Nysha Recent News

Highest Users of State Mental-health Services Getting Far-reaching New HARP Program

August 31, 2016

By Mendy Hecht, Hamaspik Gazette

Hamaspik of Rockland Among Hudson Valley Providers of Program’s Support Services

For those New Yorkers who struggle most with chronic and serious mental illness, the vicious cycle of mental illness and social failure, maddeningly, is all too inevitable.

And of those individuals, the ones who most-frequently use state mental-health services to cope with that vicious cycle is something that New York State health officials have long known about.

But with HARP, and the professional counseling and employment support that it provides, the New York State Dept. of Health (DOH) and other state agencies hope to help those highest-usage individuals in a new and more effective way—treating not just their symptoms but resolving underlying causes… and ultimately breaking that tragic vicious cycle.

Helping the neediest

The Health and Recovery Plan (HARP) program emerged in 2014 out of Gov. Andrew Cuomo’s Medicaid Redesign Team (MRT), a state consortium of public- and private-sector leaders tasked with improving Medicaid. 

The HARP program targets those individuals who’ve most used Medicaid mental-health services in the recent past.

Among other goals, HARP is designed to provide the critical social and emotional needs in patients’ lives that make it far easier for them attain and retain good long-term mental health—healthy-life staples like social skills, jobs, ongoing support and more.

The program’s first pilot efforts launched in New York City in April 2015.  By October of that year, HARP programs, which service adults age 21 and up, were rolling out across the state.

The HARP program is not for everyone with mental illness.  Neither is it exactly a new Hamaspik program.

As a matter of fact, it’s quite the opposite—it’s only for those New Yorkers whose Medicaid records indicate that they are the highest users of Medicaid-covered mental-health services.

Those individuals have been sent letters from the state DOH stating they have been selected to benefit from the new state HARP program.  The HARP program is for those letter-holders only.

To benefit from HARP, the selected individual must first choose a regional health home, a specialized healthcare provider, from a list of approved health homes included in the letter. 

The health home conducts an extensive evaluation of the individual.  It then creates a customized plan of treatment for the individual based on the 12 support services offered by HARP.

The individual is then provided a list of regional providers of those 12 support services—and depending on his or her customized plan of treatment, and the services offered by regional providers, he or she could get all of those services from one provider, or from two or even more.

Treating causes, not symptoms

Whether intervening in the lives of people with bipolar disorder, depression, obsessive-compulsive disorder, schizophrenia or other mental-health diagnoses, the HARP program gives its participants the critical short-term supports and services that they need to stay episode-free after their last relapse.

Once they are stabilized, long-term supports for months or more are also provided.

Those supports, short- and long-term, are quite specific.

They include regular and frequent home visits by a licensed social worker in the early post-crisis days, to compassionately stay on top of the patient in his or her vulnerable “drying out” stage.  Such visits critically help avoid another rehospitalization.

Said social worker will eventually guide the patient to take up regular mental-health therapy—also equally critical in tending to the personal emotional and social issues fueling their mental-health issues.

At the same time, HARP can provide the family with the equally-critical support training—making the ongoing recovery of a beloved child and sibling a family project that proactively involves loving parents, brothers and sisters, too. 

Practically speaking, that means that a trained worker comes to the house and coaches family members on what to say and do—and, more importantly, what not to say and do—to show understanding, sensitivity, care and love towards the young man or woman living with them as he or she painfully withdraws from a mental-health crisis or gets effective long-term mental-health treatment, including medication.

In short, that family support training teaches family members what their loved one is going through, and how to best be there for him or her—turning his or her recovery into a family and team effort.

A third and equally critical service—and one that arguably is the defining breakthrough service that sets HARP apart from earlier services—is one that also, upon reflection, would seem to be the most practicable, most effective and most exciting.

The HARP program recruits people who’ve recovered from mental illness, then empowers them to help peers to recover from mental illness—giving them the unique and self-affirming opportunity to give to others the gift of life and hope that was given to them. 

Under this HARP service, people who survived the pain of mental illness to achieve the stability of long-term recovery can now help others as only they can.

The HARP program provides them with training and certification, and then lets them share their common experience with those going through what they once went through, with an eye toward permanent long-term recovery.

Other services provided by HARP are one-on-one habilitation, in which the recovering patient gets a personal coach in learning (or relearning) basic self-care skills and healthy personal habits.  The coach will also help around the house and remind the patient to take his or her medications.

For the limited number of individuals with chronic mental illness who are fortunate enough to be served by it, the HARP program intervenes effectively in ways that earlier programs did not.  At the same time, a sizable number of people with chronic mental-health issues, many not high Medicaid users but no less at hospitalization risk, remain dependent on standard options.

On the front lines

This past January, Hamaspik was approved by the New York State OMH to be a HARP regional services provider in both Rockland and Kings Counties.

Heading up Hamaspik’s HARP efforts in Brooklyn is Hamaspik of Kings County’s David Schatzkamer.  At the same time, Hamaspik of Rockland’s very own Mrs. Spira is readying for the upstate agency’s October 1, 2016 date of official approval for operations.

For the past two months, Mrs. Spira—as Hamaspik of Rockland County’s lead on all things HARP—attended extensive state-provided training sessions to lay the groundwork for the agency’s latest community-oriented program.

For people in the Hudson Valley who’ve received HARP program notification letters, then, Hamaspik of Rockland County now stands by available to provide five of HARP’s 12 services.

With HARP, Hamaspik furthers its commanding position as a communal resource for a growing number of social services and supports.

If you’ve received a HARP participation letter for Rockland County, please call Kathleen Clay of Hudson River Healthcare at 914-734-8513 or Noel Sander of Hudson Valley Care Coalition at 914-502-1435.  For any questions on Hamaspik of Rockland County support services for HARP beneficiaries, please contact Mrs. Peal Spira, LMSW at 845-503-0247.