Adult Behavioral Health Home and Community Based Services ( HCBS)
Eligibility and Enrollment – HARP
A HARP is a Medicaid managed care product that manages physical health, mental health, and substance use services in an integrated way for adults with significant behavioral health needs (mental health or substance use).
What do HARPs do?
- HARPs manage the Medicaid services for people who need them
- HARPs also manage an enhanced benefit package of Home and Community-Based Services (HCBS).
- HARPs provide enhanced care management for members to help them coordinate all their physical health, behavioral health and non-Medicaid support needs.
Who is eligible for HARPs?
People must be 21 or older to join a HARP, be insured only by Medicaid and be eligible for Medicaid managed care. They also have to be eligible for a HARP. People who are eligible will get a letter in the mail from New York State or New York Medicaid Choice.
Health Home Care Managers will use the NYS Eligibility Assessment to determine if the HARP enrollees are eligible for Adult BH HCBS. The NYS Eligibility assessment will determine Tier 1 or Tier 2 eligibility. Tier 1 eligibility includes employment, education and peer support services only. Tier 2 eligibility includes the full array of BH HCBS services.
Recovery Coordination Agencies (RCA) for Adult BH HCBS.- To ensure HARP members who are not currently enrolled in a Health Home are given the opportunity to access Adult BH HCBS, the State has established a process in which a HARP eligible person can be assessed, referred to a provider, and have a HCBS Plan of Care developed. Intandem is contracted with several Managed Care Organizations to act as a RCA.
Psychosocial Rehabilitation (PSR)
These services are designed to assist the individual with compensating for or eliminating functional deficits and interpersonal and/or environmental barriers associated with their behavioral health condition. The intent of PSR is to restore the individual’s functional level to the fullest possible and as necessary for integration of the individual as an active and productive member of his or her family, community, and/or culture with the least amount of ongoing professional intervention.
Community Psychiatric Support and Treatment (CPST)
Includes time-limited goal-directed supports and solution-focused interventions intended to achieve identified person-centered goals or objectives. The following activities under CPST are designed to help individuals to achieve stability and functional improvement in the following areas: daily living, finances, housing, education, employment, personal recovery and/or resilience, family and interpersonal relationships and community integration. CPST is designed to provide mobile treatment and rehabilitation services to individuals who have difficulty engaging in site- based programs who can benefit from off-site rehabilitation or who have not been previously engaged in services, including those who had only partially benefited from traditional treatment or might benefit from more active involvement of their family of choice in their treatment.
Services are designed to assist individuals with a behavioral health diagnosis in acquiring, retaining and improving skills such as communication, self-help, domestic, self-care, socialization, fine and gross motor skills, mobility, personal adjustment, relationship development, use of community resources and adaptive skills necessary to reside successfully in home and community-based settings. These services assist individuals with developing skills necessary for community living and, if applicable, to continue the process of recovery from an SUD disorder. Services include things such as: instruction in accessing transportation, shopping and performing other necessary activities of community and civic life including self-advocacy, locating housing, working with landlords and roommates and budgeting. Services are designed to enable the participant to integrate full into the community and ensure recovery, health, welfare, safety and maximum independence of the participant.
Family Support and Training (FST)
Training and support necessary to facilitate engagement and active participation of the family in the treatment planning process and with the ongoing instruction and reinforcement of skills learned throughout the recovery process. Training includes instruction about treatment regimens, elements, recovery support options, recovery concepts, and medication education specified in the Individual Service Plan and shall include updates, as necessary, to safely sustain the participant at home and in the community. All family support and training must be included in the individual’s service plan and for the benefit of the Medicaid covered participant.
Services are time limited and offered to individuals with a clear desire to work in a competitive work environment, and require education support referrals for various disability services and accommodation(s) to participate in a secondary academic education or certified training program.
Services are time limited support for individuals with a clear desire to work and require work related experiences necessary to learn or develop non -job-task-specific soft skills. Strong soft skills increase employability and retention in the integrated and competitive work environment.
is a time limited service that supports an individual who requests assistance to improve a work record and work skills due to a limited work history and/or a current slip within the continuum of the individual’s recovery.
Intensive Supported Employment
Services consist of individualized and intense person-centered services that enable individuals with a clear desire to obtain and retain competitive employment, and require intensive employment support/accommodation to function in the competitive work environment. This service assures career growth to maintain employment.
Ongoing Supported Employment
Services provide employed individual with direct and ongoing person-centered employment support to maintain and encourage career development within the continuum of the individual’s recovery.