Managers will coordinate services across various systems, including OPWDD, the Department of Health, the Office of Alcoholism and Substance Abuse Services, and the Office of Mental Health.