On July 1, 2016, Affinity Health Plan will launch a new HARP (Health and Recovery Plan) line of business. This plan will go by the name Enriched Health. Eligibility for Enriched Health is based on a member’s prior use of mental health and substance abuse services. This new HARP includes all of the behavioral health services that were transitioned into Managed Care on 10/1/15, plus additional services known as Home and Community Based Services (HCBS).
You received this letter because you are enrolled in Medicaid. This
letter was sent to let you know about changes to NY State’s Medicaid program
and how they can help you.
Also, if you received a HARP Eligibility
letter, this is to let you know of additional services known as Home and
Community Based Services, or HCBS. Eligibility for HARP and HCBS is based on
your use of services in the past.
plan is being introduced called Enriched Health. It includes all of the
benefits you already have with Medicaid, plus some other support services for
people who qualify, like help finding a job or housing, or education support,
family support, crisis care, or helping you be the healthiest person you can
The State has specific rules when joining a HARP.
You should have received a letter explaining how you were chosen for this new
No. Enrollment is voluntary.
As long as you still meet the guidelines, you can join later.
However, New York State has said that there will be periods for open
enrollment or changes that may limit when you can join. We recommend that you
contact New York Medicaid Choice (Maximus) to find out about the next enrollment
There will be no changes to your child’s benefits. However, they will
not be able to use these other services and they will not be an Enriched Health
Enriched Health eligibility is based on a member’s past
use of certain services. Some members have been recognized as people who could
benefit from additional services to help them reach their health goals.
You can contact Beacon Health Options and they can help
You are eligible to
have Health Home services coordinate your health care. You have a choice of
which Health Home you enroll with. Once you decide, you should receive a
welcome letter from Health Home describing how they can help you with your
If you are already enrolled with a Health Home, you will
still use them for coordinating your care. If you aren’t enrolled in a Health
Home, you need to follow the same process that you do today.
there are case managers at your health plan that can provide extra help for care
A Health Home is a central point of contact and
coordination for your health care needs. There are case managers who work with
you and your doctors to make sure you are getting the services you need and
want. There are certain conditions you need to meet to be eligible for a Health
For Enriched Health members, there are services that
provide education and job training to help you reach your employment goals.
These services will be based on answers to questions your Health Home completes
with you. The services will be available starting October 2016.
Health Homes help members apply for and obtain
housing. For Enriched Health members, there are extra services to help you apply
for permanent housing, including assisted housing of different types. These
services will be based on answers to questions that your Health Home completes
with you. The services will be available starting October 2016.
With Enriched Health, members are offered extra
employment training to help them reach their employment goals. These services
will be based on answers to questions your Health Home completes with you. The
services will be available starting October 2016.
It is important that in helping you, your family is
also helped. There are other services for Enriched Health- and SNP/HCBS-eligible
members that will assist your family in supporting you as you reach your health
goals. These services will be based on answers to questions your Health Home
completes with you. The services will be available starting October
For all Medicaid-enrolled members, these
services are designed for individuals going through hard times in their everyday
life, that call for treatment in a residential-type setting outside of the home.
There is a service called Crisis Respite which offers peer and
clinical support, and a service called Intensive Crisis Respite
which offers extra clinical support. These services will be based on answers to
questions your Health Home completes with you.
ACT services are teams of people from psychiatry, nursing, psychology,
social work, substance abuse and vocational rehabilitation backgrounds who work
together to provide someone combined services based on that individual’s goals.
As the goals change, the services are adjusted to support the individual’s
changing needs. An ACT team works with you outside the clinical setting. They
can come to your home, work or other setting, whichever works best for you.
Health Homes assist members with applying for and obtaining housing.
The PROS program is designed for individuals
with severe mental illness. It has four (4) parts:
The overall goals of the PROS program
are to improve behavior, reduce relapse, increase employment, get an education
and find the best housing.
All of the
outpatient services available to you today are available to you for all
programs. This includes: Outpatient withdrawal services, opioid (pain relief)
treatment, substance abuse rehab, outpatient mental health treatment, and many
more services. You can call a peer advocacy center for more information. You
also will be receiving a new member handbook that includes the added outpatient
Medicaid & HARP: There is Comprehensive
Psychiatric Treatment, Substance Abuse rehabilitation, PROS focused on improving
behaviors, reducing relapse, increasing employment, getting an education and
finding the best housing. There are other peer supports and services based on
your need. I can have a clinician reach out to you if you would like to discuss
your specific circumstances.
HARP: There are other
programs focused on psycho-social rehabilitation, and community psychiatric
support. The programs that you would qualify for are determined based on an
assessment. You will be assigned a Health Home Care Manager, who will reach out
to you to complete the assessment.
Your care is
covered as it is today. You will not be charged for your care.
No. To get these additional services, you
have to be identified by the New York State as needing them, or your doctor can
suggest that you qualify. You will be assigned a Health Home Care Manager to go
over your needs and to help coordinate your care.
The additional HCBS services are only
available to members that have been identified by NY State as needing them. You
will be assigned a Health Home Care Manager to go over your needs and to help
coordinate your care.
A plan of care is a specially
designed way to help you reach your goals. It is designed by your Health Home
Care Manager to see what services you need.
Participants are qualified based
on their history of services used and on their current needs. To receive
specific details, please call: 1-844-HARP-999