New York State has secured approval for a Medicaid 1115 waiver, a significant initiative endorsed by the Centers for Medicare and Medicaid Services. This waiver is designed to elevate the overall quality of healthcare and improve health outcomes for all New Yorkers. With a substantial $7 billion investment distributed across the state over three years, concluding in March 2027, this program aims to revolutionize healthcare delivery.
Key initiatives funded by this waiver include:
- The establishment of Social Care Networks (SCNs) to provide essential health-related social care services to Medicaid beneficiaries.
- Strengthening the bonds between primary care providers and community-based organizations to enhance care quality and health outcomes for New York residents.
- Strategic investments in primary care infrastructure and the development of a robust and sustainable healthcare workforce within the state.
- Targeted support for geographic areas consistently facing health disparities and limited interaction with the formal healthcare system.
Delving into Social Care Networks
Community-based organizations, healthcare providers, and various entities offering health-related social needs services are encouraged to participate in Social Care Networks. The Medicaid 1115 waiver provides funding that enables organizations within these networks to seek reimbursement for specific eligible social services (PDF), as detailed in the waiver.
These networks are crucial for connecting Medicaid members with unmet health-related social needs to vital resources, including housing, nutritional support, transportation, and comprehensive care management services. A key component of these networks is the utilization of the Accountable Health Communities (AHC) screening tool, also known as the Nys 1115 Waiver Social Care Screening Tool. This tool, available as a PDF document, helps network organizations identify the social needs of Medicaid members and guide them towards appropriate support services.
Below you can find more details regarding funding opportunities and reimbursable activities for participating organizations.
Important Notice: Reimbursement for health-related social needs services through Social Care Networks and their partners in New York State will commence in January 2025. Interested organizations are advised to promptly contact the lead Social Care Networks to facilitate their integration into these vital networks.
Eligibility and Joining a Network
In New York City, three established Social Care Networks are currently operational. Organizations that deliver services within any of the boroughs can apply to join these networks.
For information on networks operating outside of New York City, please visit the NYS Department of Health: Social Care Networks website.
For any inquiries about Social Care Networks or the Medicaid 1115 waiver, please reach out to the NYS Department of Health at [email protected]. Organizations can also contact the NYC Health Department through their Community Partner Feedback Form or via email at [email protected].
