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7 Years - Partners Health Plan Gets Results

7 Years - Partners Health Plan Gets Results

Dear Members Families, & Friends,

We invite you to join us in celebrating PHP’s 7th Anniversary!

In 2016, we launched a non-profit organization and a new model of care for Individuals with Intellectual and Developmental Disabilities (IDD). We have delivered life-changing benefits and person-centered care coordination under a single and holistic plan. For the past seven years, we have been dedicated to improving lives.

We are very proud of what we have done to make healthcare more accessible to reduce health disparities. Below are highlights from last year.

Thank you for putting your trust in Partners Health Plan. We are grateful each and every day that we can assist members and families live their best lives!

With Gratitude


Kerry Delaney, CEO

What Did We Do in 2022?

We Excelled

  • An independent evaluation funded by the Centers for Medicare & Medicaid Services (CMS) reports that PHP’s innovative solutions like the pharmacy management program reduced errors, unnecessary emergency department visits, and length of hospital stays.

  • The telehealth program successfully resolved 90% of member’s concerns which prevented trips to the hospital.

  • More members completed colorectal cancer screening; diabetes testing and controls; controlled high blood pressure; completed annual dental visits and received annual flu vaccines compared to national and New York State health plans.

  • 90% of PHP members have received at least one dose of the primary COVID-19 vaccination.

  • 70% of the eligible members have received the booster dose.

We Talked About Diversity, Equity, & Inclusion

  • We expanded the Diversity, Equity, & Inclusion (DEI) Department, added more staff volunteers to our dedicated DEI council with representation from across the organization, held multiple cultural recognition forums and safe space conversations, and added to our DEI related education modules for staff.

We Expanded Our Services & Supports

  • We added 1,200 new providers, including Stonybrook Medicine enhancing our Network for members on Long Island.

  • Implemented an in-house Patient Care Assessment team to quickly get home care services in place.

  • New contracts with DentaQuest & Ridehealth to provide better dental & transportation services.

  • Partnered with Solvere Health to pilot specialized IDD mobile dental clinics at select-day service locations in Metro New York.

  • Over-the Counter (OTC) cards were added to the benefit package for more than 600 community members.

  • We launched a text messaging program to provide health care reminders, supporting preventative health care and wellness for our members.

We Supported You

  • Our Designated Representative Committee met 96 times to review more than 700 Life Plans.
  • PHP hosted 3 Member & Family meetings, Participant Advisory Committee meetings, family education sessions, and Peer Empowerment Group meetings.

We Advocated

  • Provided recommendations to OPWDD Commissioner Neifeld regarding COVID-19 protections for people with IDD.
  • Members and families testified before the General Assembly on the 2023-2027 OPWDD 5.07 Strategic Plan.
  • Members, families, and staff rallied at the NYS Capitol in support of Direct Support Professionals (DSPs).
  • Comments provided by PHP resulted in modifications to the proposed DOH 1115 waiver changes.

We Celebrated

  • PHP earned NCQA-Certification on the HEDIS Compliance Audit

Air Quality Alert 6.8.23

Dear PHP Members,

The New York State Health Department has issued an air quality alert due to the smoke in our region coming from Canadian wildfires.

We recommend following the guidance from the New York State Department of Health regarding precautions and reduction of risk due to exposure.

  • Reduce outdoor exertion and avoid long-term exposure
  • Vulnerable New Yorkers, e.g., those with heart disease, congestive heart failure, prior history of heart attach, asthma and COPD or other health risks should remain aware of their local air quality and take precautions,  as necessary.
  • Exposure can cause short-term health effects such as irritation to the eyes, nose and throat, coughing, sneezing, runny nose and shortness of breath
  • People with heart or breathing problems, children and the elderly may be particularly sensitive to particulate matter

The NYC Department of Health is recommending properly-fitted, high-quality masks to help reduce exposure if you must go outside. Per the State Health Department, please limit outside exertion. If you experience symptoms of respiratory distress, please contact your primary care physician or seek emergency medical help.  There is a website you can use to check air quality in your zip code:  www.airnow.gov

If you have additional questions, please contact your Care Manager.  You can also check for updated information from the New York State Department of Health website at https://www.governor.ny.gov/news

Are You Concerned About Diabetes?

If You Are Concerned About Diabetes

Diabetes is a disease that affects how your body turns food into energy. A lot of what you eat turns into sugar (glucose) and goes into your blood. As your blood sugar goes up your body produces insulin to let the blood sugar go into cells to produce energy. If you have diabetes your body doesn’t produce insulin (Type 1) or the cells don’t respond to insulin (Type 2), so too much sugar stays in your blood. 

