Health Homes Serving Individuals with Intellectual and/or Developmental Disabilities (Care Coordination Organization/Health Home (CCO/HH))

In April 2018, the New York State Department of Health (DOH) and the New York State Office for People With Developmental Disabilities (OPWDD) received approval from the Centers for Medicare and Medicaid Services (CMS)  to expand the Health Home Care Management program to serve individuals with intellectual and/or developmental disabilities (I/DD) through Care Coordination Organization/Health Homes (CCO/HHs). Effective July 1, 2018, CCO/HHs began serving individuals with I/DD who chose to receive this comprehensive model of Care Management. 

The expansion, tailoring, and implementation of the Health Home Care Management model was the first phase and foundation for OPWDD's transition to Managed Care. OPWDD is committed to helping individuals with I/DD live richer lives, and creating stronger person–centered services, now and in the future. The CCO/HH model provides a strong, stable, person–centered approach to holistic service planning and ensures the delivery of integrated quality care that supports the needs of individuals with I/DD.

To access CCO/HH services, please visit OPWDD's website.

The CCO/HH Provider Policy and Guidance Manual (released in July 2018) and subsequent updates to CCO/HH policy can be found on OPWDD's website at the link below:

Please see the Specialized Managed Care Transition for Individuals with Intellectual and/or Developmental Disabilities page for more information.

Care Coordination Organization /Health Home (CCO/HH) PMPM
Effective on and after 4/1/23 - PENDING CMS APROVAL
Acuity Level Ongoing PMPM Initial One Time PMPM
Upstate Downstate Upstate Downstate
Tier 1 $290 $309 $870 $927
Tier 2 $355 $379 $870 $927
Tier 3 $430 $459 $870 $927
Tier 4 $549 $586 $870 $927
Basic $271.02 $271.02 $813.06 $813.06
Care Coordination Organization /Health Home (CCO/HH) PMPM
Effective on and after 4/1/22
Acuity Level Ongoing PMPM Initial One Time PMPM
Upstate Downstate Upstate Downstate
Tier 1 $279 $297 $837 $891
Tier 2
 $341 $364 $837 $891
Tier 3
 $413 $441 $837 $891
Tier 4
 $528 $563 $837 $891
Basic $260.60 $260.60 $781.80 $781.80

Care Coordination Organization /Health Home (CCO/HH) PMPM
(Effective 7/1/20 - 3/31/22)
Acuity Level Ongoing PMPM Initial One Time PMPM
Upstate Downstate Upstate Downstate
Tier 1
 $265 $282 $795 $846
Tier 2 $324 $345 $795 $846
Tier 3 $392 $418 $795 $846
Tier 4 $501 $534 $795 $846
Basic $247.25 $247.25 $741.74 $741.74

Care Coordination Organization /Health Home (CCO/HH) PMPM
(Effective 7/1/18 - 6/30/20)
Acuity Level Ongoing PMPM Initial One Time PMPM
Upstate Downstate Upstate Downstate
Tier 1
 $338 $361 $951 $1,011
Tier 2
 $407 $436 $951 $1,011
Tier 3
 $489 $522 $951 $1,011
Tier 4
 $619 $661 $951 $1,011
Basic
 $247.25 $247.25 $741.74 $741.74

The New York State Department of Health (DOH) and the New York State Office for People With Developmental Disabilities (OPWDD) released Part I of the draft CCO/HH Application and Attachments for stakeholder review and comment in June 2017. Part I of the Application contained background and policy information for serving individuals with I/DD in CCO/HHs.

Comments on Part 1 of the draft CCO/HH Application and Attachments were submitted using the Comment Submission Form in Attachment A.  The deadline to submit comments was August 11, 2017.  Interested entities were also required to submit a Letter of Intent to the State.

The Final CCO/HH Application (Parts I and II) was released on October 6, 2017. Applicants were required to complete and submit: Part II of the Application, the CCO/HH Network Partner List (Attachment D), other requirements, and any desired supplementary attachments electronically to the State.

The following table identifies important dates and activities related to the implementation of CCO/HHs for individuals with I/DD.

Schedule for the Implementation of CCO/HHs for Individuals with I/DD
Activity Due Date
Part I of Draft CCO/HH Application and Attachments Released June 30, 2017 - Completed
Due Date to Submit Comments on Part I of Draft CCO/HH Application and Attachments August 4, 2017 - Due date extended to August 11, 2017 - Completed
Due Date to Submit Letters of Interest August 4, 2017 - Completed
Final CCO/HH Application Released (Parts I, II, and Attachments) October 6, 2017 - Completed
Due Date to Submit CCO/HH Application November 30, 2017- Completed
Review and Approval of CCO/HH Applications by the State December 1, 2017 to February 28, 2018- Completed
Due Date to Submit Updated Attachment D February 15, 2018 - Due date extended to April 13, 2018 - Completed
CCO/HH and Network Partner Readiness Activities March 1, 2018 to June 30, 2018 - Completed
State Webinars, Training, and Other Readiness Activities Through June 30, 2018 - Completed
Transition to CCO/HH Care Management for Individuals with I/DD July 2018 - Completed
Application Attachments
Attachment Title
Attachment A (PDF) Form for Submitting Comments on Draft CCO/HH Application (Comment period is closed)
Attachment B (PDF) Letter of Interest Submission Form (Submission period is closed)
Attachment C (PPTX) CCO/HH Model Graphic
Attachment D (XLSX) CCO/HH Network Partner List
Attachment E (PDF) Mercer Data Summary
  • On April 9, 2018, the Centers for Medicare and Medicaid Services (CMS) approved State Plan Amendment (SPA) #17-0025, authorizing the implementation of Health Homes for Individuals with Intellectual and/or Developmental Disabilities, known as CCO/HHs.
  • On February 28, 2019, the Centers for Medicare and Medicaid Services (CMS) approved State Plan Amendment (SPA) #18-0058. This SPA implements changes to sunset provisions of SPA 12-0030 pertaining to the MSC Program, and puts into place the Basic HCBS Plan Support as an alternative for those persons electing not to enroll in a Care Coordination Organization/Health Home (CCO/HH) for the comprehensive Care Management option. This SPA also prescribes provider qualifications for the provision of the Basic HCBS Plan Support benefit.
  • Please see the Letters of Interest page for a list of entities that indicated an interest in submitting a Health Home Application to Serve Individuals with Intellectual and/or Developmental Disabilities.