The purpose of this letter is to provide an update on the Behavioral Health Managed Care implementation for New York City-based providers. Beginning October 1, 2015, New York City-based Mainstream Managed Care Organizations (MCOs) and Health and Recovery Programs (HARPs) will manage non-Home and Community-based Service (HCBS) behavioral health services for enrolled members. Beginning January 1, 2016, New York City-based HARPs and HIV SNPs will manage behavioral health HCBS for eligible members. It is estimated that approximately 60,000 enrolled members will be affected by this change.
Beginning October 1, 2015, MCOs will be required to ensure the assessment of HARP-eligible members enrolled in HARPs or HIV SNPs using the New York State Eligibility Assessment to determine their HCBS eligibility, and if determined eligible the full Community Mental Health Assessment to help inform an HCBS Plan of Care. The entity that conducts the assessment(s) will depend upon the enrolled members’ participation in the Health Home Program.
Health Home Program Members – The Health Home Program that currently serves the enrolled member will coordinate the completion of the New York State Community Mental Health Assessment with one of its respective Health Home Care Management Agencies, or Assertive Community Treatment (ACT) programs.
Non-Health Home Program Members – The MCO will contract with Health Homes, to conduct the New York State Eligibility Assessment, and then the Community Mental Health Assessment and develop the Plan of Care for individuals eligible for HCBS.
There are several steps that MCOs, Health Home Programs, Health Home Care Management Agencies, and ACT teams in the role of Health Home Care Manager, in New York City are required to complete in preparation of October 1, 2015.
All MCOs, Health Home Programs, Health Home Care Management Agencies, and ACT teams in the role of Health Home Care Manager must ensure that its respective staff who will be required to conduct the New York State Community Mental Health Assessment or view the generated assessment outcomes have access to the Health Commerce System (HCS). This requires that staff have their own HCS user account with Trust Level 3 assurance and are assigned an appropriate user role.
Health Home Programs and Health Home Care Management Agencies, and ACT providers serving HARP eligible Health Home enrollees must ensure that all staff who will conduct the New York State Community Mental Health Assessment complete the required “Understanding the Community Mental Health Assessment” course. This course is designed to prepare assessors to use the New York State Community Mental Health Assessment instrument. This is an online, self-paced course that will take a user between 10 and 12 hours to complete. An additional course specific to administering the Eligibility Assessment will be available to assessors who have already completed the “Understanding the Community Mental Health Assessment” course on or around September 1, 2015.
Attached are two documents to support the completion of the above activities. These documents are:
Behavioral Health Managed Care Transition Guide – This document provides information about the HCS, HCS user accounts, role assignments, and the web-based application that will be used to complete the New York State Community Mental Health Assessment. bhmc_trans_guide
UAS-NY Support for Users – This document provides step-by-step information that will help staff access the “UAS-NY Test Drive” application and the UAS-NY Training Environment. Please share this document with all staff who will access the UAS-NY Training Environment to complete the Understanding the Community Mental Health Assessment course. uas_support_for_users
To facilitate communication on the Behavioral Health Managed Care Transition, each MCO, Health Home, and Health Home Care Management Agency, including those Agencies whose ACT provider is serving HARP enrollees is requested to identify a single point of contact for Health Home and care management integration activities. This individual will receive various correspondence concerning the implementation and will be responsible for disseminating the information, as appropriate, across his/her organization. Please email the contact information for this individual to the email address noted below.
For additional information please go to: http://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/harp_hiv_snp.htm
If you have any questions please contact the Health Home Project Team using the email form below. To email the project team, please:
go to: https://apps.health.ny.gov/pubdoh/health_care/medicaid/program/medicaid_health_homes/emailHealthHome.action
select “email NYS Health Homes Program”
select “Behavioral Health Implementation” in the subject line.
Thank you,
NYSDOH Health Home Program