NYS Behavioral Health (BH) Home and Community Based Services (BH HCBS) Dashboard Data The below references information found in the Data Table entitled “NYS Medicaid Adult HCBS Access Dashboard.” This data is broken out between NYC and Rest of State Regions and by each Medicaid Managed Care (MMC) Plan. This data set provides a snapshot of the number of individuals who have completed significant steps toward utilizing NYS Adult Behavioral Health (BH) Home and Community Based Services (HCBS). All data is unique recipient data meaning t hat all Individuals are counted only once. This data is updated on a monthly basis.

Col. No.

Data Set Source Description Notes

1

HARP Eligible

Medicaid Data Warehouse (MDW)

Number of individuals by MMC Plan with a HARP eligibility code (H code) and enrolled in HARP, HIV/SNP or Mainstream at the time of the data run*

Does not include Individuals who have H code but not enrolled in HARP, HIV/SNP or Mainstream.

*By excluding all other plan types, like LTC, we removed the recipients who will not be enrolled even if they have H code.

2

HARP Enrolled

Medicaid Data Warehouse (MDW)

Number of individuals by MMC Plan who have a HARP eligibility code (H code) and enrolled in HARP or HIV/SNP

Data captures the number of HARP enrollees with HARP premiums paid to NYS Medicaid Managed Care Organizations. Does not include Individuals who remain in the HARP but lost H code.

3

Health Home Enrolled

Medicaid Data Warehouse (MDW)

Number of individuals by MMC Plan with an H code who are both enrolled in a HARP/ HIV/SNP and enrolled in a Health Home (HH). Does not include HARP-enrolled individuals currently being outreached by a HH.

In contrast, Health Home enrollment data from the MAPP dashboard includes HH-enrolled and HH-outreached individuals.

4

HCBS Assessed in Past 12 Months

CMHA/ UAS Number of individuals by MMC Plan who have a H code and have completed the NYS Eligibility Assessment for Behavioral Health (BH) Home and Community Based Services (BH HCBS) within last 12 months.

BH HCBS assessment data has approximately a one-week lag. While based on claims, this data set captures only the number of individuals who have completed one or more assessments, and not the number of total assessment claims received by the MDW.

HCBS Eligible

CMHA/ UAS Number of individuals by MMC Plan who have completed the assessment within last 12 months and been found eligible for Tier 1 or 2 BH HCBS.

The eligibility rate is persistently around 100%. This element has be moved because of less usefulness.

6 LOSD Requested

As reported by MCOs

Number of members by MMC Plan with level of service determination requests submitted to MCOs

AS OMH is reformatting the templates being used to collect this Data from MCOs, this element is on hold since May 2020.

7 HCBS Auth Requested

As reported by MCOs

Number of members by MMC Plan with authorization requests for HCBS submitted to MCOs

As OMH is reformatting the templates being used to collect this data from MCOs, this element is on hold since May 2020.

8

Recipients Received HCBS in Past 12 Months

Medicaid Data Warehouse (MDW)

Number of individuals by MMC Plan who have received BH HCBS as determined by having at least one paid BH HCBS service claims within last 12 months (without claim-lag). Individuals with multiple service claims are only counted once.

BH HCBS assessment claims and provider travel supplemental claims are not included in this data set. The months that still impacted by claim-lag are excluded. For example, the dashboard updated at May 2020 includes all recipients who has least one service claim during Feb 2019-Jan 2020.

5/20/2020 1 of 2

HARP Restriction / Exemption Codes

R/ECode

Description Notes

H9 HARP eligible but pending enrollment. This person has been determined to be “categorically eligible” for a HARP. They will be given the option of enrolling in a HARP.

• If this person is already in an HIV SNP they do not have H9, but rather code H4.

• They can choose to remain in the HIV SNP or move to a HARP. • If they remain in the HIV SNP they could potentially, based on the

results of a more in depth assessment, qualify for BH HCBS services under codes H5 or H6. At this time, there should be no attempt by a HH to complete the CMHA.

