1115 New York Health Equity Reform (NYHER) Waiver Updates

The NYS DOH 1115 New York Health Equity Reform (NYHER) Waiver launched with nine regional Social Care Networks (SCNs) on January 1, 2025. It’s not too late to connect with your regional SCN!

People with intellectual and developmental disabilities (IDD), enrolled in a Medicaid Managed Care Plan who express a Health Related Social Need (HRSN) during screening are eligible for Enhanced HRSN Services. There are over 200,000 Medicaid Managed Care enrollees statewide with IDD who require a HRSN screening to determine eligibility.

There is some overlap between the 1115 Enhanced HRSN services and OPWDD waiver services, so providing services under the 1115 waiver may be an additional revenue stream. Your organization has an opportunity to serve people with IDD who are not enrolled with OPWDD or who are enrolled in OPWDD but not approved for one of the Enhanced HRSN services.

Contact information for the Social Care Networks and additional program information can be found at this LINK.