New York

Main Contact: 
Andrew Segal: Andrew[dot]Segal[at]health[dot]ny[dot]gov
NWD/SEP System
Name of Operating Agency: 
Department of Health
Participating types of NWD/SEPs: 
NY is expanding its NYConnects system so it is statewide. NYConnects offices are composed of AAAs and Local Departments of Social Services.
1-800 number: 
(800) 342-9871
Level I screen: 
NY is using an online Self-Assessment and a Level I screen done in person or over the phone by NYConnects staff.
Level II assessment: 
All Level II assessments are automated
Agency responsible for completing the financial assessment: 
Local Departments of Social Services determine financial eligibility for Medicaid. MyBenefits serves as an online portal for Medicaid enrollment.
Coordination/automation of referrals between levels (i.e., Level I and Level II) : 
An automated system will connect the Self-Assessment, Level 1 screen, MyBenefits (financial assessment), and departments responsible for conducting the Level II assessments.
Core Standardized Assessment
Elderly individuals (age 65 or older): 
interRAI Community Health Assessment (CHA); UAS-NY Community Assessment
People with developmental disabilities: 
interRAI Developmental Disability (DD); Coordinated Assessment System (CAS)
People with a serious mental illness or severe emotional disturbance: 
interRAI CHA; interRAI Community Mental Health (CMH)
People with physical disabilities: 
interRAI CHA
Conflict-Free Case Management
Mitigation strategies in place/planned: 
NY waivers or programs are conflict free or have mitigation strategies, such as state oversight, in place.
Service data: 

Claims data in addition to encounter data and cost reports from managed care organizations.

Quality measures: 

NY calculates HEDIS measures with claims data and generates Home Care Quality Indicators from its UAS-NY system for the elderly and physically disabled populations. NY also calculates the Phase I Behavioral Health Organization Metrics for the mental health population and uses various instruments for the DD population, including the National Core Indicators (NCI), the Restrictive Interventions Application (RIA), Incident Report and Management Application (IRMA), and the Health Home Care Management Assessment Reporting Tool (HHCMART).

Outcomes data: 

NY will use assessment data from the interRAI CMH and the UAS-NY system to cover all community LTSS populations with the exception of the ID/DD population. NY evaluates outcomes and satisfaction for the ID/DD population with the New York Employment System, the National Core Indicators (NCI), the Office for People with Developmental Disabilities (OPWDD) Tracking and Billing System, and the eMedNY Medicaid tracking system. The MFP Quality of Life Survey covers individuals enrolled in MFP. Finally, three surveys will be used for individuals moving to managed care: Behavioral Health Supplemental Survey, Member Transition Survey, and the Consumer Assessment of Healthcare Providers and Systems (CAHPS).

Use of Enhanced FMAP: 

NY is using Program funds to increase community capacity and encourage community placement; adjust provider rates for supported employment programs, Family Care services, and rehabilitative services in community residences; support strucutral changes; and create an Innovation Fund designed to engage NY's broad network of providers, advocates, and community leaders in developing systemic improvements that address barriers encountrered when providing community LTSS across all populations of Medicaid beneficiaries.