The biggest health risks of diabetes are associated with high blood sugar, which can increase the likelihood of blood clots and impaired blood flow by making cells sticky and blood vessels stiff.  This can damage tissues, resulting in high blood pressure, heart attacks, stroke, kidney failure, blindness, and skin infections, especially on the feet. A blood test called Hemoglobin A1C (HgbA1c) can measure the effects of blood sugar on their cells over time.  Regular measures of blood sugar will allow a person with diabetes or pre-diabetes to take measures to reduce their risks and improve their health.   

Making deliberate food choices is an excellent way to manage your weight, which makes a difference to controlling diabetes. Here are some tips: 

  • Load up on proteins first-don’t leave yourself feeling hungry by the time you get to those side dishes!
  • Choose high-quality plant-bases carbs instead of sugary items (e.g. sweet potatoes minus the marshmallows) 
  • Portions should always be small, with a variety of colors and textures-try shaving your veggies-looks are deceiving, so you’ll load your plate without needing large portion!
  • Keep moving! Helping to set/clear the table are simple ways to get some steps in!
  • Holiday baking can swap out white flour for a variety of options-no need to skip dessert if you plan right when baking!

Schedule activities such as walking, taking stairs, gardening, house cleaning, playing with a pet, anything that gets you moving!   

If you have diabetes, we are here to support you, your care manager can assist you with making sure you see your PCP and specialist if needed (Diabetes doctor called an Endocrinologist). To support your best health, it is important to see your doctors regularly and make sure you take all medications as prescribed. Your doctor may take a blood sample to check your A1c (this is a test to check how much sugar has been in your blood over the last few months), this test is a great way to see how you have been doing managing your diabetes. 

Schedule a visit with your doctor. And it’s always a good idea to have someone you trust come with you. Sometimes when we get to the doctor, we get nervous and don’t always hear what the  

doctor is saying. Having a second pair of ears helps. Also, that person can help you remember all your questions and give you support during an exam the doctor may need to do. 

Remember if you have any questions or need help to make an appointment, find a doctor to support you or need help getting your medication, your care Manager is here to help. For more information check out this helpful flyer.

Details can be found: https://www.prevention.com/food-nutrition/healthy-eating/g20495209/diabetes-friendly-thanksgiving-recipes/ 

Actual recipes: https://www.tasteofhome.com/collection/diabetic-friendly-recipes-for-thanksgiving/ and https://diabeticgourmet.com/recipes/holiday-and-special-occasions/thanksgiving-recipes 

Visit Partners Health Plan's Health Resources to learn more about the diabetes as well as other informative health-related articles.

 

H9869_Diabetes Article_2022

BronxNet Highlights Partners Health Plan's Specialized Dental Care Services

BronxNet Highlights Partners Health Plan's Specialized Dental Care Services

Karleen Haines, Chief of Member Relations and Advocacy, appeared on the BronxNet OPEN to discuss the Partners Health Plan (PHP) non-traditional care management model that will be offering specialized dental care services for PHP members-- enrollees with Intellectual and Developmental Disabilities (IDD)-- via mobile dental clinics in a partnership with Solvere Health.

PHP is the first-in-the-nation, non-profit, provider-led managed care organization, designed by IDD experts, that fully integrates Medicare and Medicaid for individuals 21 years and older with IDD. 

Capitol Pressroom Interview with COO Courtney Skivington-Wolf, RN

In the News

Capitol Pressroom Interview with COO Courtney Skivington-Wolf, RN

Partners Health Plan Chief Operating Officer Courtney Skivington-Wolf, RN was interviewed by the Capitol Pressroom, a daily public radio program that reaches more than two dozen stations across New York. Host David Lombardo spoke to Courtney about the specific needs and challenges associated with vaccinating people with Intellectual and Developmental Disabilities for the flu and COVID-19. Click here to listen to the interview.

Celebrating 6 Years: A Time to Look Ahead

This month we celebrate the PHP FIDA-IDD Plan’s 6-year birthday!

It was April 1, 2016, that the Centers for Medicare & Medicaid Services (CMS) and New York State began enrollment in New York, Long Island, Rockland & Westchester counties for the Fully Integrated Duals Advantage for Individuals with Intellectual and Developmental Disabilities (FIDA-IDD) Plan. It was designed to test a new model of care for providing Medicare-Medicaid enrollees with Intellectual and Developmental Disabilities (IDD) an opportunity to experience a more integrated, coordinated, and person-centered care focused on individuals’ long-term health and well-being so they may live a quality life.

PHP FIDA-IDD members have more opportunities to direct their own services, be involved in care planning, and live as independently in the community as possible.  Click here for PHP member stories.

As we celebrate the FIDA-IDD’s 6th birthday, we recognize the commitment of our staff to helping our members achieve their goals and the positive healthcare outcomes they deserve. We look forward to the future and to bringing more options and opportunities for our members.

