Legal Aid Society

In 2012, New York State continued its plan to enroll virtually all Medicaid beneficiaries in mandatory managed care, including vulnerable populations like the homeless, who have previously been exempt.

For the estimated 113,000 homeless individuals in New York City, the policy change could be especially difficult. Because these individuals have limited phone access and no consistent residence or shelter at which they can receive mail, the majority will be automatically assigned to a health plan and a primary care physician based on their last known zip code, creating significant barriers to care and threatening the established systems people who are homeless use to ensure their health. Through an early intervention, the Legal Aid Society (LAS) improved health care for the homeless population by assessing the enrollment process and troubleshooting barriers to care to avoid more severe consequences later on.

This project monitored the roll-out of mandatory managed care for homeless New Yorkers, identified systemic glitches, and provided real-time feedback to policymakers to help fix problems and ensure that implementation went well. LAS provided technical assistance and training to the medical and comprehensive services providers that work with the homeless population. Information gathered from this work informed discussions with the State and City about how best to administer the transition and help ensure its success.