HARPs at 5 Years: What Have We Learned?

With a goal of fostering discussion, this article discusses the recent and present efforts of NYS agencies (specifically OMH, OASAS, and DOH) to effectively serve persons living with Severe Mental Illness (SMI) and Substance Use Disorders (SUD), while controlling New York’s Medicaid costs.


The state agencies cited are by no means the only entities working to achieve these goals; they are joined by hospital systems, mental health, and substance use disorder providers, peer networks, supportive housing providers, shelter providers, private practitioners, managed care organizations, and justice-involved organizations. However, these state agencies are unique in that they are the ultimate payers.


In order to write this discussion paper, I drew upon articles and resources published by a variety of organizations, my own experiences as well as those of colleagues. Cites and related readings are provided in an Appendix. The viewpoints expressed do not represent my past or present employers.

Although published in September 2020, the article is written from a “Pre-COVID” perspective.



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