Kerry Delaney, CEO, Partners Health Plan

Celebrating and Supporting #Pride2022

​​​​​​​As allies and self-advocates, it is important to remember that LGBTQ+ rights should be celebrated and supported year-round. From organizational policies to legislation, more work is needed to improve inclusive practices that address LGBTQ+ needs. 

 

Celebrating Disability Employment Success

Partners Health Plan members are sharing their employment journey stories to elevate disability employment awareness.  These stories describe the diverse experiences of people with disabilities and the employers that are benefiting from the dedication these talented individuals bring to their professional roles.

Did you know that one in four individuals in the U.S. have some type of disability, according to the Centers for Disease Control and Prevention (CDC)?  Did you know the employment rate for a New Yorker with a disability (age 18 – 64) is 31.2% compared to 72% for a person without a disability, resulting in a gap of 40.8% according to New York State (click here)?  The COVID-19 pandemic disproportionately affected many who have already faced significant barriers to employment, compounding their economic hardships.

We must use our voices and advocate for creating more accessible and inclusive workplaces by becoming informed on the value of hiring people with disabilities.

 A person with a disability recently summed it up the best by stating, “my disabilities do not define me.  My abilities do.”

Please join us in widening the lens by elevating awareness on what needs to be done to remove barriers in the workplace, so individuals who have a disability have the opportunity to access meaningful and well-paying jobs.  Do you know an organization that is moving the dial on disability employment by removing barriers?

DentaQuest Selected by Partners Health Plan to Administer Dental Benefits for Individuals with Intellectual and/or Developmental Disabilities in New York

DentaQuest, one of the nation’s largest and most experienced Medicaid dental benefits administrators, today announced its new engagement with Partners Health Plan (PHP) to increase access to oral health care and improve outcomes for individuals with intellectual and/or developmental disabilities (I/DD).

Partners Health Plan (PHP), a nonprofit managed care organization serving individuals with I/DD, selected DentaQuest to administer dental benefits and specialized services for its members. With the addition of PHP to its other government clients, DentaQuest now serves 63% of Medicaid enrollees in the state.

“We are honored to support Partners Health Plan in its commitment to serving adults with I/DD,” said Steven Pollock, president of DentaQuest. “We’ve long recognized the importance of increasing health equity for all, and health plans like PHP that focus on underserved populations are critical to making it happen. Oral health is often overlooked as more immediate medical needs take precedence, but as we know good oral health drives overall health and everyone can benefit from routine, preventive care. Innovative approaches, such as our industry-leading case management program, provide an extra level of support for individuals with I/DD and their caregivers to navigate a complex, imperfect health system to ultimately get the right treatment, at the right time.”

DentaQuest’s case management program helps identify appropriate resources needed to resolve a member’s issue – often unrelated to health care – and coordinates access to those resources with PHP care managers to ultimately achieve optimal oral health. Together, DentaQuest’s case management team and PHP care managers partner to secure transportation, medical clearance, sedation and anesthesia, hospital level care and other dental services.  The collaboration between PHP and DentaQuest has led to a substantial increase in member utilization and appears to be addressing long standing access challenges faced by the I/DD population.

Launched in 2016, PHP develops and coordinates personalized life plans that ensure participants receive the essential medical, behavioral, dental, habilitation, and other services and supports needed. Dental care is the primary unmet need for adults with I/DD. More than 30% of children with I/DD are likely to have their first dental visit delayed, and in general, individuals with I/DD are less likely to receive necessary restorative care. Addressing this disparity is a critical component in impacting overall health equity for individuals with I/DD, as poor oral health can result not only in dental caries and gum disease, but can impact overall health, potentially leading to heart disease, cancer, and diabetes.

“The work we are accomplishing with DentaQuest shines a light on what is possible across the nation – people with I/DD deserve and can achieve lifelong optimal oral health and wellness when we create the right partnerships and invest in the right programs,” said Kerry Delaney, CEO, PHP. “We look forward to continuing our partnership and the measurable results we are seeing in dental care for PHP members.”

In the future months, PHP will also be piloting teledentistry and mobile dentistry programs in partnership with DentaQuest to increase access to oral health care for members.

About DentaQuest

DentaQuest is a purpose-driven health care company dedicated to improving the oral health of all. We do this through Preventistry® — our inclusive approach to quality care and expanded access built on trusted partnerships between patients, providers and payors. As one of the nation’s largest and most experienced Medicaid dental benefits administrators, we manage dental and vision benefits for more than 33 million Americans through a nationwide network of providers in all 50 states. Our outcomes-based, cost-effective dental solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. At the same time, we are expanding our footprint of more than 70 oral health centers in six states to deliver direct patient care in rural and underserved populations. Learn more at www.DentaQuest.com and follow us on FacebookInstagramLinkedIn, and Twitter.

