OMH, DOH and OASAS have just sent out a notification to providers
across the State in regard to assisting HARP members in accessing HCBS. Up
until now, the HCBS assessment process for HARP members was done
specifically through the Health Homes. This change will open
assessments through ‘state designated entities’ dramatically increasing
access to the pool of providers that can provide assessments. With this
change, plans will be contacting with existing provider agencies,
depending on their scope of services, to be able to provide assessments
to all eligible enrollees. We are very supportive of the concept and look
forward to greater detail.

Attached is the OMH/DOH/OASAS issued guidance sent to Managed Care Plans,
HARPs and HIVSNPs, advising them to contract with community providers to
assist HARP members in accessing Home and Community Based Services (HCBS)
who are not enrolled or do not wish to be enrolled in a Health Home. These
providers are defined as a “state designated entities (SDE)” and would
establish direct contracts with the MCO to do *Eligibility Assessments and
Person-Centered care planning for Adult Behavioral Health HCBS.

Who is the SDE?

Although the agencies identified must have a care management program within
that agency, the Adult BH HCBS assessment and care planning work is not
limited to the care management program, but may also include qualified
assessors in various parts of the agency including housing and clinical
programs. It is the intention of the State to offer HARP members the
opportunity to understand their benefit package including the new HCBS, and
be assessed for eligibility by an individual they may already have a
working relationship with when possible. As outlined in the guidance, the
assessor must follow existing conflict free case management standards, and
work with the individual to link them to Adult BH HBCS.

How can the SDE help connect the HARP enrollee I am working with to HCBS? 

If you are not a provider of health home care management services but are
working with HARP enrollees who are not linked to a health home, you may
contact the individual’s MCO to learn more about how to connect the
individual to health home care management or directly to a State Designated
Entity for access to HCBS.

A webinar will be held in the near future to provide further information.
Please contact the HCBS mailbox <omh.sm.co.hcbs-application@omh.ny.gov> for
any questions regarding the State Designated Entity for Adult BH HCBS.

 

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