Home and Community Based Services

home and community based services (HCBS)

Home and Community Based Services (HCBS) provide opportunities for adult Medicaid beneficiaries with mental illness and/or substance use disorders to receive services in their own home or community. The implementation of HCBS is a partnership of entities that creates an environment where managed care plans, service providers, plan members, families help members prevent and manage chronic health conditions and recover from serious mental illness and substance use disorders.

Person-Centered Care:
Services should reflect an individual’s goals and emphasize shared decision making approaches that empower members, provide choice, and minimize stigma.  Services should be designed to optimally treat illness and emphasize wellness and attention to the persons overall well- being and full community inclusion.
Services should be provided based on the principle that all individuals have the capacity to recover from mental illness and/or substance use disorders.  Specifically, services should support the acquisition of living, employment, and social skills and be offered in home and community based settings that promote hope and encourage each person to establish an individual path towards recovery.
Medicaid beneficiaries age 21 and older with serious mental illness and/or substance use disorders. Individuals enrolled in HIV SNPs determined by the State to be HARP-eligible may also be eligible for HCBS.

LP provides 3 HSCB Designation listed below:

1. Psychosocial Rehabilitation (PSR)

PSR services are designed to assist the individual with compensating for or eliminating functional deficits and interpersonal and/or environmental barriers associated with their behavioral health condition (i.e., SUD and/or mental health). The intent of PSR is to restore the individual’s functional level to the fullest as possible and necessary for integration  to be an active and productive member of his or her family, community, and/or culture with the least amount of ongoing professional intervention.

2.  Habilitation

Habilitation services are provided on a individual basis and are designed to assist individuals with a behavioral health diagnosis in acquiring, retaining and improving skills such as communication, self-help, domestic, self-care, socialization, fine and gross motor skills, mobility, personal adjustment, relationship development, use of community resources and adaptive skills necessary to reside successfully in home and community- based settings.

These services assist individuals with developing skills necessary for community living and, if applicable, to continue the process of recovery from an SUD disorder. Services include things such as:  instruction in accessing transportation, shopping and performing other necessary activities of community and civic life including self- advocacy, locating housing, working with landlords and roommates and budgeting. Services are designed to enable the participant to integrate full into the community and ensure recovery, health, welfare, safety and maximum independence of the participant.

3.  Peer Support – Empowerment Services

Peer Support services are peer-delivered services with a rehabilitation and recovery focus. They are designed to promote skills for coping with and managing behavioral health symptoms while utilizing natural resources and the enhancing recovery-oriented principles such as  hope and self-efficacy, and community living skills. Peer support uses trauma-informed, non-clinical assistance to achieve long-term recovery from a behavioral health disorder.

Peer activities are based on identified goals and utilizing community and natural supports. The intent of these activities is to assist individuals in initiating recovery, maintaining recovery, and enhancing the quality of personal and family life in long-term recovery.

The structured, scheduled activities provided by this service emphasize the opportunity for peers to support each other in the restoration and expansion of the skills and strategies necessary to move forward in recovery.  Individuals providing these services have life experiences/shared personal experience of recovery which is vital for the success of this service.

If you are interested in services contact our office for assistance.  The other options to determine your eligibility for services are:

*  Contact your Health Insurance/Managed Care Organization Provider (MCO)  and state you want to register for HCBS services. The MCOs are  – Healthfirst, Empire Blue Cross/Blue Shield, Fideliscare, United Healthcare Beacon – Metroplus, Affinity, VNS, Emblem Health and Amida Care.

* If you are HARP Member you may qualify for HCBS to reach your personal goals.

* Speak to your Care Manager and  state you want to obtain HCBS.

* ICAN – Independent Consumer Advocacy Network (ICAN) provides free, confidential help to consumers who are eligible for or enrolled in Health and Recovery Plans (HARPs). They can help you decide whether HARP is right for you, answer your questions about your benefits, provide advice and information, and advocate for you in the appeals process. Call ICAN at 1-844-614-8800 or email [email protected].    The contact person that has assisted Living Positive is  Frankie Herman (646)602-5687