4-Attachment B - HRSN Services.docx
DOCX document 111 KB Posted
- Attached to
- WholeYouNYC Social Care Network - Health-Related Social Need (HRSN) Service Provider Application
- Solicitation number
- 2025.01.SCN.01.01
- Issued by
- New York
About this file
This document is an Attachment B detailing Health-Related Social Needs (HRSN) Services for the WholeYouNYC Social Care Network, involving the New York State Department of Health's Office of Health Insurance Programs (OHIP) and Public Health Solutions (PHS) as the Social Care Network (SCN) lead entity for Manhattan, Brooklyn, and Queens. The attachment outlines a comprehensive set of social services across screening, care management, housing, nutrition, and transportation domains, which can be delivered and reimbursed by OHIP for eligible Medicaid populations. Services include comprehensive member need assessments, care navigation, housing modifications and support, medical respite, nutrition counseling, meal services, and transportation access.
The contract opportunity targets service providers who can contract with the SCN and comply with specific terms, with estimated quarterly service capacities and locations defined for each service category. Providers must be prepared to offer services such as home accessibility modifications, asthma remediation, rent assistance, temporary housing, nutrition education, medically tailored meals, and transportation support. Reimbursement is contingent upon meeting specific requirements, including using approved screening tools, providing emergency contacts for shelter services, and adhering to NYS certification standards where applicable. The network aims to address health-related social needs by creating a comprehensive ecosystem of service providers who can support Medicaid members across critical social service domains.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Attachment B: HRSN Services OHIP has defined a list of HRSN services that may be delivered by the SCN and reimbursed by OHIP for eligible populations and will span the following social need domains: Screening, Care Management, Housing, Nutrition, and Transportation. Providers who seek reimbursement to provide or arrange for the provision of these health-related social needs services must contract with the SCN and comply with the terms set forth in Attachments D, E and F.
| Service Category |
| HRSN Services |
| (A) |
SCN Service (Y/N) (B) Est. Min Quarterly Service Capacity (C) Est. Max Quarterly Service Capacity (D) Service Location(s) in SCN Regions-Brooklyn, Manhattan, Queens
| Screening |
| Comprehensive assessment of Member needs across a range of Health-Related Social Needs (HRSN) domains using the Accountable Health Communities (AHC) HRSN Screening Tool (or another comparable, approved format). The Screening is conducted by the SCN and other partners within the regional ecosystem (e.g., healthcare providers, case management providers, MCOs) and performed at least annually or on an as-needed basis. |
| Care Management |
| Navigation Services: The direction of a Member to HRSN services delivered by existing infrastructure, including pre-existing federal, state, and local programs, if the Member is not eligible for Enhanced HRSN Services. |
Enhanced HRSN Care Management: Care Management for Members eligible for Enhanced HRSN services (includes outreach, Referral management, Social Care Plan development, care coordination, education, and completion).
Housing[footnoteRef:2] [2: Any service provider offering any form of shelter (e.g. Medical Respite) will need to provide an emergency contact and emergency plan.]
Home Accessibility and Safety Modifications: Includes air conditioners, humidifiers, dehumidifiers, heaters, air filtration devices, refrigerators for medical treatment and prevention, and accessibility ramps, handrails, etc.
Home Remediation Service: May include mold remediation, pest remediation, and/or repairing or improving ventilation systems.
Asthma Remediation: Provision of remedial services to remove allergens in the home and provision of supportive products to eliminate or reduce asthma triggers in the home.
Recuperative Care (Medical Respite)[footnoteRef:3]: Temporary residential care and supportive services provided to homeless or unstably housed Members who do not have an acute need to be hospitalized but require health care services and supports to continue to recover from an illness or prepare for a medical procedure. Services include short-term residential care. [3: Must be a NYS-Certified Medical Respite Program provider]
Rent/Temporary Housing: Includes payment for rent and/or short-term, temporary stays for up to six months. May also include Utility Setup and Assistance.
Pre-Tenancy Services: Including support during the rental application and lease negotiation process, assistance with setting up the new housing unit, connection to resources aiding in other housing costs (e.g., rental assistance vouchers, security deposits, etc.).
Community Transitional Support: Assists Members with smooth transition into community living, including one-time moving costs (e.g., utility activation fees, pantry stocking, etc.).
Tenancy Sustaining Services: Services that support Members in maintaining tenancy, including tenant rights education and eviction protection.
Housing Transition and Navigation: Assistance with the housing search and application process.
| Nutrition |
| Nutrition Counseling and Education: Including education on topics on healthy meal preparation and connecting the individual with grocery budget resources. |
Medically tailored or clinically appropriate home delivered meals
Medically tailored or clinically appropriate food prescriptions
Pantry stocking of fresh produce and non-perishable groceries
Cooking supplies (e.g., microwave, kitchenware, refrigerator)
| Transportation |
| Access to public or private transportation services to utilize HRSN services or care management activities |
File details come from the government source that posted it. Updated .