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Network Provider Newsletter December 2019 / January 2020 | |
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Care Design NY sends thanks appreciation to our provider network for your support and collaboration. Best wishes and a joyous 2020. | |
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A Message From Care Design NY CEO James MoranCare Design NY and Partners Health Plan Are Aligned!
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We are pleased to announce that Partners Health Plan (PHP), the nation’s first and only provider-led managed care plan dedicated to providing comprehensive services to people with intellectual and developmental disabilities (I/DD), and Care Design NY (CDNY), the State’s largest Care Coordination Organization (CCO) serving people with I/DD, have formally aligned. | | | |
Under the new alignment, Partnerships, the parent organization to PHP, will also become the parent to CDNY. The alignment of these entities, in support of integrated services through comprehensive person-centered care coordination, for people with I/DD, will result in better access to services and better quality of care.
PHP began enrolling people with I/DD into its Fully Integrated Duals Advantage (FIDA) program, for people with I/DD eligible for both Medicare and Medicaid, in 2016. The PHP FIDA now has over 1,500 members and is growing each month. It operates in Westchester, Bronx, New York, Staten Island, Kings, Queens, Nassau and Suffolk Counties. In the FIDA, PHP uses a two-person care team approach, including one licensed medical practitioner, to coordinate care for each member. Each member receives a customized service plan and streamlined access to services.
PHP has received licensure from the New York State Department of Health to open a mainstream Medicaid Managed Care Plan and expects to begin enrollment in the coming months. Once the State releases the final application for I/DD provider-led plans to add I/DD Home and Community Based Services to the benefit, PHP is prepared to apply and expand into those areas now served by CDNY.
This affiliation is consistent with New York State’s vision for strong, provider-led managed care plans built from the foundation CCO’s laid for comprehensive care coordination and investments made for managed-care start-up costs. The two organizations will support each other and share resources to be more effective and efficient. CDNY members have invested in and gained a governance role with PHP and CDNY’s infrastructure will provide the foundation for PHP to begin the process of expansion.
We look forward to a successful partnership, and to furthering the joint mission of helping our members to access the highest quality healthcare and services, while promoting good health and wellness, improving quality of life and supporting each person to live the life they choose.
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I/DD Training for Providers Now Available | |
Every day, as more and more individuals with I/DD are successful at living in community settings, the need for further health care options within those communities expands. Thankfully, the wait times for individuals at I/DD specific clinics has decreased, and the access to quality healthcare has increased as more providers have joined the Care Design NY network! The Provider Relations team has developed training for network providers to address barriers for individuals with I/DD in obtaining quality healthcare from community providers.
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The trainings will include topics such as methods of effective communication, how to ensure offices and examination rooms are accessible, and how to identify when support staff can assist the provider and the I/DD patients with paperwork, communication and physical support as needed.
Our trainings are geared specifically to each type of provider and medical specialist. They will address health concerns among individuals with I/DD that are unlike those in the general population, including differences in preventive screening practices. They will also outline the need for additional care in prescribing medications for those with I/DD (especially for individuals unable to describe side effects or reactions) that may be taking multiple medications and are vulnerable to increased risk of adverse medication interactions.
This is a small sample of the effective and detailed trainings and resources we have available for Care Design NY providers and their staff.
To arrange for a training or if you would like more information, please contact Rplakstis@caredesignny.org. | |
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In an effort to further explore mental health and substance use in the I/DD world, Care Design NY’s Provider Relations Specialist, Gordon Collier, spoke with Jeffrey Hallenbeck, a Licensed Mental Health Counselor and the Director of Clinical Services at Living Resources. Living Resources, a Developmental Disabilities Service Provider Agency in Albany, is dedicated to providing life enhancing services to individuals challenged by intellectual and/or developmental disabilities and brain injury survivors.
Mr. Hallenbeck oversees behavioral health services for a large number of individuals living with I/DD in both residential and day program settings, many with co-morbid psychiatric issues and histories of extensive trauma. He discusses the clinical services available at Living Resources, including those specifically designed and implemented for the I/DD community and those with dual diagnosis. He also addresses the challenges faced by all types of providers concerning behavioral and mental health, and the availability of education available focused on individuals with I/DD. | |
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Comprehensive Care Management
& Health Care Coordination | |
Annette Dunnah, MSN, RN, CDDN, Director of Health Care Management at Care Design NY, answered some of the most frequently asked questions the Provider Relations department receives from providers, individuals and families and Care Managers around health care coordination. | | | |
Ms. Dunnah has extensive operational and clinical experience in the areas of intellectual and developmental disabilities, long-term care, sub acute rehabilitation, and acute care. She has a Master of Science in Nursing, Registered Nurse, and is a Certified Developmental Disabilities Nurse (CDDN). | |
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ADDITIONAL HEALTH CARE COORDINATION RESOURCES FOR PROVIDERS:
CLICK HERE for an informational brochure on the role of the CCO Care Manager for providers, what to expect from the Care Design NY Care Manager, and how providers and Care Managers can work together in coordinating services. | |
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SAVE THE DATE to join us on January 30, 2020 at 1:00 PM for the January Provider Webinar. Stay tuned for more information about the topics that will be addressed and for an invite and registration information. | |
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Media Opportunity for Network Providers | |
Would you or your organization like to be featured in this newsletter or other Care Design NY publication? In order to highlight the circle of support and appreciation at Care Design NY, stories and positive experiences from members, their families and Care Managers, are being gathered throughout the state. To date, these stories and "shout-outs" have been from individuals, Care Managers or families recognizing Care Managers or providers and organizations. Now it's your turn! Have you had a particularly positive experience with a Care Design NY member or Care Manager that you'd like to share?
We'd love to include your story or "shout out" in an upcoming publication, social media post and/or video and enhance how we promote and represent our provider network in our materials and outreach.
Email us your story, "shout-out" or another idea of how you and/or your organization could be featured working with the individuals you support at providerrelations@caredesignny.org and we will be in touch about editorial or photo-shoot opportunities! | |
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Network Provider Resources
| Provider Spotlight Archives - Helpful Documents - Webinars | | | |
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Do you have questions or feedback? We'd love to hear from you!
Contact Care Design NY Provider Relations at providerrelations@caredesignny.org (518) 235-1888 or (877) 855-3673 for an Emergency after hours (5 pm – 8:30 am business days and 24 hours on weekends and Care Design NY holidays) | | | |
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If you would no longer like to receive this newsletter, simply unsubscribe. | |
Care Design NY | 8 Southwoods Blvd., Suite 110, Albany NY 12211 | |
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