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Transition of the NHTD and TBI Programs to Managed Care

On Oct. 8, 2015, the New York State Assembly held a public hearing in regards to Traumatic Brain Injury (TBI) treatment and services. The hearing was held by the Assembly committee on health, committee on mental health and the task force on people with disabilities. The purpose of the hearing was to listen to testimony on the issues of patients being correctly diagnosed in the emergency room, availability of treatments and services, complications/delays of treatment in regards to worker’s compensation cases and transitioning New York’s Medicaid “TBI Waiver” participants to managed care. A variety of testimonies were heard from TBI participants, families, DOH staff, providers, clinicians and associations and advocates.  LeadingAge New York’s Vice President for Advocacy and Public Policy Ami Schnauber also testified. Please watch her testimony here (minute 29:30).

As we have previously reported to members, LeadingAge NY serves on the Nursing Home Transition and Diversion (NHTD) and TBI transitions work group and several subcommittees. The first subcommittee meeting was held on Oct. 6th. The agenda included cross walking the NHTD and TBI Medicaid waiver services with the various services provided by different plans. Most of the discussion centered on what waiver services “elements” should be incorporated into the plans benefits and those elements need to be incorporated for all present and future plan members that have a TBI. The agenda also included discussion on outreach material, an overview of the UAS-NY and the problems encountered when this tool is used for participants with a cognitive deficit, and an overview of rate setting.

We will continue to keep members posted on additional information as it becomes available.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871