Frequently Asked Questions
What is Health Home Care Management?
Health Home Care Management is a new way to coordinate care, combining developmental disability services and supports with health, wellness and behavioral health services. This new way of coordinating care offers more options, greater flexibility and better outcomes. Health Home Care Management will be provided by Health Home/Care Coordination Organizations (HH/CCOs).
Health Home Care Management will better support people, including those with complex needs. It will provide consistency in services and allow for better information sharing, resulting in more flexible and comprehensive service planning.
What is a CCO?
CCO stands for Care Coordination Organization. These are organizations that were formed by existing developmental disability service providers. These new organizations will be staffed by Care Managers with training and experience in the field of developmental disabilities.
What is a Care Manager?
Your Medicaid Service Coordinator (MSC) has arranged for the services you receive. To better help you, many MSCs have taken special training and are now Care Managers. In most cases, you’ll continue with the same MSC as they become Care Managers.
A Care Manager is a person who will work with you to create your Life Plan. Many Care Managers will be current Medicaid Service Coordinators who have received additional training to become Care Managers in the new system. Your Care Manager will help coordinate services across systems—including New York State’s Office for People With Developmental Disabilities (OPWDD), the Department of Health and the Office of Mental Health—providing you one place to plan all your service needs.
What is a Life Plan?
The Life Plan will replace the Individualized Service Plan (ISP). It will be reviewed routinely and updated as needed based upon your life goals and changing needs. Your Care Manager will work with you to create a plan based on your wants and needs. Your Life Plan will include coordination of your developmental disability related supports and your other services, like medical, dental and mental health.
What about my other services?
No other services will be affected, and families will continue to receive services from the same providers who are now part of the Prime Care Network.
What other changes will occur?
You will have access to many more services to help you meet your goals. Care Managers will be trained to coordinate health, wellness and behavioral health services as part of your Life Plan, working with you for total care coordination.
Will I be able to choose my service providers?
Yes! Your services are not changing, but those services will be better coordinated.
Is joining a HH/CCO mandatory?
You are not required to enroll, but to make sure you receive the same services you have through current Medicaid Service Coordination, you will need to enroll by June 30, 2018.
After July 1, 2018, all service coordination, including Medicaid Service Coordination and Plan of Care Support Services, will be provided by CCOs, like Prime Care. By choosing to enroll in Health Home Care Management, you will receive an improved level of service to help you or your loved one coordinate all services.
If you do not want to receive the more comprehensive care management that will be provided with Health Home Care Management, you can talk to your service coordinator about the option to receive Basic Home and Community Based Services (HCBS) Plan Support.
Basic HCBS Plan Support will also be provided by Prime Care, but it will be a very minimal coordination option, less than the support you currently receive if you are enrolled in Medicaid Service Coordination, and it will not include coordination of health care or mental health services. You are less likely to keep your current service coordinator if you choose this option.
When will the transition to Health Home Care Management take effect?
Prime Care Coordination will begin providing Health Home Care Management services on July 1, 2018.
Who will have access to my plan and how will my personal information be protected?
CCOs will be required to have an electronic health record system that links the service providers involved in your care and allows your health information and Life Plan to be accessible to you and your care team. All CCOs must follow strict security protocols to protect your Personal Health Information.