Important Information About the Care Coordination Transition
Dear Family Members and Advocates,
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 our agency’s role in the process and some other things for you to consider.
What is Changing?
OPWDD Is changing the way MSC services are delivered and reimbursed. These changes will also impact individuals who receive Plan of Care Support Services (PCSS) instead of MSC. Beginning July 2018, MSC will become “Health Home Care Management” and PCSS will become “HCBS Care Management”. Both types of Care Management services will be delivered by a new type of organization, called a Care Coordination Organization/Health Home (CCO/HH). The CCO/HH that QSAC partnered with is Advance Care Alliance of NY (ACANY).
What is most important to remember is: 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.
Why is MSC Becoming Care Management?
This new CCO/HH model will emphasize more person-centered, integrated care and reward comprehensive service coordination. In some ways, you can think of it as “MSC Plus” where “Plus” means coordinating with a person’s medical and mental health providers. The purpose is to make sure that all the services and supports received are high quality and reflect your and/or your family member’s personal goals and preferences. The CCO/HH will also promote timely access to care for people with I/DD, helping find a doctor or mental health professional when they need one or if they want to make a change. However, this will in no way limit which medical and/or mental health providers a person can see.
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 only 6 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.
With a network of more than 90 OPWDD-funded agencies located across 10 counties, ACANY expects to enroll more than 23,000 members in its CCO/HH.
2018-2019: A Transition 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 QSAC to support the existing 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 QSAC, as Care Managers, until the following year (July 2019). During this “transition year”, ACANY will reimburse us for their services and will also provide technical resources 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?
Right now, you do not have to do anything. Sometime in the coming months, 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.
OPWDD is centralizing resources and updates on the CCO/HH transition — click here to visit OPWDD's site about the CCO/HH transition.
In the near future, ACANY will offer regional town hall meetings to allow you to meet their leadership and have questions answered. We will communicate those dates at a later time.
We look forward to working with you to ensure a smooth enrollment process and seamless transition to a more comprehensive coordination of services for you and your family.
Lisa A. Veglia, LCSW, M.P.A., SAS
Chief Executive Officer