TIP SHEET

Medicaid Service Coordination (MSC)

What is Medicaid Service Coordination?

Medicaid Service Coordination (MSC) is the process of identifying and securing Medicaid-funded services for individuals with developmental disabilities through the New York State Office of People With Developmental Disabilities (OPWDD).

Who is eligible for Medicaid Service Coordination?

Anyone who has a developmental or intellectual disability can apply for MSC. In New York State, residents must have Medicaid and current medical, psychological, and psychosocial evaluations in order to be eligible to enroll.

In order for a person to receive MSC, a person must have a documented diagnosis of a developmental disability, be enrolled in Medicaid, demonstrate a need for ongiong coordination of supports and services, and not live in a formal residential setting such as an Intermediate Care Facility (ICF), Developmental Center (DC), Psychiatric Hospital, Small Residential Unit (SRU), Nursing Facility or Hospital, or any other Medicaid-funded setting that provides service coordination.

Who provides Medicaid Service Coordination services?

Medicaid Service Coordinators (MSCs) provide these services and typically work at agencies that serve people with developmental disabilities.

What does an MSC do?

MSCs helps individuals and their families create and maintain an Individualized Service Plan (ISP) by identifying, coordinating, and monitoring OPWDD funded services such as:

  • Socialization/recreation programs
  • Afterschool programs
  • Behavior management
  • Clinic services
  • Employment
  • Day programs
  • Specialty skills training
  • Family support services
  • Residential services
  • Legal/advocacy

How do I enroll in MSC?

In NYC, people who are eligible can enroll in MSC services in two ways:

  • Through OPWDD’s Developmental Disabilities Regional Offices (DDRO)
  • Through a nonprofit service provider (like AHRC, UCPNYC, YAI, Heartshare, etc.)

Most nonprofit MSC providers work with families directly to determine eligibility and help with the enrollment process (including getting updated evaluations, additional forms, etc.).

To determine eligibility, call your borough's DDRO office

For a list of DDROs and their contact info, visit our tip sheet here: Click Here.

CATEGORY
Family Support, Developmental disability services, Financial Support, Working and Adult Life, Adult systems and services, Support for health, Support for independent living
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