Proposed Health Home Plus for Children

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DRAFT

12/20/2016 Stakeholder Meeting – Health Home Plus for Children

In response to numerous and thoughtful comments on the proposal presented by the OMH Commissioner on the November 21, 2016 Webinar to serve high need SED children in the NY State Health Home Program, the following modifications were proposed on December 20, 2016 at a stakeholder meeting hosted by the Commissioner of OMH. Please provide your comments and feedback on or before January 12, 2016 to HHSC@health.ny.gov and enter SED Health Home Plus for Children in the subject line. The November 21st proposal has been rescinded.

  1. The State will be developing a designation called "Health Home Plus" for the highest need SED population. This will be known as Health Home Plus for Children.
    • This designation will require that any child scoring high on CANS–NY acuity and who meets additional high risk clinical criteria will be served by care managers on a required 1:12 caseload.
    • The State will develop additional high risk clinical criteria in consultation with stakeholders to identify the Children´s Health Home Plus population.
    • This could include criteria such as recent discharge from inpatient or residential, juvenile justice involvement, co–occurring disorders, etc.
    • CMAs providing services to high acuity children also must serve Health Home Plus.
    • We will maintain the important role of the SPOA as a critical access point for children and families; therefore, SPOAs will enter a referral into the MAPP HHTS Referral Portal and recommend the CMA directly to the HH. Functionality in MAPP HHTS will be explored.
    • Health Homes and SPOAs are strongly encouraged to collaborate. The HH will honor the SPOA suggested CMA assignment unless an unusual circumstance or significant concerns are raised by the Health Home.
    • There will be a 6–month transition period for the development and implementation of HH Plus for Children.
    • As part of the State´s performance management of all Health Homes, the State will closely monitor caseload sizes of CMAs serving the Children´s Health Home plus population as well as quality concerns for high acuity children in HH Plus. Possible financial penalties, including no longer allowing new referrals, will be explored to address poor performance on the above issues.
  2. The following are additional significant changes from the original proposal.
    • The only required caseloads will be for those who meet the HH plus criteria for SED children.
    • The current Health Home standards for recommended caseloads will be unchanged except for children meeting criteria for Health Home Plus.
    • It is expected that Health Homes will manage caseloads appropriately to meet these recommendations whenever possible. The State will apply performance management for service quality for all caseloads, with specific attention for high acuity children.
    • In addition, the proposed staffing qualifications to serve medium SED children is now a recommendation and will no longer be required.
    • Due the HH Plus development with the required caseload of 1:12, there will no longer be SPOA assignments i.e. "slots".