Mohawk Valley Health System will close two of its long-term care-related programs, but one will continue with a new provider.
But the adult day care program will close on Friday. The program is offered at the closed Rehabilitation and Continuing Care Services Center on the St. Luke Campus, which reopened in June 2023 after being closed during the COVID-19 pandemic.
But demand for the program is not as high as it was before the pandemic, and the health system is struggling to find enough staff, officials said.
Also, the health system’s long-term managed care plan, Seniors Health Network, ceased operations effective June 1. The network managed the care of Medicaid beneficiaries (and some privately paying patients) in Oneida and Herkimer counties.
But MVHS has reached an agreement with VNS, the state’s largest nonprofit managed long-term care plan, to enroll Seniors Network Health members who don’t choose to enroll in another plan within 60 days of being notified of the change.
“Our top priority is ensuring that people in our community who need assistance with everyday health and support activities can continue to receive care in the comfort of their own home, while seeing the caring faces of family and friends,” said Amy Bowerman, vice president of Post-Acute Rehabilitation Services at MVHS.
The agreement, approved by the New York State Department of Health, will allow MVHS to continue its role in caring for seniors and people with disabilities who were previously part of the Seniors Health Network.
“We are committed to ensuring a smooth transition for Senior Network Health Plan members so they don’t experience any interruptions or changes in care as they transition to the VNS Health MLTC plan,” said Dan Savitt, president and CEO of VNS Health.
About 350 people in Oneida and Herkimer counties are enrolled in the Senior Health Network. Prior to the contract, about 200 people in those counties were enrolled in VNS, which also serves Madison and Onondaga counties in Central New York.
In Oneida and Herkimer counties, three more companies offer plans: Fidelis Care, iCircle and Nascentia Health Options.
Senior Health Network helped people who wanted to continue living in their own homes rather than move into long-term care facilities, but needed help to do so, by creating a care plan that covered all of an individual’s needs, including home health care, housekeeping, dental care, physical therapy, medication management, transportation, meal delivery, respiratory therapy and adult day care.
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But MVHS was forced to end the program due to a regulatory change included in the 2023-2024 state budget that requires all managed long-term care plans to implement Medicare Advantage Dual Eligible Special Needs Plans that earn at least three stars on the federal rating system, which help consolidate benefits for participants who are enrolled in both Medicaid and Medicare.
The provision required managed long-term care plans without dual-qualified plans to either terminate their programs or merge with or be acquired by another plan that meets the new requirements.
MVHS has no such dual eligible plan, but VNS has one that is rated three-star.
Adult day care staff are working with families to develop post-closure safety plans for everyone in our program. Staff are informing their primary care physicians, insurance companies, and case managers, if applicable, for everyone in our program.
They distributed lists of local resources that could help, including other day programs and transportation services, and met with people in their programs and their caregivers to develop transition plans and help implement those plans.
