Independent Evaluation of the New York State 1115 Waiver Amendment: The Children's Design: Interim Findings

Abstract

As part of ongoing redesign efforts, New York State proposed, and the Centers for Medicare and Medicaid Services approved, concurrent amendments to the existing six 1915(c) waivers and the 1115 Medicaid Redesign Team waiver. To streamline care for children and youth under age 21 who have needs for physical and behavioral health services and home-and community-based services, the State consolidated the existing six 1915(c) waivers into a new 1915(c) waiver in April 2019. The 1115 waiver amendment, implemented in October 2019, allows the state to move the services covered by the consolidated 1915(c) waiver from fee for service to Medicaid managed care and to target eligibility to medically needy Family-of-One children. Together, these waiver amendments are called the "Children's Design." To meet the requirements for the 1115 waiver renewal application, the State commissioned the RAND Corporation to conduct an interim evaluation to identify the facilitators of, and barriers to, the Children's Design implementation and to describe and delineate the pre-implementation trends in the outcomes of interest to prepare for a summative evaluation. This research was carried out within the Access and Delivery Program in RAND Health Care.RAND Health Care, a division of the RAND Corporation, promotes healthier societies by improving health care systems in the United States and other countries. We do this by providing health care decisionmakers, practitioners, and consumers with actionable, rigorous, objective evidence to support their most complex decisions.For more information, see www.rand.org/health-care,