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Why choose Tri County Care?
- New York State (NYS) is moving individuals with intellectual and developmental disabilities (IDD) into managed care by designating entities to serve as regional Care Coordination Organizations/Health Homes (CCOs). CCOs will be required within five years to become Managed Care Organizations (MCOs), or to contract with eligible MCOs. The establishment of CCOs will also meet the federal requirements for conflict free care management. OPWDD anticipates that these CCOs will begin operation in early 2018, and that after a period of transition all Medicaid Service Coordination (MSC) staff will become employees of the CCO.
- Tri-County Care is seeking OPWDD designation as a CCO. Tri-County will partner with existing MSC agencies to provide conflict free care management services and to provide a path to managed care. MSC agencies will be required to partner with a single CCO as part of the establishment of these entities. Existing MSC agencies should act now to join a regionally oriented CCO with a non-profit focus and managed care expertise. This memo highlights the benefits Tri-County Care offers its CCO partners.
- Tri-County Care participation requires no financial investment
Tri-County Care has expertise in both managed care and IDD.
- Tri-County is an experienced provider of service coordination for individuals with IDD. It has expertise across a range of services and types of care, including MSC, Article 16 services, Department of Health (DOH) supported services, and more. Importantly, its affiliated entity operates a member-focused, non¬profit Managed Long Term Care (MLTC) plan serving nearly 2,000 individuals in diverse communities. This provides a logical path to managed care for individuals with IDD. CCOs that decide not to invest in becoming managed care entities will have to contract with an MCO. The affiliated Hamaspik MLTC will provide a seamless, cost-free transition to managed care.
Tri-County’s CCO is led by the affiliated MLTC’s Executive Director. The MLTC has an extensive network and experience serving individuals with IDD.
- Mr. Yoel Bernath is leading the CCO initiative, and has experience establishing and running the Hamaspik MLTC. The MLTC’s broad network includes Rockland, Orange, Dutchess, Ulster, Sullivan, and Putnam counties. Yoel was also instrumental in the MLTC receiving NYS approval to develop a Developmental Disabilities Individual Support and Care Coordination Organization (DISCO).
Tri-County’s affiliate provides home care and consumer-directed care to individuals in New York City and the Hudson Valley.
- Hamaspik provides home care services in 13 counties (Bronx, Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, Westchester, Kings, Nassau, New York, Queens, and Richmond). Expanding upon this success, the New York City Human Resources Administration recently chose Hamaspik to provide consumer-directed personal assistance services (CDPAP) to NYC Medicaid fee-for-service beneficiaries.
Tri-County is community-focused and has offices in the Hudson Valley and New York City.
- Existing MSC agencies will be required to contract with a CCO for up to one year before service coordination staff must be transitioned. MSC agencies in the Hudson Valley should choose a CCO partner committed to their area and the existing MSC workforce. Tri-County has local offices in the Hudson Valley and is committed to working with its CCO partners to ensure a seamless transition to managed care for individuals, staff, and providers. A local office in NYC will provide the same customer service to providers from that region.
Tri-County is a not-for-profit, no-fee, community-focused organization.
- Tri-County is a community-oriented, non-profit service coordination provider. It is also a health insurer. Unlike insurers that are not provider led, Tri-County focuses on providing care to individuals with IDD and their families rather than on insurance company profits. Its commitment to the Hudson Valley and downstate communities includes individuals, families, and existing MSC agencies. To ease MSC agencies’ transition to becoming CCO partners and into managed care, Tri-County will not charge CCO partners a membership fee.
Tri-County’s CCO partners will be represented in decisions regarding the allocation of individuals.
- Each CCO partner will be offered representation on the Tri-County Care Advisory Board. This board will oversee an established policy for enrollee and service referrals. This will ensure provider agencies are properly represented in Tri-County decisions affecting the provision of services to individuals with IDD.
Tri-County will work with CCO partners to ensure continuity of employment for existing MSC staff.
- Tri-County will work with each partner agency that currently provides MSC services to develop a tailored workforce plan that meets OPWDD requirements and ensures that existing staff maintain their employment and relationships with individuals with IDD and their families. Tri-County will also lease space from existing agencies to keep services in communities that are currently being served.
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