Increasing Access:
Adult Behavioral Health
Home and Community Based Services

The Medicaid Managed Care Health and Recovery Plan (HARP) provides enrollees with specialized supports to remain in the community. It also assists with rehabilitation and recovery through access to Adult Behavioral Health Home and Community Based Services (BH HCBS).

New York State (NYS) has experienced slower than anticipated access to BH HCBS for HARP members and has actively sought to determine the root cause for this delay.

Following implementation of BH HCBS, the State and key stakeholders identified challenges, including: difficulty enrolling HARP members in Health Homes (HH); locating enrollees and keeping them engaged throughout the lengthy assessment and Plan of Care development process; ensuring care managers have understanding of BH HCBS (including person-centered care planning) and capacity for care managers to effectively link members to rehab services; and difficulty launching BH HCBS due to low number of referrals to BH HCBS providers.

To address these challenges and ramp up utilization and access to BH HCBS, NYS has removed the full HCBS Assessment requirement, received CMS approval for increases to HCBS rates and increased consumer education. NYS is taking the following steps to engage HARPs to expand access to BH HCBS. These include:

1. Movement of HCBS funding into HARP premiums
2. Allowing HARPs to Contract with State Designated Entities (SDE) for HCBS assessments and plans of care
3. Creation of BH HCBS Quality/Infrastructure Funds
   1. BH HCBS Quality Funds to reward HARPs and providers for successfully engaging members in HCBS
   2. BH HCBS Infrastructure Funds to assist providers in solving access problems

NYS will partner with HARPs and providers to better assist in acing BH HCBS. More information on these initiatives is provided below.

Information and Guidance on Increasing Access to BH HCBS

• Overview of Initiatives to Increase BH HCBS Access

Adult BH HCBS Quality/Infrastructure Funding Programs

• Infrastructure Program Guidance
• Infrastructure Funding Application Template
• Infrastructure Proposal Administration and Overhead Cap Revision

Recovery Coordination (State Designated Entities)

• Recovery Coordination (State Designated Entity) Policy
• Adult BH HCBS Plan of Care Template for Recovery Coordinators
• Claiming and Documentation for Recovery Coordination Agencies
• Continuity of Care for Adult BH HCBS
• List of Recovery Coordination Agencies *

*This is a list of all Recovery Coordination Agencies (RCAs) to date that have a contract with at least one Medicaid Managed Care Organization (MCO) in New York State. These agencies receive referrals - from the MCO or a community provider - for HARP members who need a NYS Eligibility Assessment and a Plan of Care developed for Adult Behavioral Health (BH) Home and Community-Based Services (HCBS).

Note: This list is for informational purposes only. Not all RCAs are contracted with every MCO in New York State. This list is updated periodically as changes occur. Members and/or referring providers should contact the member’s Managed Care Organization (MCO) for a list of their contracted RCAs and most up-to-date information.