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Changes in store in NYS for the way services for the disabled are coordinated

Watertown Daily Times - 4/16/2018

April 16--WATERTOWN -- A state-driven initiative is replacing the Medicaid Service Coordination program for families with disabled members.

"In essence the Medicaid Service Coordination is moving from providers to care coordination organizations to expand services," said Howard W. Ganter, executive director of the Jefferson Rehabilitation Center.

Families and guardians who receive such services have a decision to make. The new program begins Sunday, July 1.

For its part, JRC recently sent out letters to families that say the Medical Service Coordination program, also known as Plan of Care Support Services, is being replaced by a new program called Health Home Care Management.

"Life plans" are being replaced with "individualized service plans." The new management plan will provide coordination of services received from other systems, such as mental health, medical and dental care.

The new Health Home Care Management program will be provided by care coordination organizations.

CCOs are new organizations, with six in the state. They will be staffed by care managers, which in many cases will be current Medicaid service coordinators. Both programs are Medicaid-funded.

"The change to service coordination is meant to improve the current system and to strengthen the service coordinator role," Susan J. Beiswenger, administrator of program supports and admissions at JRC said in a phone interview. "There's going to be additional responsibilities placed on the current service coordinators when they transition to care managers. The intent is to strengthen the coordination role."

Mrs. Beiswenger said there will be no loss of services.

"Any change is difficult, especially for the family members who may be fearful they are going to be losing services," Mrs. Beiswenger said. "The whole goal is to enhance the current services which they receive."

new care coordinators

Utica-based LifePlan CCO NY is one of the new care coordination organizations that received designation from the state's Office for People With Developmental Disabilities and Department of Health. It has partnered with several agencies in the state, including locally JRC, Disabled Persons Action Organization, Northern New York Cerebral Palsy Association and the St. Lawrence County chapter of NYSARC. LifePlan CCO NY has a total partnership of 68 nonprofit agencies in 38 counties.

Prime Care Coordination is the other CCO that has been authorized to provide services in the Northern New York (region 2) area. A Prime Care Coordination spokeswoman said the only agency the CCO works with now in Northern New York is CNY Quest, based in Utica, which serves some residents in Lewis County.

People who receive services may choose the care coordination organization working with their current Medicaid service coordinator and agency or choose a different CCO available in their counties.

On its website, LifePlan CCO says people with disabilities receiving MSC care now will, through care management, receive:

--Improved outcomes through care coordination including healthcare, personal and social supports

--Improved disease-related care for chronic conditions

--Improved access to preventative care

two service options

Mrs. Beiswenger said who people who don't wish to receive the care management services provided by the new program can talk to their service coordinators about the option to receive Basic Home and Community Based Services.

Both the new program and "basic" programs involve a care plan that is reviewed biannually and monitors health and safety. The full home care management program adds the coordination of access to behavioral health services, identifies community-based resources, uses technology to link services, connects care providers and "navigates" systems for families and individuals.

MSCs working for provider agencies will have the opportunity to apply to become care managers and work for one of the CCOs. Provider agencies have options within a one-year allotted time frame to transition to Medicaid service coordinators to care managers under the chosen CCO.

The state Office for People With Developmental Disabilities says education and experience requirements will be waived for existing Medicaid service coordinators who apply to serve as care managers for CCOs and are determined by the CCO to have the skills to provide care management.

Also, the CCOs will be required to provide "Health Home" core services training for MSCs who do not meet the minimum education and experience requirements.

Becoming a care manager

The state Office for People With Developmental Disabilities says Health Home care managers who serve adults and children with developmental disabilities must meet the following qualifications:

--A bachelor's degree with two years' relevant experience, or

--A license as a registered nurse with two years of relevant experience, or

--A master's degree with one year of relevant experience.


(c)2018 Watertown Daily Times (Watertown, N.Y.)

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