Dear Members, Families, and Friends,

Across the country today, June 19, we mark the 159^th anniversary of Juneteenth, or Freedom Day, as it is also known. Juneteenth, a combination of the words "June" and "nineteenth," celebrates the emancipation of enslaved Black Americans in the United States. Our offices are closed to demonstrate our commitment to racial justice and to support our core values in diversity, equity, inclusion, and belonging (DEIB).

Establishing Juneteenth as a corporate holiday is one of many actions we have taken to promote understanding and foster mutual respect. Our foundational DEIB work is shaping a transformative culture to advocate for greater diversity, equity, inclusion, and belonging in our workplace and in support of members and families.

On June 13, we held our first DEIB Round Table for external stakeholders. The event provided a forum to listen and gather issues that matter to members and families. These diverse insights and perspectives will help to inform our advocacy strategies for members and families to ensure they represent the diverse perspectives of our members. 

Our advocacy platform is built on a strong foundation of championing disability inclusion and bringing about meaningful change for individuals with Intellectual and Developmental Disabilities (IDD). In our proactive efforts, we are advocating for safe and affordable housing, meaningful employment, education, access to culturally competent holistic health care, and adequate funding in the IDD delivery support system. We are committed to advocating for individuals with IDD so they may participate fully, safely, and free from prejudice in their everyday lives.

Let us gather and celebrate this Juneteenth to reflect on the history and contributions of the Black and Latin American communities. The 2024 national Juneteenth theme, “Their Wildest Dreams,” honors the achievements of freed slaves and their descendants. It is a reminder that our history is important and that while some progress has been made, there is still much work to be done. Click here for details on 2024 Juneteenth events in New York State communities that will provide opportunities for us to learn, celebrate and reflect on the holiday’s historical significance.

Our commitment to members and families is embodied in our values. These values help us demonstrate our priority of helping people with IDD live life to the fullest and on their terms. On Juneteenth, and beyond, let us discover our similarities and find new ways to shine our light and support each other!

In Gratitude & Community,

Kerry Delaney, CEO

Transcript:

Hi, I'm Dr. Steven Merahn, Medical Director at Care Design New York and Partners Health Plan.  

It's Fall, also known as flu season. Unfortunately, at the same time, we're seeing an increase in the number of cases of COVID infection in New York State.  

And while the number of COVID cases remains low, there are some significant increases in the number of hospitalizations and deaths from COVID in individuals who are most vulnerable to severe infection.  

These risk factors for severe infection include advanced age, multiple medical conditions, including heart and lung disease or cancer, history of smoking, and of particular importance here, people with intellectual and developmental disabilities.  

Vaccines are the single most powerful tool we have to prevent severe disease for both flu and COVID. And while the vaccines may not always prevent infection, they are well proven to reduce the risk of severe infection and hospitalization, as well as making your symptoms milder and shorten the course of any infection. 

So, please get your flu vaccine and COVID vaccine as soon as possible. You can safely get them both together. And keep in mind that the new COVID vaccine is not a booster. It's a new formulation designed to protect you against new variations of the virus.  

Other ways to prevent infection include frequent hand washing, use of hand sanitizer, practicing cough etiquette, covering your mouth with a tissue you dispose or coughing into your elbow, and many people are choosing to wear a mask when in public or crowded places. Many health systems are having their professional staff wear masks to protect patients and visitors.  

Flu and COVID share many signs and symptoms in common. This includes cough, runny, stuffy nose, tiredness, fever, muscle aches and pains. 

First, if you start to feel sick, stay out of public places, work, or group programs.  

Second, if you start to feel sick, test for COVID as soon as you can. Early detection of COVID is important and there are medications, one is called Paxlovid, you can take early in the course of an infection that can induce your risk of serious infection. To be most effective, they need to be taken in the first five days of your illness, and that's why early testing is so important. Talk to your doctor or pharmacist about medication once you get a positive test.  

Finally, whether flu or COVID infection, you should always seek medical care if you have trouble drinking fluids, have trouble breathing, or don't have enough breath to finish a sentence, your lips or nails are discolored or blue, your fever doesn't respond to medications, or you're just too sleepy to stay awake during the day.  

I know this was a lot of information, but I hope it helps you have a healthy fall and winter season.  

And thanks for listening.  

For more information, reach out to your Care Manager. 

Dear Members, Families, and Friends,

Over the last few months, a number of new forms (also known as “variants”) of COVID-19 virus have appeared in communities across the United States. This has been associated with an increase in the number of people getting sick, and hospitalized, due to COVID-19 infection. .

While the total number of cases remains low, in New York State the number of positive tests has increased 400% since June. Experts are sure this is the beginning of a wave of infections that will continue to increase into the Fall and Winter.