About Partners Health Plan

Partners Health Plan (PHP) is the first-in-the-nation, provider-led managed care organization that fully integrates Medicare and Medicaid for individuals 21 years and older with Intellectual and Developmental Disabilities (IDD), so they have the most complete care package. PHP provides person-centered care for whole-person wellness addressing the physical, behavioral, and social needs of individuals to assist them in living a quality life. The plan operates in 4 New York State regions (nine downstate counties): New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County. For more information, visit www.phpcares.org.

DSP Advocacy Phone Campaign

Act Now!

DSP Advocacy Phone Campaign

For the past two years, New York State has not invested in direct care staff who work for nonprofit agencies (just those who work in State operated facilities).  Individuals with IDD and their families, our members, need the individuals they depend upon to earn a living wage. The system is in crisis! 

A phone campaign is underway for advocates to call Governor Hochul and tell her to invest in people with IDD by making DSPs who work in nonprofit agencies a budget priority.  

Please help elevate awareness! Follow these steps:

STEP 1: Call Governor Hochul's office at: 518-474-8390, press 3, then press 2 to speak to a person or 1 to leave a message.

STEP 2: Message script:

My name is (NAME) from (your city/town) and I am (a person IDD/family member of a person with IDD/friend of a person with IDD). I am calling to urge Governor Hochul to include money in the Executive budget proposal for Direct Care professionals who support people with Intellectual and Developmental Disabilities (IDD). These are essential workers for the health, safety, and quality of life for people with IDD. They need a living wage as they barely earn above the minimum wage and are leaving their employment to find work to support their families. Our state has a terrible worker shortage because NY doesn’t pay a living wage for non-profit Direct Care Professionals.  We need Gov Hochul to include a wage increase for Direct Care Professionals who work for NON-PROFIT IDD PROVIDERS in her Executive Budget proposal. Thank you!

STEP 3: When you've made your phone call, please enter in this tracking form: Record your participation in Call The Governor Campaign (google.com)

Health Care Options Expanded for PHP Members: Stony Brook Medicine Joins PHP Provider Network

BRONX, NY, October 4, 2022— On September 1, 2022, Stony Brook Medicine joined the Partners Health Plan (PHP) provider network offering services to PHP members.
Kerry Delaney, PHP CEO stated, “We are very happy to welcome them back into our network. This will expand care options for PHP members. Stony Brook Medicine is an extensive health care system. It includes three acute care hospitals and many affiliated specialty groups and physicians with specialized services for individuals with Intellectual and Developmental Disabilities (IDD). This relationship will deepen the care choices that PHP members and their families have come to expect from us in providing state-of-the-art supports and services.”
For more information on the Stony Brook Medicine providers and locations that are now part of the PHP provider network, please contact: This email address is being protected from spambots. You need JavaScript enabled to view it..
About the facilities and services in the Stony Brook Medicine – PHP relationship
3 Acute Care Hospitals:
• Stony Brook University Hospital, Stony Brook, NY
• Stony Brook Eastern Long Island Hospital, Greenport, NY
• Stony Brook Southampton Hospital, Southampton, NY
Affiliated specialty groups and physicians that offer the following services:
• Ambulatory Health Centers
• Cardiovascular Disease
• Dialysis
• Family Medicine
• GI and Hepatology
• Inpatient/Outpatient Psychiatry
• Mammography
• Oncology
• Orthopedics
• Podiatry
• Radiology
• Sleep Disorders
• Urology

Medical Director Dr. Steven Merahn, MD Featured on ABA Podcast

Medical Director Dr. Steven Merahn, MD
Featured on ABA Podcast

An amazing podcast, Building Better Businesses in ABA (Applied Behavior Analysis), featured Partners Health Plan Medical Director, Dr. Steven Merahn, MD.

Dr. Merahn shares his views on health as a social imperative to equitably improve the ability for individuals with IDD to succeed in the world on their own terms and participate authentically as active members of family and community.  

Members Only Event: Partners Health Plan (PHP) Seeks to Overcome Dental Health Disparities For Individuals with IDD

Members Only Event: Partners Health Plan (PHP) Seeks to Overcome Dental Health Disparities For Individuals with IDD

Specialized Dental Care for those with Intellectual and Developmental Disabilities (IDD) Comes to Metro NY.

January 9, 2023 — New York
Individuals with Intellectual and Developmental Disabilities (IDD) are known to have poorer oral/dental health than people without IDD. Studies show that people with IDD have 30% more untreated cavities, 50% more missing teeth, and 150% more gum disease.

