Taking the next step in our mission to serve individuals with intellectual and other developmental disabilities and their families.
Why We Created PHP
This specialized managed care initiative traces its roots to the creation of the Association for Retarded Citizens (ARC) in the late 1940s (then known in New York as the State Association for the Help of Retarded Children, or AHRC). The founding parents believed that children with intellectual and other developmental disabilities (IDD) had the absolute right to grow, develop, participate in, and contribute to society. At that time, very few services and programs existed for children with IDD other than institutionalization and their parents became convinced that they had to create the necessary opportunities. They began by advocating for reforms, and when that proved insufficient they started to actively develop programs, services, and supports that would enable their children to participate in the same activities of everyday life as their typically developing peers.
In recent years, recognizing the sometimes fragmented delivery of services and supports and the lack of coordination between long-term services and health care for individuals with IDD—especially as persons with IDD and their families aged—the Downstate NYSARC chapters began evaluating approaches to integrate the full continuum of care. This was a logical extension of the robust capacity that had been developed to meet the habilitative needs of ARC/AHRC beneficiaries and families over the years. The goal was to seamlessly and efficiently integrate physical and behavioral health services with other long-term services and supports such as habilitation and develop processes and tools to evaluate and continuously improve the overall performance of a fully integrated system.
The Downstate ARCs/AHRCs decided that the best way for parents to assure the long-term future of their children was to participate in the development and implementation of a managed care program in the same manner as they had developed the other core components of habilitative care. They set out to build an organization that features all of the best practices of managed care and meets or exceeds each and every quality metric and reporting requirement, but at the same time tailored to the unique needs of individuals with intellectual and other developmental disabilities.
Incorporated in 2012 and granted a Certificate of Authority to operate a Managed Long-Term Care Plan (MLTCP) in 2013, PHP represents New York State’s first managed care plan exclusively dedicated to serving persons with intellectual and other developmental disabilities. PHP was also approved by the Federal Centers for Medicare and Medicaid Services (CMS) to operate a specialized Fully Integrated Duals Advantage (FIDA) Plan for individuals with IDD who have both Medicare and Medicaid. PHP’s FIDA-IDD plan will operate in nine New York counties (i.e., the five boroughs of New York City, Nassau, Rockland, Suffolk, and Westchester Counties) beginning in April 2016. Known as “PHP Care Complete FIDA-IDD Plan,” the plan will provide all Medicare- and Medicaid-covered services, including OPWDD services to eligible individuals who elect to participate.