A PARTNERSHIP CREATED TO IMPROVE CARE FOR NEW YORKERS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES
PHASE 1: CARE COORDINATION ORGANIZATIONS
The first phase in OPWDD’s efforts to improve the delivery of services came on July 1, 2018, when it introduced Care Coordination Organizations (CCOs). CCOs are specialized Health Homes* that work with people with intellectual and developmental disabilities and their families to coordinate health AND developmental disability services – to develop an integrated, comprehensive care plan (known as a “Life Plan”).
The Life Plan document is a person-centered plan, reflecting the members’ individual goals, dreams and preferences. It incorporates health and behavioral health services, community and social supports, and other services to assist individuals and families with accessing services that support well-rounded and fulfilling lives in their communities.
Care Managers work with members and their families to ensure that the member’s Life Plan is fully implemented, services are provided, and that their needs are being met.
CCOs are regulated by both the NYS Department of Health (DOH) and the NYS Office for People with Developmental Disabilities (OPWDD). Eligibility for CCO care management and OPWDD services is managed through the NYS OPWDD Front Door Regional Offices. CCO staff assist members and families with the eligibility process and enrollment in Care Coordination services.
PHASE 2: INTEGRATED MANAGED CARE
Since that time the TriaDD partners have created a best-in-class I/DD Provider-Led managed care model that builds on national experiences and successes. We call this model “MyCompass”.
As noted, the roll-out of CCOs was intended to be the State’s first phase in a gradual move to managed care. In January of 2019, while the details of this transition were being (and continue to be) developed by the state**, three of the seven New York State CCOs came together to form a statewide partnership to explore managed care/care management options – TriaDD. Since that time the TriaDD partners have created a best-in-class I/DD Provider-Led managed care model that builds on national experiences and successes. We also continue to explore alternative options to managed care to better coordinate and manage services and supports for people with I/DD.
The three CCOs – Advanced Care Alliance, LIFEPlan, and Person Centered Services are all I/DD provider led, and familiar partners to many of the people now receiving care. These three entities currently coordinate care for over 60,000 individuals with I/DD, covering all 62 counties in the State***. The TriaDD partnership will leverage the group’s size, expertise, and statewide reach to expand health-care choices, encourage and train providers to accommodate people with I/DD into their medical and dental practices, increase preventive care, and ultimately improve outcomes.
TriaDD believes that children and adults with intellectual and developmental disabilities deserve to live in the community where they can experience quality lives that include education, work, friends, and family. Services that support people with I/DD should promote individual growth and development, in community settings. TriaDD will use the group’s long history of serving individuals with I/DD and combine it with a world class health-care network, with the goal of helping people live fully inclusive lives and offering individuals and families improved quality of life.
Our CCO partners represent the largest network of I/DD service providers in New York, with 200+ affiliated non-profit agencies. Combined, we employ over 2,000 dedicated care managers, with offices in every region of the state. This means we can offer non-profit values with best-in-class services, making sure a move to managed care can still reflect the values of the community being served.
TriaDD’s model ensures that proven, experienced Care Coordination Organizations in every part of the state are driving the future of care for people with I/DD, and that individuals and families are offered more choice while being empowered to make their own health-care decisions.
*NYS Health Homes: In New York State, many people get their health benefits through the Medicaid Program. Most people are generally healthy however, others may have chronic health problems. Many are unable to find providers and services, which makes it hard for people to get well and stay healthy. The New York State Health Home program was created with these people in mind. The goal of the Health Home program is to make sure its members get the care and services they need. This may mean fewer trips to the emergency room or less time spent in the hospitals, getting regular care and services from doctors and providers, finding a safe place to live, and finding a way to get to medical appointments (from the NYS Department of Health Website).
**Specialized I/DD Plans – Provider Led (SIP-PLs) – in August 2018 NYS OPWDD issued a draft guidance document for public comment, outlining the state’s proposed requirements for forming and rolling out specialized, provider led, managed care plans for people with I/DD. Updated SIP-PL guidance has not yet been released and is now anticipated to come out for public comment in late winter/early spring of 2020.
***Advanced Care Alliance coordinates care for people in 10 counties in the downstate area. Person Center Services currently reaches 18 counties in the western region of the state; and LIFEPlan CCO NY serves individuals in 38 counties across the northern, central, and southern part of the state, and the Hudson Valley.