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NY 1115 Medicaid Waiver: Social Care Networks Tackle Challenges


In a landmark move, the recent approval of the New York State 1115 Medicaid Waiver Amendment marks a significant shift in healthcare priorities, emphasizing the crucial role of addressing social drivers of health and promoting health equity. Standing up regional Social Care Networks (SCNs) represents an opportunity and challenge for experienced non-profits interested in expanding their missions while coordinating in new ways with other regional partners. Activate Care is an organization that partners with SCNs looking for innovative ways to address the challenges this emerging care model presents to evolving existing operations. Challenges include topics such as: 

How do we identify and contract with CBOs for Community Care Coordination?

Leading organizations have been preparing for the SCN care model defined by the New York 1115 waiver. In preparation, these organizations recognize the need for a structured, data-driven approach to vet, engage, and contract with other community partners. This work requires a process to assess the capabilities of potential partners and contract with other entities to foster a relationship that promotes accountability and shared results. Activate Care refers to a CareHub model to ensure that partners have an experienced partner to establish and govern the relationships of the SCN. Our advanced community care platform, CareHub, has been the cornerstone for seamless care coordination across diverse organizations, fostering collaboration and efficiency in line with the waiver's objectives for over a decade. 

How do we strengthen Community-Based Organization (CBO) Networks?

Once we have a network of community partners, the SCN will require a management and governance structure for ongoing communications, workflow standards, and technology integrations. Identifying and contracting with partner CBOs is just the beginning. Recognizing the significance of these networks in addressing health-related social needs, the SCN will need support to facilitate collaboration among healthcare providers, MCOs, and CBOs. Activate Care works with SCNs to partner with CBOs to gain valuable community insights, promote shared resources, and establish a collective effort toward enhancing the overall health landscape in New York.

How do we leverage and build the needed Community Care Workforce?

The key to SCN success lies in the ability of SCN professionals to engage Medicaid members. This implies community-based professionals empowered with training, technology, and investment. The ability to recruit, hire, train, and retain these professionals will be foundational to SCN’s success. Whether an SCN is hiring new community professionals or integrating the workforce already in place, the SCN must have the human resource capabilities to support these community professionals while having the data to adapt this role as the care model evolves. This recruiting and development capability is central to what we do at Activate Care. We recognize the pivotal role of community health workers (CHWs) in elevating care management programs and alleviating traditional workforce shortages. Through workforce training and competency building, we prioritize CHWs' needs, providing training and professional development opportunities and establishing a reliable pipeline of trusted community partners.  

Scaling Solutions for a Visionary Future

These examples of the challenges presented by the NY 1115 waiver merely scratch the surface of Activate Care's potential to support the waiver's new initiatives. The overarching goals of the waiver align directly with our vision of a future where every individual has access to compassionate, high-quality care. Let's have a call if you're looking for a partner who has walked this path and tailored offerings to meet specific needs. We believe realizing the outcomes we all want to see requires connecting individuals into their communities, ushering in an era where healthcare is not just a service but a holistic experience for all. 

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