The biggest reason for this health disparity is access to oral health care for children and adults with IDD: lack of preventive and regular care, including management of secondary medical conditions that are related to oral health, leads to more significant oral health problems. Wait times for IDD specialized services can be as long as a year at practices and dental school programs that offer them.

But Partners Health Plan (PHP), a NY-based health plan that is exclusively dedicated to supporting the health and well-being of individuals with IDD, is committed to ensuring the oral health of its members.

“Improving access to dental care for our community of service in New York State is mission-critical,” added Steven Merahn, MD, Medical Director, Partners Health Plan. “Our overarching goal is to improve the quality of life of our members and the relationship between oral health and overall well-being is well established.”

“Our overarching goal is to improve the quality of life of our members and the relationship between oral health and overall well-being is well established.”

Steven Merahn, MD, Medical Director, Partners Health Plan.


To achieve this goal, PHP has partnered with Solvere Health to deploy specialized IDD mobile dental clinics at select-day service locations in Metro New York to reduce travel demands. Solvere Health is a company that specializes in the delivery of high-quality clinical services through group health events via mobile medical units or pop-up clinics to underserved populations. Individuals with IDD may struggle with the sights, sounds and experiences encountered during dental care, and the PHP-Solvere Dental Health Program will conduct specialized desensitization sessions to prepare individuals for the dental care experience and mobile clinic environments. The mobile dental units are also fully accessible for individuals with mobility challenges.

“Expanding the availability of quality healthcare services to underserved communities is central to Solvere Health's mission. We view the collaboration with Partner Health Plan as a way to make quality dental care accessible to persons with I/DD,” stated Edward Lorch, CEO, Solvere Health, “Our mobile clinics offer a solution that is empathetic and considerate. We factor in the patient population's comfort (including desensitization), convenience, mobility, and communication. When engineering and staffing the mobile clinic, we understand that taking a holistic view of the patient leads to a positive oral healthcare experience and repeat preventative care.”

“This mobile dental clinic initiative is a very exciting opportunity as it will open access to oral healthcare,” noted Rita Marie Bilello, DDS, CEO, and former Dental Director of Metro Community Health Centers. “This new dental care model will bridge a much-needed gap for Partners Health Plan (PHP) members, all adults with IDD, who have been unable to access routine preventative oral health care services. Mobilizing dental services will begin to address some of the access issues and will allow for PHP to better assist in getting their members the oral care that they need.”

The first mobile dental clinic for PHP members is scheduled at the PHP corporate headquarters located at 2500 Halsey Street in the Bronx on Saturday, February 18, 2023. Future mobile health clinic locations will include locations in the New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County where PHP operates. PHP welcomes partnerships with local agencies to serve as destination sites for a mobile clinic.

For more information please contact: This email address is being protected from spambots. You need JavaScript enabled to view it..

News organizations that want to attend/cover the first clinic should reach out to Elizabeth Wales, Assistant Vice President, Strategic Communications at This email address is being protected from spambots. You need JavaScript enabled to view it. or by phone at 518-410-5629.

About Partners Health Plan
Partners Health Plan (PHP) is the first-in-the-nation, provider-led managed care organization that fully integrates Medicare and Medicaid for individuals 21 years and older with Intellectual and Developmental Disabilities (IDD), so they have the most complete care package. PHP provides person-centered care for whole-person wellness addressing the physical, behavioral, and social needs of individuals to assist them in living a quality life. The plan operates in 4 New York State regions (nine downstate counties): New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County. For more information, visit www.phpcares.org.

About Solvere Health
Working with state and federal, institutional, and corporate partners, Solvere Health brings a business discipline to health challenges across the United States through onsite, mobile, and digital healthcare solutions. Deploying a team of highly motivated, accountable problem solvers, we stand up sustainable, end-to-end programs in rapid response to group health events, disaster relief, and underserved rural communities, via onsite pop-ups, mobile clinics, and strategically placed brick-and-mortar locations. Our efficient approach combines exacting strategic planning, comprehensive compliance management, unparalleled logistics, state-of-the-art mobile healthcare technology, and emerging digital health applications.

Message from the CEO: ADA Anniversary 2023

Message from the CEO

The Americans with Disabilities Act Anniversary

July 26, 2023

Dear Members, Families, and Friends,

Today, we celebrate the 33rd anniversary of passing the Americans with Disabilities Act (ADA). It was signed into law by George H. W. Bush on July 26, 1990.

Together, we must remove the physical barriers we have created and the social barriers that we have accepted. Our nation will never be truly prosperous until all within it prosper.

George H. W. Bush
41st President of the United States
July 26, 1990

This landmark law, enacted 33 years ago, provides Americans with disabilities a comprehensive civil rights protection against discrimination in everyday activities including access to medical services. The law strives to ensure independent living, equality of opportunity, and economic self-sufficiency.

