MRT Waiver Application Includes NY Connects

Aug. 16, 2012 - PRLog -- Albany, NY – New York State has formally submitted a request for an amendment to the Section 1115 Partnership Plan Waiver to allow the state to reinvest up to $10 billion of $17.1 billion in federal savings generated by reforms made by Governor Cuomo’s Medicaid Redesign Team, and the waiver includes funding for the expansion of NY Connects.

The NY Connects funding would provide needed support for expansion and enhancement of New York’s Aging and Disability Resource (ADRC) also known as NY Connects. The investment would roll out over the five year period with $10 million set aside for the first year and $18.4 million for each of the remaining four years.  

“This would be a welcome investment since NY Connects has been underfunded for many years,” said Laura Cameron, Executive Director of the New York State Association of Area Agencies on Aging. “If approved the waiver will help NY Connects become more comprehensive in its effort to provide long term services and supports more efficiently.

Medicaid reform savings will be used to implement an action plan to transform the state's health care system and enable New York to fully implement the Medicaid Redesign Team action plan, facilitate innovation, and lower health care costs over the long term. The waiver application must be approved at the federal level by Centers for Medicare and Medicaid Services (CMS) in order to be implemented.

The announcement was made in the Blue Room of the State Capitol by Health Commissioner Dr. Nirav Shah and James Introne, Deputy Secretary to the Governor for Health.

Representatives of the Department of Health announced the schedule for Waiver Public Forums during the Aging Concerns Unite Us (ACUU) conference in June. The forums were lead by Medicaid Director Jason Helgerson at four locations throughout the state. The goal was to gather information about practices that would contribute to Medicaid Redesign savings.

NYSAAAA members – AAA Directors and Commissioners - attended and spoke at all of the forums. Check out photos from some of the forums by clicking on http://www.flickr.com/photos/sheila_carmody/sets/ for photos from the forums.

To view the waiver in its entirety, visit http://www.health.ny.gov/health_care/medicaid/redesign/do...



EXCERPTS FROM “New York State Medicaid Redesign Team (MRT) Waiver Amendment”

Waiver excerpt, page 67:
3) Expand New York Connects - Improving Satisfaction
Transforming long term care delivery and achieving true integration is going to require enhanced communication, community outreach and training for members, their families, providers and advocates. New York is going to need “boots on the ground” across the state to help facilitate these significant changes. New York has a severely under-funded system of Aging and Disability Resource Centers (ADRCs) – called New managed care. Additionally, the Affordable Care Act (ACA) and the MRT also provide unprecedented opportunities for the aging services networks. The increasing need for long-term care services, due to the impending dramatic shift of individuals over the age of 65, combined with the number of disabled adults and children with impairments, demands innovative policy and programs. NY Connects, a federally endorsed Aging and Disability Resource Center is positioned to provide locally accessible, consumer-centered access points that provide comprehensive information about long term care options and linkages to services. It is presently is operational in 54 counties. Additional funding will be needed to expand the program into the New York City metropolitan region as well as four upstate counties where the program is not currently available. New York Connects sites will also help reduce Medicaid expenditures by providing counseling to individuals and families regarding their long term care needs so that they can stay in their homes and actually stay off Medicaid. In addition the use of a front end will enhance the state’s ability to access satisfaction data directly from consumers, a much needed component of the long term care delivery system. ADRCs have been successful in other states and with a relatively modest investment through the waiver New York could see comparable benefits. The waiver funding needed to support the start up for expansion and enhancement of New York’s ADRC capacity over the five year period is $10 million the first year and $18.4 million for the remaining four years. Allocation of this funding will be based on the population of aged and disabled individuals by region.

Waiver excerpt, page 68:
6) Ombudsperson Program Supporting Choice
Even with investments in ADRC’s and significant plan oversight, there will be situations in which members need assistance to understand their benefits, advocate for themselves related to the quantity and/or quality of service they are receiving from plans, and access a resource for information. New York seeks to create a statewide Ombudsperson Program that will assist members who are concerned or unhappy with the quality of service they are receiving from their plans. The aim of this effort is anticipated to reduce grievances and appeals and ensure that members have an independent and knowledgeable voice that can help them. The state would seek to replicate a similar program currently in operation in Wisconsin, and would look for a single statewide contractor who would use subcontractors across the state to ensure sufficient coverage and personalized attention for members. This investment recognizes that savings from Medicaid should be reinvested in approaches that enhance the members’ participation in their care and supports a higher degree of consumer satisfaction in significant and perhaps frightening change from the FFS delivery system. The ramp up of such a program would require a year one investment of $3 million and then to maintain the investment through the transition phase an additional $5 million for each successive year.