NYS Behavioral Health (BH) Home and Community Based Services (BH HCBS) Dashboard Data The below references information found in the Data Table entitled “NYS Medicaid Adult HCBS Access Dashboard.” This data is broken out between NYC and Rest of State Regions and by each Medicaid Managed Care (MMC) Plan. This data set provides a snapshot of the number of individuals who have completed significant steps toward utilizing NYS Adult Behavioral Health (BH) Home and Community Based Services (HCBS). All data is unique recipient data meaning t hat all Individuals are counted only once. This data is updated on a monthly basis.
Col. No.
Data Set Source Description Notes
1
HARP Eligible
Medicaid Data Warehouse (MDW)
Number of individuals by MMC Plan with a HARP eligibility code (H code) and enrolled in HARP, HIV/SNP or Mainstream at the time of the data run*
Does not include Individuals who have H code but not enrolled in HARP, HIV/SNP or Mainstream.
*By excluding all other plan types, like LTC, we removed the recipients who will not be enrolled even if they have H code.
2
HARP Enrolled
Medicaid Data Warehouse (MDW)
Number of individuals by MMC Plan who have a HARP eligibility code (H code) and enrolled in HARP or HIV/SNP
Data captures the number of HARP enrollees with HARP premiums paid to NYS Medicaid Managed Care Organizations. Does not include Individuals who remain in the HARP but lost H code.
3
Health Home Enrolled
Medicaid Data Warehouse (MDW)
Number of individuals by MMC Plan with an H code who are both enrolled in a HARP/ HIV/SNP and enrolled in a Health Home (HH). Does not include HARP-enrolled individuals currently being outreached by a HH.
In contrast, Health Home enrollment data from the MAPP dashboard includes HH-enrolled and HH-outreached individuals.
4
HCBS Assessed in Past 12 Months
CMHA/ UAS Number of individuals by MMC Plan who have a H code and have completed the NYS Eligibility Assessment for Behavioral Health (BH) Home and Community Based Services (BH HCBS) within last 12 months.
BH HCBS assessment data has approximately a one-week lag. While based on claims, this data set captures only the number of individuals who have completed one or more assessments, and not the number of total assessment claims received by the MDW.
HCBS Eligible
CMHA/ UAS Number of individuals by MMC Plan who have completed the assessment within last 12 months and been found eligible for Tier 1 or 2 BH HCBS.
The eligibility rate is persistently around 100%. This element has be moved because of less usefulness.
6 LOSD Requested
As reported by MCOs
Number of members by MMC Plan with level of service determination requests submitted to MCOs
AS OMH is reformatting the templates being used to collect this Data from MCOs, this element is on hold since May 2020.
7 HCBS Auth Requested
As reported by MCOs
Number of members by MMC Plan with authorization requests for HCBS submitted to MCOs
As OMH is reformatting the templates being used to collect this data from MCOs, this element is on hold since May 2020.
8
Recipients Received HCBS in Past 12 Months
Medicaid Data Warehouse (MDW)
Number of individuals by MMC Plan who have received BH HCBS as determined by having at least one paid BH HCBS service claims within last 12 months (without claim-lag). Individuals with multiple service claims are only counted once.
BH HCBS assessment claims and provider travel supplemental claims are not included in this data set. The months that still impacted by claim-lag are excluded. For example, the dashboard updated at May 2020 includes all recipients who has least one service claim during Feb 2019-Jan 2020.
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HARP Restriction / Exemption Codes
R/ECode
Description Notes
H9 HARP eligible but pending enrollment. This person has been determined to be “categorically eligible” for a HARP. They will be given the option of enrolling in a HARP.
• If this person is already in an HIV SNP they do not have H9, but rather code H4.
• They can choose to remain in the HIV SNP or move to a HARP. • If they remain in the HIV SNP they could potentially, based on the
results of a more in depth assessment, qualify for BH HCBS services under codes H5 or H6. At this time, there should be no attempt by a HH to complete the CMHA.
H1 HARP enrolled without BH HCBS eligibility. • This person was assessed and is not eligible for BH HCBS, or • Has not yet been assessed for BH HCBS eligibility
At this time, HH should begin the CMHA process if it has not yet done so and found the person not eligible for BH HCBS services.
H2 Enrolled in a HARP. The person has been assessed and determined to be eligible for Tier 1 BH HCBS (peer supports, employment supports, education supports).
As authorized by the HARP, referrals should be made by the HHCM to BH HCBS service providers.
H3 Enrolled in a HARP. The person has been assessed and determined to be eligible for Tier 2 BH HCBS (which includes all Tier 1 services listed under H2, plus psychosocial rehab, community psychiatric supportsand treatment, etc.)
As authorized by the HARP referrals should be made by the HHCM to BH HCBS service providers.
H4 Enrolled in an HIV SNP as HARP eligible. • The person has been assessed and is not eligible for BH HCBS, or • The person has not yet been assessed for BH HCBS eligibility.
