Generative Resources

Effective October 1, 2011 NewYork-Presbyterian System SelectHealth will be responsible for the Pharmacy Benefit for its members.   The following links are provided:

SelectHealths Web Site:  http://www.nyp.org/selecthealth

Formulary:  NYPSSH Formulary

Instructions to Access Pharmacy Network Directory:  Guest Instructions to Pharmacy Database

CVS Caremark:  CVS Caremark

A Legacy of Care

This 15 minute plenary session video produced by HRSA HIV/AIDS Bureau  first aired during the 2010 Ryan White Grantee Meeting.

Interviewees from New York include:

• Peter Gordon, MD
• Jay Dobkin, MD
• Victoria Sharp, MD
• Eli Camhi, LMSW

http://www.youtube.com/watch?v=SOGD8dueHeI&feature=youtube_gdata_player/

NewYork-Presbyterian System SelectHealth’s Special Project of National
Significance featured in HRSA HIV/AIDS Bureau 2010 Biennial Progress Report

Going the Distance
The Ryan White HIV/AIDS Program
20 Years of Leadership, A Legacy of Care

This progress report celebrates the legacy of the first responders to the AIDS epidemic, the 1990 passage of the first Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, and the creation of and progress made by the Health Resources and Services HIV/AIDS Bureau. It presents the history of the CARE Act, now renamed Ryan White HIV/AIDS Treatment Extension Act, and its components, case studies illustrating the pursuit of excellence throughout the years, successes, and the challenges to come. The report includes the FY08 Ryan White HIV/AIDS Program Data Summary tables, figures, and references.

See Chapter 3 page 35. Case Study: SelectHealth, NewYork-Presbyterian System

Congratulations to all the New York providers included in
the Report:

Boriken Neighborhood Health Center
Bronx Lebanon Hospital Center AIDS Center
AIDS Service Center
St Luke’s-Roosevelt Hospital Center: The Center for Comprehensive Care

The report is available here:

http://hab.hrsa.gov/data/files/2010progressrpt.pdf

Hard copies are available free from HRSA:
http://ask.hrsa.gov/detail_materials.cfm?ProdID=4456

Approaching the Triple Aim for NY’s HIV Population

Eli Camhi, MSSW 1 , Joel Menges 2 , Franklin Laufer,Ph.D. 3, Ira Feldman 3

1 NewYork-Presbyterian System SelectHealth, NY, NY, 2 The Lewin Group, 3 New York State Department of Health, AIDS Institute

Poster presentation at the Institute for Healthcare Improvement’s 22nd Annual National Forum on Quality Improvement in Health Care December 5-8, 2010, in Orlando, Florida

Poster in pdf format available here:  Approaching the Triple Aim for NY’s HIV Population

The original Triple Aim article was published in Health Affairs May/June 2008 and guides the IHI Triple Project
which is described on the IHI web site : http://www.ihi.org/IHI/Programs/StrategicInitiatives/TripleAim.htm

QUALITY & ACCOUNTABILITY: Donald M. Berwick, Thomas W. Nolan, and John Whittington The Triple Aim: Care, Health, And Cost The remaining barriers to integrated care are not technical; they are political. Health Affairs, May/June 2008; 27(3): 759-769. View or download this article here:  Full Text

It is now possible to find current NewYork-Presbyterian System SelectHealth HIV Specialist Primary Care Providers (HIV PCPs) through an online interactive database.  While the Plan has always made this information available online through its Provider Directory (http://www.nyp.org/selecthealth), this searchable database offers users a quicker way to find specific PCPs.

Follow the link below and choose “Login as a Guest” to view the database.  No password is required.  Providers can be found by search or by selecting one of 3 views: Provider Last Name, Borough, and Practice Location.

This Document provides a simple description on how to access the website.

https://nyps-selecthealth.webexone.com

This resource will be most useful to COBRA Programs and Community Based Organizations. Please pass it on.

The quickest way to enroll in a New York City HIV Special Needs Plan (SNP) is to call Medicaid CHOICE (1-800-505-5678). For people with hearing problems, please call the TTY/TDD number, which is 1-888-329-1541.

Medicaid CHOICE accepts calls:

• Monday – Friday 8:30 am to 8:00 pm
• Saturday 10:00 am to 6:00 pm

Operators are available who can speak English, Spanish, Haitian Creole, Chinese, Russian and also other languages upon request. Here are some tips to get done quickly:

• Have your Medicaid number on hand.
• The counselor will ask you for your Medicaid number and tell you if you are eligible to enroll in a Plan.
• If you know which SNP you want to join, tell the counselor your choice.
• If you don’t know what SNP your doctor/provider is in then the counselor can look them up and tell you. The counselor can tell you about all the SNPs and the Managed Care Plans serving your borough. The counselor cannot choose a SNP or Plan for you.
• If you do not have a doctor/provider then decide in which borough you would like to receive your care and the counselor will assist you in identifying available providers in each SNP.
• If you are eligible the counselor will tell you the date you will be enrolled.
• Once you select a SNP the counselor, after gathering some basic information from you, will connect you to the SNP member services staff so you can talk to them.

The call can take 20-40 minutes.

Remember during mandatory enrollment

“To have a choice you must make a choice!”

As of July 2010 the following Plans/SNPs are available to eligibles Medicaid beneficiaries in New York City:

On July 1, 2010 the NYSDOH Office of Medicaid Managed Care announced a revised start date of September 1, 2010 for mandatory Medicaid managed care enrollment for eligible PLWHAs. Mandatory packets will be sent to Brooklyn residents first.