H1 HARP enrolled without BH HCBS eligibility. • This person was assessed and is not eligible for BH HCBS, or • Has not yet been assessed for BH HCBS eligibility

At this time, HH should begin the CMHA process if it has not yet done so and found the person not eligible for BH HCBS services.

H2 Enrolled in a HARP. The person has been assessed and determined to be eligible for Tier 1 BH HCBS (peer supports, employment supports, education supports).

As authorized by the HARP, referrals should be made by the HHCM to BH HCBS service providers.

H3 Enrolled in a HARP. The person has been assessed and determined to be eligible for Tier 2 BH HCBS (which includes all Tier 1 services listed under H2, plus psychosocial rehab, community psychiatric supportsand treatment, etc.)

As authorized by the HARP referrals should be made by the HHCM to BH HCBS service providers.

H4 Enrolled in an HIV SNP as HARP eligible. • The person has been assessed and is not eligible for BH HCBS, or • The person has not yet been assessed for BH HCBS eligibility.

At this time, HH should begin the CMHA process if it has not yet done so and found the person not eligible for BH HCBS services.

H5 The person is enrolled in an HIV SNP and has been assessed and determined eligible for Tier 1 BH HCBS (peer supports, employment supports, education supports).

As authorized by the HARP referrals should be made by the HHCM to BH HCBS service providers.

H6 The person is enrolled in an HIV SNP and has been assessed and determined eligible for Tier 2 HCBS (includes all Tier 1 services listed under H2, plus psychosocial rehab, community psychiatric supportsand treatment, etc.).

As authorized by the HARP referrals should be made by the HHCM to BH HCBS service providers.

5/20/2020 2 of 2

c sl

t t t l ll

NYSMedicaidAdultHCBSA cesDashboard,Region:NYC Source:MDW,UAS/CMHA&MCOsreportedData.UpdateDate:5/11/2020.AlMetricsintheupperpartofthisdashboardarecountofuniquerecipients.

PlanAlias HARPEligible HARPEnrolled HealthHomeEnrolled HCBSAssessedinPast12Months RecipientsRec'dHCBSinPast12Months

0K 10K 20K 30K 40K0K 10K 20K 30K 0K 2K 4K 6K 8K0K 1K 2K 3K 4K 5K 6K 0 200 400 600 800

Plan1

Plan2

Plan3

Plan4

Plan5

Plan6

Plan7

Plan8

Plan9 905

4,385

16,260

3,980

7,865

31,974

15,056

2,290

4,440

905

3,473

13,851

3,425

6,819

26,562

12,146

2,290

3,534

293

706

3,030

805

1,624

6,800

2,991

734

650

138

480

2,001

522

1,146

5,264

1,798

494

441

138

480

2,001

522

1,146

5,264

1,798

494

441

14

77

219

14

173

789

202

18

30

14

77

219

14

173

789

202

18

30

NYCSubtotal 87,155 73,005 17,633 12,284 1,536

InPercentage

PlanAlias

HARPEligible % HARPEnrolled/HARPEligible % HHEnrolled/HARPEnrolled % HCBSAssessedinPast12Months/HARP Enrolled