At this time, HH should begin the CMHA process if it has not yet done so and found the person not eligible for BH HCBS services.
H5 The person is enrolled in an HIV SNP and has been assessed and determined eligible for Tier 1 BH HCBS (peer supports, employment supports, education supports).
As authorized by the HARP referrals should be made by the HHCM to BH HCBS service providers.
H6 The person is enrolled in an HIV SNP and has been assessed and determined eligible for Tier 2 HCBS (includes all Tier 1 services listed under H2, plus psychosocial rehab, community psychiatric supportsand treatment, etc.).
As authorized by the HARP referrals should be made by the HHCM to BH HCBS service providers.
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c sl
t t t l ll
NYSMedicaidAdultHCBSA cesDashboard,Region:NYC Source:MDW,UAS/CMHA&MCOsreportedData.UpdateDate:5/11/2020.AlMetricsintheupperpartofthisdashboardarecountofuniquerecipients.
PlanAlias HARPEligible HARPEnrolled HealthHomeEnrolled HCBSAssessedinPast12Months RecipientsRec'dHCBSinPast12Months
0K 10K 20K 30K 40K0K 10K 20K 30K 0K 2K 4K 6K 8K0K 1K 2K 3K 4K 5K 6K 0 200 400 600 800
Plan1
Plan2
Plan3
Plan4
Plan5
Plan6
Plan7
Plan8
Plan9 905
4,385
16,260
3,980
7,865
31,974
15,056
2,290
4,440
905
3,473
13,851
3,425
6,819
26,562
12,146
2,290
3,534
293
706
3,030
805
1,624
6,800
2,991
734
650
138
480
2,001
522
1,146
5,264
1,798
494
441
138
480
2,001
522
1,146
5,264
1,798
494
441
14
77
219
14
173
789
202
18
30
14
77
219
14
173
789
202
18
30
NYCSubtotal 87,155 73,005 17,633 12,284 1,536
InPercentage
PlanAlias
HARPEligible % HARPEnrolled/HARPEligible % HHEnrolled/HARPEnrolled % HCBSAssessedinPast12Months/HARP Enrolled
% RecipientsRec'dHCBSinPast12Months/ HCBSAssessedinPast12Months
0K 5K 10K 15K 20K0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100%
Plan1
Plan2
Plan3
Plan4
Plan5
Plan7
Plan8
Plan9
15,056
16,260
4,440
2,290
7,865
3,980
4,385
905
15,056
16,260
4,440
2,290
7,865
3,980
4,385
905
100%
100%
80%
81%
87%
86%
85%
79%
100%
100%
80%
81%
87%
86%
85%
79%
18%
32%
25%
24%
24%
22%
20%
32%
18%
32%
25%
24%
24%
22%
20%
32%
12.5%
21.6%
14.8%
16.8%
15.2%
14.4%
13.8%
15.2%
12.5%
21.6%
14.8%
16.8%
15.2%
14.4%
13.8%
15.2%
11%
15%
11%
16%
10%
7%
4%
3%
11%
15%
11%
16%
10%
7%
4%
3%
NYCSubtotal 87,155 83.8% 24.2% 16.8% 12.5%
Note(s): 1.Column1,2,3,5arefromMDW/PRDM asofupdatedateinthesubitle;column4arefromUASasofupdatedateinthesubitle;StatearereformatingthedatacolectedfromMCOsforLOSDsandPriorauthorizations.Thesetwocolumnswilbeaddedbackonceit'savailable. 2.The"Past12Months"inColumn5isdefinedasthe12-monthperiodbeforethemostrecent4monthsthatarestilsubjecttoclaim-lag(themostrecent4monthsareexcluded).Forexample,the12-monthperiodforJune2020reportisMarch2019-Feburary2020.
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c sl
t t t l ll
NYSMedicaidAdultHCBSA cesDashboard,Region:ROS Source:MDW,UAS/CMHA&MCOsreportedData.UpdateDate:5/11/2020.AlMetricsintheupperpartofthisdashboardarecountofuniquerecipients.