SSI beneficiaries have 90 days to choose a Mainstream Plan or SNP. Non-SSI beneficiaries have 60 days to choose but can request an additional 30 days. If the client does not choose a Mainstream Plan or SNP then they will be auto assigned to a Mainstream Plan. They will not be auto assigned to an HIV Special Needs Plan. Approximately 2,500 Packets per month will be sent.

The estimated number of eligibles by borough are:

5,148 Brooklyn

6,084 Bronx

3,528 Manhattan

1,768 Queens

514 Staten Island

17,042 Total

In addition a city-wide “Heads Up” letter will be sent August 1, 2010 to all eligibles alerting them of mandatory implementation.

For the most current information regarding mandatory managed care in New York State visit:

NYSDOH

http://www.health.state.ny.us/health_care/managed_care/living_with_hiv/

NYCDOHMH

http://www.nyc.gov/html/doh/html/hca/hca1.shtml

The following calendar shows the possible implementation timeline based on public notices.

Over the past few years a number of significant reports have been released describing various aspects of HIV Special Needs Plans.  If you know of other relevant reports send an email to me at ecamhi@generes.com.

Report Links

Information needs of case managers caring for persons living with HIV

Rebecca Schnall, James J Cimino, Leanne M Currie, Suzanne Bakken, JAMIA doi:10.1136/jamia.2010.006668

Perceptions of Factors Influencing Use of an Electronic Continuity of Care Record for Case Management of Persons Living with HIV, 2010
Schnall R, Gordon P, Camhi E, Bakken S.

AIDS Care (in press)

HIV patients’ willingness to share personal health information electronically
Paul A. Teixeira, Peter Gordon, Eli Camhi, Suzanne Bakken

Patient Education and Counseling, In Press, Corrected Proof, Available online 17, August 2010, ISSN 0738-3991, DOI: 10.1016/j.pec.2010.07.013.

http://www.sciencedirect.com/science/article/B6TBC-50T949V-1/2/4040fd9fd402dd3e60bbd2ecada2264b

Barriers to implementation of a Continuity of Care Record (CCR) in HIV/AIDS care.

Rebecca Schnall, Michelle Odlum, Peter Gordon, Suzanne Bakken

Stud Health Technol Inform 2009 vol. 146 pp. 248-52
http://booksonline.iospress.nl/Content/View.aspx?piid=12659

Lewin – Evaluation of  New York’s HIV Special Needs Plan Program: Cost and Usage Impacts – November 6, 2009

Evaluation of New Yorks HIV Special Needs Plan Program: Cost and Usage Impacts – November 6 2009

Feasibility of using audio computer-assisted self-interview (ACASI) screening in routine HIV care

Bruce R. Schackman a;  Zubin Dastur ab;  David S. Rubin c;  Judith Berger d;  Eli Camhi e;  Julie Netherland f;  Quanhong Ni a; Ruth Finkelstein f

• a Department of Public Health, Weill Cornell Medical College, New York, USA
• b New York University School of Medicine, New York, USA
• c New York Hospital Medical Center of Queens, Flushing, NY, USA
• d St. Barnabas Hospital, Bronx, NY, USA
• e NewYork Presbyterian System Select Health, New York, USA
• f  The New York Academy of Medicine, New York, USA

AIDS Care, Volume 21, Issue 8 August 2009 , pages 992 – 999

http://www.informaworld.com/smpp/content~content=a915041453~db=all

Comparison of Fee-for-Service, Mainstream Managed Care and HIV Special Needs Plans (SNPs) Shows Better Quality in Managed Care – August 2008

http://www.health.state.ny.us/press/releases/2008/2008-08-01_comparison_of_delivery_systems.htm

“Choices in Care” Ranks HIV Care in Special Needs Managed Care Plans as Superior to Traditional Medicaid – August 2008

http://www.health.state.ny.us/press/releases/2008/2008-08-01_choices_in_care_study.htm

Beyond satisfaction: Using the Dynamics of Care assessment to better understand patients’ experiences in care

Bruce Rapkin1 , Elisa Weiss1 , Rosy Chhabra3 , Laura Ryniker1 , Shilpa Patel1 , Jason Carness1 , Roberto Adsuar1 , Wendy Kahalas2 , Carol DeLaMarter2 , Ira Feldman2 , Judy DeLorenzo2 and Ellen Tanner2

• 1  Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, USA
• 2  AIDS Institute, New York State Department of Health, Albany, USA
• 3  Department of Pediatrics, Albert Einstein College of Medicine, Bronx, USA

Health and Quality of Life Outcomes 2008, 6:20

http://hqlo.com/content/6/1/20

Are People Getting the Care they Need?  by Bruce D. Rapkin, Ph.D. – The Body Summer 2005

http://www.thebody.com/content/art14266.html

HIV Special Needs Plans (SNPs): A New Health Care Option in New York by Doug Wirth – The Body Winter 2005-2006

http://www.thebody.com/content/art30275.html

Developing a Managed Care Delivery System in New York State for Medicaid Recipients with HIV – American Journal of Managed Care – 1999

Ira Feldman, MPA; Humberto Cruz, MS; Judy DeLorenzo, MS; Julia Hidalgo, ScD; Hope Plavin, MPA; and John Whitaker, MS

http://www.ajmc.com/media/pdf/AJMC99novFeldmnAIDS145_65.pdf

On February 2, 2010 I attended the public ceremony of the swearing in of the Presidential Advisory Council on HIV/AIDS (PACHA) in Washington, DC.

This is an extract of my public comments before the Council.

Follow this link if the video does not display.

http://www.youtube.com/watch?v=7inSmBOy70o

The full video of the session is 90 minutes long and can be seen here:

http://www.whitehouse.gov/photos-and-video/video/presidential-advisory-council-hivaids