We are keeping track of this but want to make sure the IDD community remains safe. People with IDD, as well as the elderly, and those with chronic illnesses such as lung disease, cancer, heart disease and others, are vulnerable to severe illness, increased risk of hospitalization, and other consequences of COVID-19 infections.

Let’s make sure everyone – people with IDD and those that care for, and about them - is protected and can protect each other.

FIRST, with vaccines that are well-proven to prevent severe illness

Please get a flu vaccine as soon as possible.  The flu and COVID-19 can “look and act alike” and getting a flu vaccine will protect you from a known health risk every Fall and Winter. Care Managers can help ensure you get all the vaccines needed to protect your health.

There will be an updated COVID-19 vaccine that will be available in the Fall, one that will offer protection against some of the new variants. Even if you have not received a booster in the past, you should get this version.

Finally, if you or your loved one is over 60 years of age, talk to your primary care provider about getting the new vaccine against RSV, a virus that can cause severe lung disease in older adults. Last year the rate of hospitalizations for RSV among adults was 10X higher than usual. The RSV vaccine can be given at the same time as the flu and COVID-19 vaccines.

If you have any questions about vaccines, please reach out to your healthcare provider.

AND, with physical precautions

Handwashing, physical distancing, and mask usage are all well-established, easy to use and well proven ways to prevent spread of all respiratory infections. 

Masking remains a personal choice. However, healthcare professionals are increasingly considering a return to masking as a precaution in healthcare and residential settings, like hospitals and nursing homes.  Some experts are suggesting that caregivers for those who are at risk should consider using masks as well. Healthcare settings like clinics and hospitals are also reinforcing the importance of workers – including healthcare professionals like nurses and aides - staying home if they are sick.

FINALLY, with early interventions

If you find yourself with ‘flu-like’ symptoms like fever, cough, headache, or muscle pain, get tested as soon as possible. If you test positive, have mild to moderate symptoms and are in a high-risk group, you should ask your doctor or pharmacist for a medication called Paxlovid. Paxlovid can reduce hospitalization rates by 80% if taken within five days of symptom onset.

People who are positive for COVID-19 should stay home or isolate themselves for at least five (5) days. 

We will keep track of the trends and any changes in recommendations for prevention and treatment. 

Thanks for your attention,

Steven Merahn, MD
Medical Director

References:

• Positive Tests Over Time, by Region and County | Department of Health (ny.gov)
• COVID-19 Forecasts: Hospitalizations | CDC
• Americans at high risk advised to wear masks as new Covid variant detected | Coronavirus | The Guardian
• Lessons From the COVID-19 Pandemic: Updating Our Approach to Masking in Health Care Facilities | Annals of Internal Medicine (acpjournals.org)

Attention Providers who Prescribe Enteral Supplies or Support Members in Need of Enteral Supplies

We would like to provide an industry update as a follow-up to our Winter 2023 Provider Newsletter article concerning nationwide shortages of enteral nutrition supplies. Unfortunately, this shortage is continuing to occur at the manufacturer level..

The largest manufacturers of enteral products (Nestle and Abbott) have advised that shortages may continue through the end of 2023 and into 2024..

We have been monitoring the ongoing shortage and would like to share recommendations on how to manage enteral nutrition needs of the individuals you support to avoid gaps in service.

• PHP’s DME department would like to remind providers that there are substitute products available from other manufacturers available on the market.
• A new physician order will be required to transition your patients to an alternate product.
• Nestle Alternatives
• Abbott Alternatives

You can reach our DME team by phone at 646-455-1594 and by fax at 646-948-1027.

PHP has an in-house team of DME specialists to assist in ordering Durable Medical Equipment, Prosthetics, Orthotics, and Medical Supplies for PHP Care Complete FIDA-IDD Plan Participants. If a patient you support needs any DME/POS items, please ensure that a complete script and letter of medical necessity (LOMN) is provided to PHP in a timely manner.

NYC FAIR is hosting a virtual Town Hall on Thursday, 11.9 at 7:00 PM via Zoom. Guest speakers include:

• Becki Lifford, Assistant Director, Office of Strategic Initiatives, OPWDD
• Cathy Varano, Chief Administrative Officer, Care Design NY
• Randy Bolton, Executive Committee, NYC FAIR

Register to attend and learn more about what a Life Plan is, what it includes, and why it’s helpful. Submit any questions in advance via the online registration form or email: This email address is being protected from spambots. You need JavaScript enabled to view it.. The join link will be emailed ahead of the meeting.

Learn More | Register

Inclusion Benefits All: An Employment Success Story

Learning Objectives:

• The business case for inclusion of employees with IDD and neurodiversity in the workplace
• How circle of support teams can advocate in the current state of employment for those with disabilities
• A personal story of employment success and growth, of a talented and determined individual

Steven Merahn, MD, Medical Director, present "Value and Outcomes in IDD Care: A Radical Proposal” at the NY Alliance Annual Conference on April 19, 2023. The presentation focused on new models for outcomes measurement and value of services provided to the Intellectual and Developmental Disabilities (IDD) community. Dr. Merahn explored how to drive meaningful impact for individuals with IDD, supporting their efforts to fully participate (emotionally, socially, economically) and succeed as active, productive members of family and community.