Thanks to the ADA, individuals with disabilities can participate in all aspects of society. It also paved the way for the Supreme Court Olmstead decision in 1999, which protects the right of people with disabilities to receive services in the most integrated setting possible providing them with greater independence and opportunities to live, work, and participate in their communities.

Additionally, the ADA anniversary coincides with Disability Pride Month, a time dedicated to recognizing and celebrating how individuals with disabilities take pride in their diverse human experiences. The ADA and Disability Pride Month symbolize decades of activism toward embracing the identities and rights of people with disabilities. These events inspire us to see disability through the lens of equity.

Our entire team provides members and their families with the most innovative Intellectual and Developmental Disabilities (IDD) care coordination so they may live life to the fullest with tailored supports and services. We are dedicated to advocating to ensure their voices are heard and their needs are met.

In the more than three decades since the passage of the ADA, there is still much work to be done to remove barriers and achieve true inclusion and equality for people with IDD. This includes expanding and strengthening the workforce of direct support professionals and improving support to family caregivers that provide the most assistance for individuals with IDD to be truly included in their communities. I’m confident that together with our members, their families, and our partners, we will continue to create positive change and continue to improve the quality of life for members and families.

On behalf of the entire team, thank you for putting your trust in us. Today, on the ADA anniversary, let us recommit to shaping a future where persons with disabilities enjoy all their human rights and fundamental freedoms.

In Gratitude,

Kerry Delaney
CEO

Message from the CEO: Juneteenth 2024

Message from the CEO

Juneteenth 2024

Dear Members, Families, and Friends,

Across the country, on Wednesday, June 19, we will mark the 158th anniversary of Juneteenth, or Freedom Day, as it is also known. Juneteenth, a combination of the words "June" and "nineteenth," celebrates the emancipation of enslaved Black Americans in the United States. Our offices will be closed to demonstrate our commitment to racial justice and to support our core values in diversity, equity, inclusion, and belonging (DEIB).

Establishing Juneteenth as a corporate holiday is one of many actions we have taken to promote understanding and foster mutual respect. Our foundational DEIB work is shaping a transformative culture to advocate for greater diversity, equity, and inclusion in our workplace and in support of members and families.

On June 13, we held our first DEIB Round Table for external stakeholders. The event provided a forum to listen and gather issues that matter to members and families. These diverse insights and perspectives will help to inform our advocacy strategies for members and families to ensure they represent the diverse perspectives of our members. 

Our advocacy platform is built on a strong foundation of championing disability inclusion and bringing about meaningful change for individuals with Intellectual and Developmental Disabilities (IDD). In our proactive efforts, we are advocating for safe and affordable housing, meaningful employment, education, access to culturally competent holistic health care, and adequate funding in the IDD delivery support system. We are committed to advocating for individuals with IDD so they may participate fully, safely, and free from prejudice in their everyday lives.

Let us gather and celebrate on Juneteenth to reflect on the history and contributions of the Black and Latin American communities. The 2024 national Juneteenth theme, “Their Wildest Dreams,” honors the achievements of freed slaves and their descendants. It is a reminder that our history is important and that while some progress has been made, there is still much work to be done. Click here for details on 2024 Juneteenth events in New York State communities that will provide opportunities for us to learn, celebrate and reflect on the holiday’s historical significance.

Our commitment to members and families is embodied in our values. These values help us demonstrate our priority of helping people with IDD live life to the fullest and on their terms. On Juneteenth, and beyond, let us discover our similarities and find new ways to shine our light and support each other!

In Gratitude & Community,
Kerry Delaney, CEO
Kerry Delaney, CEO

Message from the Medical Director: COVID-19 & Flu Season

Watch a short video with a message from our Medical Director Steven Merahn, MD, about COVID 19 and Flu season!

Transcript:

Hi, I'm Dr. Steven Merahn, Medical Director at Care Design New York and Partners Health Plan.  

It's Fall, also known as flu season. Unfortunately, at the same time, we're seeing an increase in the number of cases of COVID infection in New York State.  

And while the number of COVID cases remains low, there are some significant increases in the number of hospitalizations and deaths from COVID in individuals who are most vulnerable to severe infection.  

These risk factors for severe infection include advanced age, multiple medical conditions, including heart and lung disease or cancer, history of smoking, and of particular importance here, people with intellectual and developmental disabilities.  

Vaccines are the single most powerful tool we have to prevent severe disease for both flu and COVID. And while the vaccines may not always prevent infection, they are well proven to reduce the risk of severe infection and hospitalization, as well as making your symptoms milder and shorten the course of any infection. 

