NYS Health and Recovery Plan (HARP)/ Behavioral Health Medicaid Managed Care Plans

Adults enrolled in Medicaid and 21 years or older with select Serious Mental Illness (SMI) and Substance Use Disorder (SUD) diagnoses having serious behavioral health issues are eligible to enroll in a new type of health plan, HARP.  Health and Recovery Plans (HARPs) will manage care for adults with significant behavioral health needs. They will facilitate the integration of physical health, mental health, and substance use services for individuals requiring specialized approaches, expertise and protocols which are not consistently found within most medical plans. In addition to the State Plan Medicaid services offered by Mainstream Managed Care Organizations (MCOs), qualified HARPs will offer access to an enhanced benefit package comprised of Home and Community Based Services (HCBS) designed to provide the individual with a specialized scope of support services not currently covered under the State Plan.  HARPs will contract with Health Homes, or other State designated entities, to develop a person-centered care plan and provide care management for all services within the care plan, including the HCBS.

NYS Behavioral Health Home and Community Based Services (BH HCBS)

BH HCBS will be available to adults meeting Serious Mental Illness (SMI) and Substance Use Disorder (SUD) criteria and risk factors who are enrolled in the HARP and found eligible through an assessment.  The New York State Office of Mental Health (OMH), Office for Alcoholism and Substance Abuse Services (OASAS), and Department of Health (DOH) oversee a BH HCBS provider application process for adult behavioral health providers wishing to provide BH HCBS in NYS. This application allows adult behavioral health providers to attest to provide new adult BH HCBS, which are currently available for eligible individuals in Health and Recovery Plans (HARPs) and HIV Special Needs Plans (SNPs) in NYC as of January 2016 and will be available beginning October 2016 in the rest of the State. These BH HCBS are recovery oriented and designed to assist individuals with significant behavioral health needs living in the community. This application and subsequent designation does not mandate providers to offer these services.

BH HCBS for eligible adults include the following:

• Psychosocial Rehabilitation
• Community Support and Treatment (CPST)
• Habilitation Services
• Family Support and Training
• Short-Term Crisis Respite
• Intensive Crisis Respite
• Education Support Services
• Peer Support Services
• Non-medical Transportation
• Pre-vocational Services
• Transitional Employment
• Intensive Supported Employment
• On-going Supported Employment
• Self-directed Care (to be implemented at a later time as a pilot program)