Dr. Steven Merahn also presented on Autism Outcomes at the annual meeting of the Council of Autism Service Providers (CASP) in Tampa, FL on April 23, 2023. Dr. Merahn’s “Radical Proposal” engaged participants in a discussion about the ongoing challenges of defining the value of services provided to children with autism and how to best measure them. The goal is to look beyond autism symptoms and help map a plan for children with autism across their lifespan. CASP is an international trade association of autism service provider organizations focused on delivering quality, safe and effective care.   

On April 19, Karleen Haines, Chief of Member Relations and Advocacy with PHP member, Ackeem Duggan, presented, “Inclusion Benefits All: An Employment Journey," at the NY Alliance Annual Conference. An inspiring employment journey of an individual to achieve independence and community involvement and how advocacy paved his bright future of employment and other neurodiverse individuals in the country and in New York.

Recruiting, hiring, and maintaining a workforce inclusive for those with Intellectual and Developmental Disabilities (IDD) form the bedrock of this presentation. 

Ackeem works for the New York City Police Department as the Director of Community Affairs Bureau. LEARN MOREabout Ackeem's employment story.

Albany, NY – Special Olympics New York is pleased to announce that their Virtual Health & Wellness Forums will now be sponsored by Care Coordination Organization Care Design NY and Partners Health Plan (PHP), the only IDD-specialized health plan in New York.

These Health & Wellness Forums allow the Special Olympics NY community a space to engage with health-focused individuals and organizations, with the goal of bettering access to health care, education, and inclusive activities for people with intellectual disabilities.

“Health and wellness are paramount to the continued competitive success of our athletes,” said Special Olympics New York President & CEO Stacey Hengsterman. “We know our friends at Care Design NY and Partners Health Plan feel the same, and we are grateful for their support.”

“We are thrilled to begin a partnership with Special Olympics New York which includes sponsoring virtual health and wellness forums geared towards educating and empowering individuals with IDD,” said Kerry Delaney, CEO of Care Design NY and Partners Health Plan. “We share a common bond in developing and advancing inclusive health initiatives where everyone can participate and improve their physical and social-emotional well-being. This partnership is truly a win-win, and we are proud to be part of it.”

The Virtual Health & Wellness Forums began on September 19 with 2023 Special Olympics NY Golisano Health Leadership Award recipient Claire Watson. The next forum will commence on Tuesday, October 17 at 6:30 PM with Downstate Clinical Director Laura Malick, RD. Prospective attendees are invited to register here.

Partners Health Plan (PHP) has expanded dental services to its members, adults (21 years and older) with Intellectual and Developmental Disabilities (IDD). Through its nonprofit, non-traditional tailored IDD care model, PHP partnered with Solvere Health to bring mobile dental clinics to members, making oral care accessible.

On Saturday, May 6, the Institutes of Applied Human Dynamics (iAHD) hosted the mobile dental clinic at their Bainbridge dayhab location. PHP members were treated by oral health care providers with specific expertise related to individuals with IDD.

Erica Robinson, iAHD Director of Clinical Supports stated,

“It was amazing that we were able to have thirteen individuals receive dental services on Saturday on location at IAHD! The collaboration with Partners Health Plan, Solvere Health, and iAHD is the future of dental services for people supported.”

Karleen Haines, Chief of DEIB & Member Advocacy, Veronica Crawford, Individual and Family Liaison and Self-Advocate, and Carrie Delong, RN, Director of Health Care Management presented, "Managing my Health and Wellness" at The New York Alliance's Living & Working in the Community Conference; an event focused on innovative, best practices in Self-Direction. 

Workshop participants received tips, tools, and resources to support individuals in achieving and maintaining independence through overall health and wellness. 

Partners Health Plan is a not-for-profit managed care organization serving individuals with IDD to support their goals and dreams. 

LEARN MORE ABOUT SELF DIRECTION

Partners Health Plan CEO Kerry Delaney and Medical Director Steven Merahn, MD, showcased their leadership and expertise at the 12th Annual Special Needs Plan (SNP) Leadership Summit. The summit (May 24-26), organized by RISE, brings together influential figures in the health plan industry to share insights on enhancing patient outcomes.

Delaney and Dr. Merahn had the privilege of opening the summit and delivering a presentation titled "Intellectual and Developmental Disability: A Health Disparities Population." The presentation demonstrated how Individuals with Intellectual and Developmental Disabilities (IDD) should be classified by federal and state governments as a “health disparities population.”

