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State Level Advocacy to Advance Peer Services: New York Example

State Level Advocacy to Advance Peer Services: New York Example. Harvey Rosenthal, NYAPRS ACMHA Peer Leaders Seminar March 25, 2014. NYS Medicaid Redesign Response: Managed Integrated BH & Medical Care. STATE MEDICAID AGENCY DOH. OMH. OASAS. Health and Recovery Plan ( HARP) Health Plan.

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State Level Advocacy to Advance Peer Services: New York Example

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  1. State Level Advocacy to Advance Peer Services: New York Example Harvey Rosenthal, NYAPRS ACMHA Peer Leaders Seminar March 25, 2014

  2. NYS Medicaid Redesign Response: Managed Integrated BH & Medical Care STATE MEDICAID AGENCY DOH OMH OASAS Health and Recovery Plan (HARP) Health Plan Health and Recovery Plan (HARP) Health Plan + BHO Health and Recovery Plan (HARP) Health Plan + BHO Health Home Team: Provider Network Health Home Team Health Home Team Health Home Team = Physical and/or behavioral health care provider 2

  3. Peer Services Recommendations ofNY’s Behavioral Health Work Group Peer services should be incorporated into the new behavioral health specialty managed care system. ….Medicaid funding will be sought for peer services through waivers, grants, and program funding. Advance and improve the peer workforce through funding for training and education, certification, and leadership development, as well as through the establishment of an accreditation process for peer-run agencies. Peer services will be incorporated into Health Homes

  4. NYS Proposed 1915.i HCBS Option Enhanced Medicaid Benefits for HARPs Rehabilitation Psychosocial Rehabilitation Community Psychiatric Support and Treatment (CPST) Residential Supports/Supported Housing Habilitation Crisis Intervention Short-Term Crisis Respite Intensive Crisis Intervention Mobil Crisis Intervention Educational Support Services Support Services Family Support and Training Non- Medical Transportation Individual Employment Support Services Prevocational Transitional Employment Support Intensive Supported Employment On-going Supported Employment Peer Supports Self Directed Services

  5. Beyond HEDIS BH Measures 7 days from inpatient discharge to outpatient appointment 30 days to filled prescription

  6. Additional 1915.i Related Outcome Measures for HARPs • Participation in employment • Enrollment in vocational rehabilitation services and education/training • Improved or Stable Housing status • Access to and use of Peer Support • Longer Community tenure, Decreased Hospital Readmissions • Decreased Criminal justice involvement • Improvements in functional status • Cultural & Linguistic Competence, Engagement

  7. NYS HARP Financing Recommendations Capture Medicaid savings from reduced use of BH inpatient, emergency room and clinic use and REINVEST them into funding 1915.i expansions “Reinvestment should be focused on high priority areas, including housing, employment services, peer services, and family support.” Create financial rewards and incentives for wellness outcomes and the use of recovery and peer services

  8. Some Proposed HARP Selection Criteria Experience with peer support services (e.g. direct contracting or readiness to contract, network participation, referrals to peer services) Experience with rehabilitation, employment and housing support services

  9. Medicaid Health Homes • Health homes provide: • Dedicated care managers who assure that enrollees receive all needed medical, behavioral, and social services from their assembled networks of treatment, housing and social services • in accordance with a single care management plan • that is shared with all providers via an electronic healthcare record

  10. Medicaid Health Homes Goal • Health homes are accountable for reducing avoidable health care costs, specifically preventable hospital admissions and readmissions, skilled nursing facility admissions and emergency room visits and meeting quality measures. • Active engagement • 24-7 response • Focus on well coordinated discharge and treatment planning

  11. Health Home Financing Health home leaders get a monthly rate for each person served that pays for care management, electronic health care record system and administrative costs. Advocacy with state and health home lead agencies: Health homes can re-program care management dollars to buy peer services

  12. $25 Million in State Hospital Reinvestment 2014-15 Executive Budget

  13. $120 Million In Medicaid Investments for Behavioral Health Transformation Initiatives 2014-15 Executive Budget

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