Medicaid Service Coordination FAQ

What is Medicaid Service Coordination (MSC)?

MSC is a Medicaid State Plan service provided by the Office of People with Developmental Disabilities (OPWDD), which assists individuals with developmental disabilities in gaining access to necessary supports and services appropriate to their needs.
MSC is provided by qualified service coordinators and uses a person-centered planning approach in developing, implementing and maintaining an Individualized Service Plan (ISP) with and for a person with developmental disabilities. MSC promotes an individual’s rights to informed choice, individualized services and supports, and service satisfaction.

What can MSC do to help me?

Service Coordinator serves as an advocate in helping people access necessary supports and services, including but not limited to the following:

  • Community Habilitation (HCBS waiver)
  • Educational
  • Day Habilitation (HCBS waiver)
  • Family Reimbursement
  • Legal Guardianship
  • Medical/Clinical
  • Recreation
  • Residential (HCBS waiver)
  • Respite (HCBS waiver)
  • Summer Camp

A person must have an MSC in order to pursue enrollment in any of the Medicaid Waiver Home and Community Based Services (HCBS).

What are some of the responsibilities of a Service Coordinator?

A Service Coordinator is responsible for conducting a thorough assessment, that focuses on identifying the needs and wants of an individual by gathering information from him or her, as well as from their family members, medical providers, educators, and any other service providers involved in their life.
This interdisciplinary approach is essential in helping the MSC understand the individual’s needs and wants, so that we may develop an Individualized Service Plan (ISP) that will reflect an authentic picture of their hopes, dreams, desires and goals for personal growth.

MSC will link the individual to services and supports by way of referrals and assistance in navigating resources throughout the OPWDD and provider system. MSC will ensure that there is consistent monitoring and follow-up in pursuing activities and contacts that are necessary to ensure that the care plan (or the ISP) is effectively implemented. This includes ensuring that services are adequate to the individual; that changes in the needs or status of the person are monitored and followed up with; determining whether the person is receiving needed services to safeguard them in their home and community (i.e., health and safety monitoring); determining whether the person is satisfied with services and supports; determining other relevant information pertaining to the person.

MSC will be held to the highest quality standard through service documentation that is prepared by the Service Coordinator in accordance with state requirements and regulations.

What are my responsibilities as an MSC participant?

MSC is a partnership between the individual being serviced, their family members and the Service Coordinator. It is expected that all parties will be actively involved in the service provision process. Being available on a regular basis for a home or program visit with your Service Coordinator to discuss services and supports and any other relevant information is considered best practice to quality services. Ideally, the Service Coordinator should be meeting up with the individual at least every other month in their home or program setting and every six months to review the service plan along with the family members and service providers.

Do I have to pay to receive MSC?

No. MSC is funded through Medicaid. This service does not affect Medicaid eligibility. Service Coordinators can assist in maintaining Medicaid eligibility, as well as provide assistance in maintaining other benefits and entitlements including SSI, Social Security benefits or Food Stamps.

What if I am not happy with my Service Coordinator?

Here at Daybreak Independent Services we are dedicated to our mission statement: We Understand, We Connect, We Commit. We are driven to provide quality services to its individuals and their families.
We are in the business of providing informed choice to our individuals. If you should have a specified concern with MSC services or the Service Coordinator, please do not hesitate in reaching out to the MSC Supervisor, who will listen to you and exhaust all attempts to accommodate your concerns. You should also be aware that you have a right to choose a different MSC provider and should inform us of your choice to change provider agencies as soon as possible to avoid gaps in service provision. We will help you with this process. Should you feel the need to withdraw from MSC at any time, your Service Coordinator or MSC Supervisor can assist you in withdrawing from the service in its totality.

Should you have any further questions, please feel free to contact Mirna D. Matos, Program Coordinator, at (914)733-3325