Single Source Procurement: Regional Resource Development Centers

Pursuant to New York State Finance Law § 163.10(b), The New York State Department of Health is presenting the following summary of relevant circumstances, and material and substantial reasons why a competitive procurement was not feasible.

The Office of Health Insurance Programs (OHIP) Division of Long Term Care (DLTC) requests a waiver to issue a time and cost extension for the nine current regional contracts for the Regional Resource Development Centers (RRDC). The current contracts expire on December 31, 2014. This request is for an eighteen month time and cost extension (January 1, 2015 to June 30, 2016).

Chapters 615 and 627 of the Laws of 2004 amended NYS Social Services Law to authorize the State's Nursing Home Transition and Diversion (NHTD) waiver program. The Medicaid (MA) waiver, approved by the federal Centers for Medicare and Medicaid Services (CMS) in 2007 and subsequently re-approved in 2010, provides New York's seniors and other individuals living with disabilities a wide array of health and supportive services in the least restrictive, most appropriate available setting.

Chapter 196 of the Laws of 1994, Article 27-CC, amended NYS Social Services Law to establish the NYS Traumatic Brain Injury (TBI) waiver program within DOH. This legislation charged the Department, "to develop a comprehensive statewide program ... with primary emphasis on community based services and to develop outreach services and to utilize existing organizations with demonstrated interest and expertise in serving persons with traumatic brain injuries and, within funds available, enter into contracts with such organizations." Since NYS Fiscal Year 1995-96, the enacted budget has appropriated funding in support of this program. This waiver serves individuals who would otherwise be cared for in a nursing facility and who, considered as an aggregate group, can be served at less cost in a community setting.

The current date for transition of the two programs to Managed Long Term Care is September 2015. However, the transition workgroup has not finalized the timeline for movement of the service population to MLTC and this target date is fluid. A phase-in of the target population may be required while sufficient provider capacity is developed. It is anticipated that other delays in the transition process will occur. There are a number of unresolved issues presented by the Centers for Medicare and Medicaid (CMS); in particular, CMS must approve the transition plan for the change in service delivery. The needs of the service population must continue to be addressed as the transition proceeds. The program will require the continued operation of the RRDCs and the delivery of waiver services. At this time, it is anticipated that the NHTD and TBI waiver programs will completely transition to the MLTC service model by June 2016. Until that time, RRDCs continue to serve a critical role in service delivery, transition planning and closure activities related to the termination of the 1915 c waiver programs. These offices also provide critical data relevant to the transition process and serve as the prior authorization agent, while waiver services continue to be provided.

Adequate operational funding of the RRDCs is crucial to continue the maximization of Medicaid savings and ensure the transition of the current fee for service system to managed care.

Procurement / Program Name Regional Resource Development Centers
Contractor Name(s) Multiple – Please see attached.
Contract Period 1/1/2015 – 6/30/2016 (18 month extension)
Contract Number(s) C026002 – C026009, C026652