SYRACUSE — AIDS Community Resources has some major changes on its plate as it prepares to move into a Medicaid Health Home. Those changes include a broader mission and possibly a new name for the not-for-profit, which helps individuals with HIV/AIDS and those affected by it. And AIDS Community Resources may also have to hire […]
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SYRACUSE — AIDS Community Resources has some major changes on its plate as it prepares to move into a Medicaid Health Home.
Those changes include a broader mission and possibly a new name for the not-for-profit, which helps individuals with HIV/AIDS and those affected by it. And AIDS Community Resources may also have to hire more employees and grow into more space over time.
That’s because the organization will become part of a Medicaid Health Home starting July 1. A Medicaid Health Home is not a brick-and-mortar facility — it is a new model under New York’s Medicaid program that was spurred by the 2010 federal health-care reform law.
A Health Home is a model of care management that has all of a Medicaid recipient’s caregivers communicating, according to the New York State Department of Health. Health Homes, which are being rolled out for individuals with chronic conditions, will be made up of health-care providers, health plans, and community-based organizations.
Within the Health Home structure, a care manager oversees an individual’s care, helping that individual stay healthy and out of the hospital. The model also aims to spur providers, health plans, and community organizations to share medical records to help prevent medical services like tests from being duplicated.
AIDS Community Resources, which currently has a Medicaid case-management program, will fill the role of a community-based organization in the new Health Home model. The organization must adapt to the new model in July if it wants to continue
offering case management to people on Medicaid with HIV/AIDS, according to its executive director, Michael Crinnin.
“If we don’t participate in this program, then our case management will go away in two years,” he says. “That’s not acceptable to me. It would be a terrible blow to the people we serve.”
However, to participate in a Health Home, the organization will need to offer case management for people with chronic diseases other than HIV/AIDS, Crinnin says. So AIDS Community Resources is preparing to work with patients with chronic diseases like diabetes, chronic obstructive pulmonary disease, and high blood pressure.
The not-for-profit already has some experience with those diseases, according to Crinnin. It commonly encounters a range of chronic diseases when helping individuals manage HIV/AIDS.
“A majority of our clients have these other chronic diseases,” Crinnin says. “You can’t manage HIV out of the broader context. We’re already experts in this without meaning to be.”
AIDS Community Resources has one of its staff members working on generic health issues like health insurance and prescriptions. That staff member is in the process of developing curriculums about different chronic diseases, Crinnin says. The not-for-profit plans to continue to expand its expertise in chronic diseases and train its case managers in those diseases, he adds.
New name
The new, wider-ranging care-management role will likely spur a name change at AIDS Community Resources. The organization will maintain its expertise helping people with HIV/AIDS but will also need to be accessible to others, Crinnin says. And he recognizes that some people may balk at receiving services from an organization with AIDS in its name.
“The stigma is so intense,” he says. “We understand that for us to participate, we either need to change the name of the agency or come up with a whole new division.”
Crinnin isn’t sure whether the organization will choose to change its name or operate two divisions. He also hasn’t established a timeline for making that decision.
Possible growth
The Health Home changes may also lead to growth at AIDS Community Resources, according to Crinnin. Chronic-disease case-management programs are relatively scarce in the not-for-profit’s nine-county coverage area, which includes Cayuga, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, and St. Lawrence counties, he says.
“There are a number of behavioral-health targeted case-management programs,” he says. “There aren’t many chronic-disease programs.”
Crinnin does not know how many additional patients to expect because of the Health Home model. AIDS Community Resources currently has a caseload of about 250 clients at any one time, although some of its case-management clients are not on Medicaid, he says.
New York State has essentially guaranteed the organization will have a minimum of 229 Medicaid clients for about two years, Crinnin says. But it could receive additional clients any time after July 1, he says.
Crinnin could not provide any estimates for the number of new patients AIDS Community Resources will receive. He has been in touch with organizations Downstate, where the Health Homes initiative was implemented in January, but still is not sure exactly what to expect.
“The people in the first phase, they haven’t gotten contracts,” he says. “And they’ve gotten no Health Home assignments. I’m thinking probably we’re not going to get any [new] clients assigned to us until the fall.”
If AIDS Community Resources does receive new clients, it will probably have to hire more staff members and lease additional facility space. It currently employs 78 people and has locations in Syracuse, Utica, Watertown, Auburn, Oswego, and Canton. The not-for-profit leases a 9,000-square-foot headquarters at 627 W. Genesee St.
The organization will not leave its Syracuse headquarters if it needs more space, Crinnin says. Instead, it will search for a location to augment its current facility.
AIDS Community Resources does not know what its Medicaid reimbursement rate will be under the new Health Homes program. That’s a big question mark for the organization — Medicaid provides nearly a quarter of its revenue.
The not-for-profit’s revenue totaled $3.8 million in its last fiscal year, which ended June 30, 2011. Its budgeted revenue for the current fiscal year ending in June 2012 is $4.4 million.
Crinnin says it’s difficult to plan ahead for Health Homes with so much uncertainty. But he’s trying to position AIDS Community Resources to act quickly when more information is available.
“I think people are still kind of scrambling to catch up,” he says. “I’ve never been in a situation where it’s so volatile.”