More than three decades after the passage of the Americans with Disabilities Act (ADA), disabled Americans still face barriers to health care, lower quality of care, and disparate health outcomes. The IDD population faces challenges regarding access to health care for their urgent and long-term needs. Further, they struggle with inequitable access to transportation, education, housing, employment and other non-medical determinants of health. Existing health, economic and social policies worsen these disparities.

Throughout their presentation, Delaney and Dr. Merahn examined individuals with IDD to address the distinct patterns of conditions, functional limitations, and risk factors that impact their health quality. Recognizing that traditional SNP operations and care models may not sufficiently support goal achievement for individuals with IDD, they explored IDD through the lens of health disparities. This approach allows for the development of a person-centered care model that accounts for functional, home, and community supports.

The presentation also provided valuable insights into the challenges and best practices for caring for individuals with IDD, with the goal of generating value not only for members, but for family/caregivers, provider networks, and the plan itself.

A specialized mobile dental clinic, in partnership with Solvere Health, brought dental care and smiles to Partners Health Plan (PHP) members on February 18. PHP is the first-in-the-nation, non-profit, provider-led managed care organization that fully integrates Medicare and Medicaid for individuals 21 years and older with IDD. We are dedicated to expanding access to quality healthcare to assist members in living quality lives.

Individuals with Intellectual and Developmental Disabilities (IDD) are known to have poorer oral/dental health than people without IDD. Studies show that people with IDD have 30% more untreated cavities, 50% more missing teeth, and 150% more gum disease.

The biggest reason for this health disparity is access to oral health care for children and adults with IDD: lack of preventive and regular care, including management of secondary medical conditions that are related to oral health, leads to more significant oral health problems. Wait times for IDD specialized services can be as long as a year at practices and dental school programs that offer them.

But Partners Health Plan (PHP), a NY-based health plan that is exclusively dedicated to supporting the health and well-being of individuals with IDD, is committed to ensuring the oral health of its members.

“Improving access to dental care for our community of service in New York State is mission-critical,” added Steven Merahn, MD, Medical Director, Partners Health Plan. “Our overarching goal is to improve the quality of life of our members and the relationship between oral health and overall well-being is well established.”
To achieve this goal, PHP has partnered with Solvere Health to deploy specialized IDD mobile dental clinics at select-day service locations in Metro New York to reduce travel demands.

Solvere Health is a company that specializes in the delivery of high-quality clinical services through group health events via mobile medical units or pop-up clinics to underserved populations. Individuals with IDD may struggle with the sights, sounds and experiences encountered during dental care, and the PHP-Solvere Dental Health Program will conduct specialized desensitization sessions to prepare individuals for the dental care experience and mobile clinic environments. The mobile dental units are also fully accessible for individuals with mobility challenges.

“Expanding the availability of quality healthcare services to underserved communities is central to Solvere Health's mission. We view the collaboration with Partner Health Plan as a way to make quality dental care accessible to persons with I/DD,” stated Edward Lorch, CEO, Solvere Health, “Our mobile clinics offer a solution that is empathetic and considerate. We factor in the patient population's comfort (including desensitization), convenience, mobility, and communication. When engineering and staffing the mobile clinic, we understand that taking a holistic view of the patient leads to a positive oral healthcare experience and repeat preventative care.”

“This mobile dental clinic initiative is a very exciting opportunity as it will open access to oral healthcare,” noted Rita Marie Bilello, DDS, CEO, and former Dental Director of Metro Community Health Centers. “This new dental care model will bridge a much-needed gap for Partners Health Plan (PHP) members, all adults with IDD, who have been unable to access routine preventative oral health care services. Mobilizing dental services will begin to address some of the access issues and will allow for PHP to better assist in getting their members the oral care that they need.”

About Partners Health Plan
Partners Health Plan (PHP) is the first-in-the-nation, provider-led managed care organization that fully integrates Medicare and Medicaid for individuals 21 years and older with Intellectual and Developmental Disabilities (IDD), so they have the most complete care package. PHP provides person-centered care for whole-person wellness addressing the physical, behavioral, and social needs of individuals to assist them in living a quality life. The plan operates in 4 New York State regions (nine downstate counties): New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County. For more information, visit www.phpcares.org.

About Solvere Health
Working with state and federal, institutional, and corporate partners, Solvere Health brings a business discipline to health challenges across the United States through onsite, mobile, and digital healthcare solutions. Deploying a team of highly motivated, accountable problem solvers, we stand up sustainable, end-to-end programs in rapid response to group health events, disaster relief, and underserved rural communities, via onsite pop-ups, mobile clinics, and strategically placed brick-and-mortar locations. Our efficient approach combines exacting strategic planning, comprehensive compliance management, unparalleled logistics, state-of-the-art mobile healthcare technology, and emerging digital health applications.