So, please get your flu vaccine and COVID vaccine as soon as possible. You can safely get them both together. And keep in mind that the new COVID vaccine is not a booster. It's a new formulation designed to protect you against new variations of the virus.  

Other ways to prevent infection include frequent hand washing, use of hand sanitizer, practicing cough etiquette, covering your mouth with a tissue you dispose or coughing into your elbow, and many people are choosing to wear a mask when in public or crowded places. Many health systems are having their professional staff wear masks to protect patients and visitors.  

Flu and COVID share many signs and symptoms in common. This includes cough, runny, stuffy nose, tiredness, fever, muscle aches and pains. 

First, if you start to feel sick, stay out of public places, work, or group programs.  

Second, if you start to feel sick, test for COVID as soon as you can. Early detection of COVID is important and there are medications, one is called Paxlovid, you can take early in the course of an infection that can induce your risk of serious infection. To be most effective, they need to be taken in the first five days of your illness, and that's why early testing is so important. Talk to your doctor or pharmacist about medication once you get a positive test.  

Finally, whether flu or COVID infection, you should always seek medical care if you have trouble drinking fluids, have trouble breathing, or don't have enough breath to finish a sentence, your lips or nails are discolored or blue, your fever doesn't respond to medications, or you're just too sleepy to stay awake during the day.  

I know this was a lot of information, but I hope it helps you have a healthy fall and winter season.  

And thanks for listening.  

For more information, reach out to your Care Manager. 

 

Message from the Medical Director: COVID-19 Update

Message from the Medical Director

An Update on COVID-19

Dear Members, Families, and Friends,

Over the last few months, a number of new forms (also known as “variants”) of COVID-19 virus have appeared in communities across the United States. This has been associated with an increase in the number of people getting sick, and hospitalized, due to COVID-19 infection. .

While the total number of cases remains low, in New York State the number of positive tests has increased 400% since June. Experts are sure this is the beginning of a wave of infections that will continue to increase into the Fall and Winter.

We are keeping track of this but want to make sure the IDD community remains safe. People with IDD, as well as the elderly, and those with chronic illnesses such as lung disease, cancer, heart disease and others, are vulnerable to severe illness, increased risk of hospitalization, and other consequences of COVID-19 infections.

Let’s make sure everyone – people with IDD and those that care for, and about them - is protected and can protect each other.

FIRST, with vaccines that are well-proven to prevent severe illness

Please get a flu vaccine as soon as possible.  The flu and COVID-19 can “look and act alike” and getting a flu vaccine will protect you from a known health risk every Fall and Winter. Care Managers can help ensure you get all the vaccines needed to protect your health.

There will be an updated COVID-19 vaccine that will be available in the Fall, one that will offer protection against some of the new variants. Even if you have not received a booster in the past, you should get this version.

Finally, if you or your loved one is over 60 years of age, talk to your primary care provider about getting the new vaccine against RSV, a virus that can cause severe lung disease in older adults. Last year the rate of hospitalizations for RSV among adults was 10X higher than usual. The RSV vaccine can be given at the same time as the flu and COVID-19 vaccines.

If you have any questions about vaccines, please reach out to your healthcare provider.

AND, with physical precautions

Handwashing, physical distancing, and mask usage are all well-established, easy to use and well proven ways to prevent spread of all respiratory infections. 

Masking remains a personal choice. However, healthcare professionals are increasingly considering a return to masking as a precaution in healthcare and residential settings, like hospitals and nursing homes.  Some experts are suggesting that caregivers for those who are at risk should consider using masks as well. Healthcare settings like clinics and hospitals are also reinforcing the importance of workers – including healthcare professionals like nurses and aides - staying home if they are sick.

FINALLY, with early interventions

If you find yourself with ‘flu-like’ symptoms like fever, cough, headache, or muscle pain, get tested as soon as possible. If you test positive, have mild to moderate symptoms and are in a high-risk group, you should ask your doctor or pharmacist for a medication called Paxlovid. Paxlovid can reduce hospitalization rates by 80% if taken within five days of symptom onset.

People who are positive for COVID-19 should stay home or isolate themselves for at least five (5) days. 

We will keep track of the trends and any changes in recommendations for prevention and treatment. 

Thanks for your attention,


Steven Merahn, MD
Medical Director

References:

New Report Determines Partners Health Plan’s FIDA-IDD Demonstration Shows Positive Impact and Progress for Enrollees with Complex Care Needs

BRONX, NY, July 6, 2022— Partners Health Plan (PHP), a nonprofit managed care organization dedicated to serving individuals with Intellectual and Developmental Disabilities (IDD), is pleased to announce that the results of an independent evaluation funded by the Centers for Medicare & Medicaid Services (CMS) indicate positive returns for enrollees in the New York Fully Integrated Duals Advantage for Individuals with Intellectual and Developmental Disabilities (FIDA-IDD) demonstration.