% RecipientsRec'dHCBSinPast12Months/ HCBSAssessedinPast12Months

0K 5K 10K 15K 20K0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100%

Plan1

Plan2

Plan3

Plan4

Plan5

Plan7

Plan8

Plan9

15,056

16,260

4,440

2,290

7,865

3,980

4,385

905

15,056

16,260

4,440

2,290

7,865

3,980

4,385

905

100%

100%

80%

81%

87%

86%

85%

79%

100%

100%

80%

81%

87%

86%

85%

79%

18%

32%

25%

24%

24%

22%

20%

32%

18%

32%

25%

24%

24%

22%

20%

32%

12.5%

21.6%

14.8%

16.8%

15.2%

14.4%

13.8%

15.2%

12.5%

21.6%

14.8%

16.8%

15.2%

14.4%

13.8%

15.2%

11%

15%

11%

16%

10%

7%

4%

3%

11%

15%

11%

16%

10%

7%

4%

3%

NYCSubtotal 87,155 83.8% 24.2% 16.8% 12.5%

Note(s): 1.Column1,2,3,5arefromMDW/PRDM asofupdatedateinthesubitle;column4arefromUASasofupdatedateinthesubitle;StatearereformatingthedatacolectedfromMCOsforLOSDsandPriorauthorizations.Thesetwocolumnswilbeaddedbackonceit'savailable. 2.The"Past12Months"inColumn5isdefinedasthe12-monthperiodbeforethemostrecent4monthsthatarestilsubjecttoclaim-lag(themostrecent4monthsareexcluded).Forexample,the12-monthperiodforJune2020reportisMarch2019-Feburary2020.

5/20/2020 1 of 3

c sl

t t t l ll

NYSMedicaidAdultHCBSA cesDashboard,Region:ROS Source:MDW,UAS/CMHA&MCOsreportedData.UpdateDate:5/11/2020.AlMetricsintheupperpartofthisdashboardarecountofuniquerecipients.

PlanAlias HARPEligible HARPEnrolled HealthHomeEnrolled HCBSAssessedinPast12Months RecipientsRec'dHCBSinPast12Months

0K 10K 20K 30K 40K 50K0K 10K 20K 30K 0K 2K 4K 6K 8K 10K 0K 2K 4K 6K 0 500 1000 1500 2000

Plan1

Plan2

Plan4

Plan5

Plan6

Plan8

Plan11

Plan13

Plan15

Plan16

Plan17

Plan18 2,607

8,135

8,579

1,838

3,005

2,015

482

3,350

41,002

11,971

4,957

2,341

2,181

6,126

6,803

1,641

2,516

1,634

357

2,464

31,558

9,838

3,979

1,753

956

1,696

2,147

416

893

491

90

855

9,189

2,935

914

608

538

1,044

1,000

347

398

322

58

573

5,325

2,074

577

335

538

1,044

1,000

347

398

322

58

573

5,325

2,074

577

335

177

195

303

124

152

21

8

192

1,694

819

97

65

177

195

303

124

152

21

8

192

1,694

819

97

65

ROSSubtotal 90,282 70,850 21,190 12,591 3,847

InPercentage

PlanAlias

HARPEligible % HARPEnrolled/HARPEligible % HHEnrolled/HARPEnrolled % HCBSAssessedinPast12Months/HARP Enrolled

% RecipientsRec'dHCBSinPast12Months/ HCBSAssessedinPast12Months

0K 5K 10K 15K0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100%

Plan1

Plan2

Plan4

Plan6

Plan8

Plan11

Plan13

Plan15

Plan16

Plan17

Plan18

11,971

2,341

4,957

3,350

2,015

3,005

1,838

8,579

8,135

2,607

482

11,971

2,341

4,957

3,350

2,015

3,005

1,838

8,579

8,135

2,607

482

75%

80%

82%

74%

74%

81%

84%

89%

79%

75%

84%

75%

80%

82%

74%

74%

81%

84%

89%

79%

75%

84%

35%

23%

30%

35%

25%

30%

35%

25%

32%

28%

44%

35%

23%

30%

35%

25%

30%

35%

25%

32%

28%

44%

19.1%

14.5%

21.1%

23.3%

16.2%

19.7%

15.8%

21.1%

14.7%

17.0%

24.7%

19.1%

14.5%

21.1%

23.3%

16.2%

19.7%

15.8%

21.1%

14.7%

17.0%

24.7%

19%

17%

39%

34%

14%

38%

36%

30%

19%

33%

7%

19%

17%

39%

34%

14%

38%

36%

30%

19%

33%

7%

ROSSubtotal 90,282 78.5% 29.9% 17.8% 30.6%

Note(s): 1.Column1,2,3,5arefromMDW/PRDM asofupdatedateinthesubitle;column4arefromUASasofupdatedateinthesubitle;StatearereformatingthedatacolectedfromMCOsforLOSDsandPriorauthorizations.Thesetwocolumnswilbeaddedbackonceit'savailable. 2.The"Past12Months"inColumn5isdefinedasthe12-monthperiodbeforethemostrecent4monthsthatarestilsubjecttoclaim-lag(themostrecent4monthsareexcluded).Forexample,the12-monthperiodforJune2020reportisMarch2019-Feburary2020.