PlanAlias HARPEligible HARPEnrolled HealthHomeEnrolled HCBSAssessedinPast12Months RecipientsRec'dHCBSinPast12Months
0K 10K 20K 30K 40K 50K0K 10K 20K 30K 0K 2K 4K 6K 8K 10K 0K 2K 4K 6K 0 500 1000 1500 2000
Plan1
Plan2
Plan4
Plan5
Plan6
Plan8
Plan11
Plan13
Plan15
Plan16
Plan17
Plan18 2,607
8,135
8,579
1,838
3,005
2,015
482
3,350
41,002
11,971
4,957
2,341
2,181
6,126
6,803
1,641
2,516
1,634
357
2,464
31,558
9,838
3,979
1,753
956
1,696
2,147
416
893
491
90
855
9,189
2,935
914
608
538
1,044
1,000
347
398
322
58
573
5,325
2,074
577
335
538
1,044
1,000
347
398
322
58
573
5,325
2,074
577
335
177
195
303
124
152
21
8
192
1,694
819
97
65
177
195
303
124
152
21
8
192
1,694
819
97
65
ROSSubtotal 90,282 70,850 21,190 12,591 3,847
InPercentage
PlanAlias
HARPEligible % HARPEnrolled/HARPEligible % HHEnrolled/HARPEnrolled % HCBSAssessedinPast12Months/HARP Enrolled
% RecipientsRec'dHCBSinPast12Months/ HCBSAssessedinPast12Months
0K 5K 10K 15K0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100%
Plan1
Plan2
Plan4
Plan6
Plan8
Plan11
Plan13
Plan15
Plan16
Plan17
Plan18
11,971
2,341
4,957
3,350
2,015
3,005
1,838
8,579
8,135
2,607
482
11,971
2,341
4,957
3,350
2,015
3,005
1,838
8,579
8,135
2,607
482
75%
80%
82%
74%
74%
81%
84%
89%
79%
75%
84%
75%
80%
82%
74%
74%
81%
84%
89%
79%
75%
84%
35%
23%
30%
35%
25%
30%
35%
25%
32%
28%
44%
35%
23%
30%
35%
25%
30%
35%
25%
32%
28%
44%
19.1%
14.5%
21.1%
23.3%
16.2%
19.7%
15.8%
21.1%
14.7%
17.0%
24.7%
19.1%
14.5%
21.1%
23.3%
16.2%
19.7%
15.8%
21.1%
14.7%
17.0%
24.7%
19%
17%
39%
34%
14%
38%
36%
30%
19%
33%
7%
19%
17%
39%
34%
14%
38%
36%
30%
19%
33%
7%
ROSSubtotal 90,282 78.5% 29.9% 17.8% 30.6%
Note(s): 1.Column1,2,3,5arefromMDW/PRDM asofupdatedateinthesubitle;column4arefromUASasofupdatedateinthesubitle;StatearereformatingthedatacolectedfromMCOsforLOSDsandPriorauthorizations.Thesetwocolumnswilbeaddedbackonceit'savailable. 2.The"Past12Months"inColumn5isdefinedasthe12-monthperiodbeforethemostrecent4monthsthatarestilsubjecttoclaim-lag(themostrecent4monthsareexcluded).Forexample,the12-monthperiodforJune2020reportisMarch2019-Feburary2020.
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NYSMedicaidAdultHCBSServiceClaimsandEncountersDashboard Source:MDW (EncountersOnly),UpdateDate:4/30/2020
NYC ROS GrandTotal
HCBSServiceSub-Catgy NClaims/Encounters UniqueRecipients NClaims/Encounters UniqueRecipients NClaims/Encounters UniqueRecipients
Total 49,519 2,731 134,870 5,612 184,389 8,343
PeerSupportServices 15,313 1,057 37,873 2,617 53,186 3,674
ProviderTravelSupplement 5,927 753 30,737 2,739 36,664 3,492
PsychosocialRehabilitation 5,683 293 20,241 1,077 25,924 1,370
HabilitationServices 2,617 184 13,435 891 16,052 1,075
EducationSupportServices 3,213 428 12,341 1,243 15,554 1,671
Short-term CrisisRespite 9,338 783 1,671 281 11,009 1,064
CommunitySupportandTreatment 2,446 171 7,641 573 10,087 744
Pre-vocationalServices 2,454 294 4,362 494 6,816 788
IntensiveSupportedEmployment 1,926 217 4,568 551 6,494 768
FamilySupportandTraining 204 29 1,000 115 1,204 144
On-goingSupportedEmployment 163 26 756 68 919 94
TransitionalEmployment 235 32 228 37 463 69
IntensiveCrisisRespite 17 10 17 10
ClaimsVolumeTrend RecipientsServedTrend NYC ROS 1,865
8K
7K
6K
HCBSServiceColorLegend
PeerSupportServices
ProviderTravelSupplement
PsychosocialRehablitation
HablitationServices
IntensiveSupportedEmployment
FamilySupportandTraining
On-goingSupportedEmployment
TranstionalEmployment
1500
NYC/ROSColorLegend
NYC
ROS
1,731
1,7001,663 1,503 1,650
1,391 1,546
1,3731,34 19 ,4371,244
1,289EducationSupportServices IntensiveCrisisRespite
NumofRecip[Line]
1,124 1,117Short-termCrisisRespite
CommunitySupportandTreatment
1,026
ClaimsVol.[Area] 5K 1,0129331000
Pre-vocationalServic 794 961es
4K 672 814
611671 587580 706 4975653K 545522 563 585426500
498346398 470313325 377447277PeerSupportServices 320 3142K 292 319 331322202 259 25391PeerSupportServices 22259PsychosocialRehablitation 113334412611 1421K PsychosocialRehablitation 177 1EducationSupportServices 0 44 1411 1111611EducationSupportServices
IntensiveSupportedEmployment0K
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