The FIDA-IDD demonstration is a pilot program established to test the success of delivering services that address the whole person and promote community involvement and independence for people with IDD eligible for both Medicare and Medicaid benefits. According to the findings, PHP is well on its way toward meeting those objectives.

“This is an extremely positive report,” said Kerry Delaney, CEO of PHP, “but also acknowledges in a realistic way the challenges we have faced.” Those challenges stemmed from the newness of managed care for providers in the space, lack of plan coverage awareness for covered entities, and providers’ refusal to participate or offer services to the population just to name a few. Despite these challenges, key findings reflect that if implemented correctly, managed care can be a viable option to serve people with IDD.”

Key Findings:

  • Through the comprehensive “It’s All About Me” (I AM) assessment tool, PHP effectively elicited responses from the IDD population about health and wellness needs allowing enrollees to leverage control over benefit options impacting their everyday lives.
  • Innovative solutions like the pharmacy management program reduced errors, unnecessary emergency department visits, and length of hospital stays. Similarly, the telehealth program successfully resolved 90% of consultations virtually. The rewards incentive program “Choose Health” also received positive feedback for motivating members to achieve preventive health goals.
  • While the new rate payment method has been a challenge to cover certain member populations, like older and frailer members, programs like pharmacy management are viewed as innovative cost-savings strategies.
  • Regularly engaging stakeholders from the Participant Advisory Committee helped to address real-time needs, like improvements to transportation services and communications efforts.

One of the best measures of the impact Partners Health Plan has had on member health and experiences comes from the members themselves. PHP FIDA-IDD plan member, Jessica, stated, “Recently I needed special comprehension therapy for my legs and was able to get something to help me at home. This keeps me healthy and helps my ability to walk. I want to keep my independence. I also have support from my Care Manager and my Broker with my self-direction!”

As the agency responsible for the IDD program in New York State, the Office for People With Developmental Disabilities (OPWDD) was integral in the demonstration’s design and implementation. “OPWDD has been pleased to collaborate with Partners Health Plan on the FIDA-IDD program, which has offered people an opportunity to coordinate their health and long-term care services in a new and innovative way,” said OPWDD Commissioner Kerri Neifeld. “We look forward to continuing to work with Partners Health Plan and the larger provider community to ensure quality supports and services are available to NYers with intellectual and developmental disabilities.”
Read the full report here: https://innovation.cms.gov/data-and-reports/2022/fai-ny-fida-idd-prelim-firstsecondevalrpt.

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About Partners Health Plan: Partners Health Plan (PHP) is the first-in-the-nation, provider-led managed care organization that fully integrates Medicare and Medicaid for individuals 21 years and older with intellectual and/or developmental disabilities (I/DD), so they have the most complete care package. PHP provides person-centered care for whole-person wellness addressing the physical, behavioral, and social needs of individuals to assist them in living a quality life. The plan operates in 4 New York State regions (nine downstate counties): New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County. For more information, visit www.phpcares.org.

About CMS Financial Alignment Initiative: The Centers for Medicare & Medicaid Services (CMS) created the Medicare-Medicaid Financial Alignment Initiatives (FAI) Demonstrations to test in partnership with States integrated care models for dually eligible beneficiaries with the goal to improve care for dually eligible beneficiaries and reduce program costs through an aligned financial and person-centered care coordination structure. A longstanding barrier to coordinating care for Medicare-Medicaid enrollees has been the financial misalignment between Medicare and Medicaid. For more information, visit Financial Alignment Initiative (FAI) | CMS.

 

Nutrition Tips for 2023

It’s easy to feel bombarded by the latest healthy eating trend or buzzworthy ingredient. But good nutrition is really about consistently choosing healthy foods and beverages. With healthy eating patterns, it’s possible to enjoy food and beverages that reflect your preferences, cultural traditions, and budgetary considerations.

Tips for a healthy diet in 2023: 

  • Bump up your Fiber intake
  • Increase Calcium and Vitamin D 
  • Add more Potassium **People with chronic kidney disease and people taking certain medications may have too much potassium in their blood, speak with your doctor before making a change to your Potassium intake**
  • Limit added Sugars
  • Replace Saturated Fats
  • Cut back on Sodium
  • Keep Hydrated **At a minimum 4-6 cups per day**
  • Limit Sugary drinks
  • Limit processed foods 

** Please note that fluid intake & Potassium intake needs to be done in consideration of your current health condition diagnosis and discussed with your primary health care provider.

Healthy eating emphasizes fruits, vegetables, whole grains, dairy, and protein. A healthy and balance diet can have great overall effects for your health and wellbeing. You should always consult with your doctor before making any major changes to make sure the choices are right for you.

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