5/20/2020 2 of 3

i

i i

i

i

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

NYSMedicaidAdultHCBSServiceClaimsandEncountersDashboard Source:MDW (EncountersOnly),UpdateDate:4/30/2020

NYC ROS GrandTotal

HCBSServiceSub-Catgy NClaims/Encounters UniqueRecipients NClaims/Encounters UniqueRecipients NClaims/Encounters UniqueRecipients

Total 49,519 2,731 134,870 5,612 184,389 8,343

PeerSupportServices 15,313 1,057 37,873 2,617 53,186 3,674

ProviderTravelSupplement 5,927 753 30,737 2,739 36,664 3,492

PsychosocialRehabilitation 5,683 293 20,241 1,077 25,924 1,370

HabilitationServices 2,617 184 13,435 891 16,052 1,075

EducationSupportServices 3,213 428 12,341 1,243 15,554 1,671

Short-term CrisisRespite 9,338 783 1,671 281 11,009 1,064

CommunitySupportandTreatment 2,446 171 7,641 573 10,087 744

Pre-vocationalServices 2,454 294 4,362 494 6,816 788

IntensiveSupportedEmployment 1,926 217 4,568 551 6,494 768

FamilySupportandTraining 204 29 1,000 115 1,204 144

On-goingSupportedEmployment 163 26 756 68 919 94

TransitionalEmployment 235 32 228 37 463 69

IntensiveCrisisRespite 17 10 17 10

ClaimsVolumeTrend RecipientsServedTrend NYC ROS 1,865

8K

7K

6K

HCBSServiceColorLegend

PeerSupportServices

ProviderTravelSupplement

PsychosocialRehablitation

HablitationServices

IntensiveSupportedEmployment

FamilySupportandTraining

On-goingSupportedEmployment

TranstionalEmployment

1500

NYC/ROSColorLegend

NYC

ROS

1,731

1,7001,663 1,503 1,650

1,391 1,546

1,3731,34 19 ,4371,244

1,289EducationSupportServices IntensiveCrisisRespite

NumofRecip[Line]

1,124 1,117Short-termCrisisRespite

CommunitySupportandTreatment

1,026

ClaimsVol.[Area] 5K 1,0129331000

Pre-vocationalServic 794 961es

4K 672 814

611671 587580 706 4975653K 545522 563 585426500

498346398 470313325 377447277PeerSupportServices 320 3142K 292 319 331322202 259 25391PeerSupportServices 22259PsychosocialRehablitation 113334412611 1421K PsychosocialRehablitation 177 1EducationSupportServices 0 44 1411 1111611EducationSupportServices

IntensiveSupportedEmployment0K

Nov/.

Feb/.

May/.

Aug/.

Nov/.

Feb/.

May/.

Aug/.

Nov/.

Feb/.

May/.

Aug/.

Nov/.

Feb/.

May/.

Aug/.

Nov/.

Feb/.

May/.

Nov/.

Feb/.

Ma y/.

Aug/.

Nov/.

Feb/.

May/.

Aug/.

Nov/.

Feb/.

May/.

Aug/.

Nov/.

Feb/.

May/.

Aug/.

Nov/.

Feb/.

May/.

Nov/15

Jan/16

Mar/16

May/16

Jul/16

Sep/16

Nov/16

Jan/17

Mar/17

May/17

Jul/17

Sep/17

Nov/17

Jan/18

Mar/18

y/18

Jul/18

Se p/18

Nov/18

Jan/19

Mar/19

May/19

Jul/19

Sep/19

Nov/19

Jan/20

Mar/20

May/20

MonthofDOS

Ma

5/20/2020 3 of 3