Services - CFTSS and HCBS
COVID specific state guidance located in first section.
Children and Family Treatment and Support services (CFTSS formerly SPA)
Youth Peer Support and Training (YPST): Preparing for Managed Care - Webinar - Nov 18, 2019
- Provides service overview with case examples and discusses managed care billing, contracting, medical necessity/UM, referrals, and recommendations for YPST.
Family Peer Support Services (FPSS): Preparing for Managed Care - Webinar - May 13, 2019
- Provides refresher of FPSS and discusses Managed Care billing, contracting, medical necessity, referrals and recommendation process for FPSS.
- FAQ document from this training
Children and Family Treatment and Support Services: OLP, PSR, CPST Refresher - Webinar - Oct 25, 2018
- Provides a refresher for OLP, CPST and PSR; reviews what was presented on those services at the in-person Children and Family Treatment and Support Services trainings held in May and June. Also covers additional context and examples.
Utilization Management for CFTSS: OLP, CPST, PSR - Webinar - September 18, 2018
- Discusses process of Utilization Management for OLP, CPST, and PSR including medical necessity, utilization management requirements and strategies to optimize utilization management.
- FAQ document from this training
Children and Family Treatment and Support Services Training - In-person training - May/June 2018
- Reviews 4 of the new CFTSS (formerly SPA): OLP, CPST, PSR and FPSS including service descriptions and implementation details.
- FAQ document from this training
Documents/Guidance
CFTSS OLP and CPST Designation/Licensure Update
- CMHRS Regulation Waiver - extended July 20, 2021
- Transitioning to a CMHRS Program Guidance - July 6, 2020
- CMHRS Guidance - August 2019
- CMHRS CPAR Application Guidance - Jan 2020
- Provider agencies who do not otherwise have an OMH license, and would like to apply for CMHRS licensure, are required to complete the OMH Comprehensive Prior Approval Review (CPAR) application process.
- CMHRS EZ PAR Application Guidance - Sept 23, 2019 - for currently designated OMH OLP/CPST providers
- State Presentation - August 2019 - currently designated OLP/CPST providers are required to review
- CFTSS Incident Reporting Manual - Updated August 1, 2019
UM Authorization Grid for CFTSS: OLP, CPST, PSR, FPSS, YPST, and CI
- Includes information about individual Managed Care Plan requirements for notification, pre-authorization and concurrent review for OLP, CPST, PSR, FPSS, YPST, and CI services.
CFTSS Pathways to Care - State Refresher - August 2019
- Resource sheet on the referral and recommendation process for accessing CFTSS.
CFTSS Health Record Documentation - Provider Guidance - June 2019
CFTSS Concurrent Review Authorization Sample Request Form -NYS approved and released Jan 7, 2019
- The form was developed in collaboration with providers MMCPs as a sample template to capture all the necessary information to substantiate medical necessity for CFTSS. Some MMCPs will require concurrent review authorization after the first three visits. This form can be used by providers who are making concurrent review authorization requests to MMCPs. This form is not required by the State.
CFTSS Example of Medical Necessity/LPHA Recommendation Form - NYS released as a sample recommendation form. Use of this form is not required.
Home and Community Based Services (HCBS)
Children's HCBS Plan of Care Workflow and Service Authorization for HCBS Providers - Oct 18, 2019
- For Children's HCBS Providers
- Reviews the Plan of Care Workflow policy and Service Authorization for HCBS and the carved-in to Medicaid Managed Care benefit.
Children's Aligned HCBS Webinar Series - reviews the HCBS array. FAQ documents available for Webinars 1-4.
- Webinar 1: HCBS Caregiver/Family Supports and Services, Community Self-Advocacy Training and Supports & Respite - March 1, 2019
- Webinar 2: HCBS Prevocational Employment and Supported Employment - March 8, 2019
- Webinar 3: HCBS Community Habilitation, Day Habilitation and Palliative Care Services - March 15, 2019
- Webinar 4: Family Peer Support Services, Youth Peer Support and Training & Crisis Intervention as Interim HCBS - March 22, 2019
- Updated Authorization and Payment for Adaptive and Assistive Equipment, Vehicle Mods, Environmental Mods and Non-Medical Transportation - June 6, 2019
Children's Aligned HCBS LOC Eligibility Determination and Documentation Review - Webinar - April 23, 2019
- Reviews how to conduct a HCBS/LOC Eligibility Determination and the necessary documentation.
Children's Aligned HCBS LOC Eligibility Part 2 - Webinar - June 14, 2019
- Covers the process and information needed for HHCM and C-YES to work collaboratively with OPWDD DDROs regarding HCBS LOC Eligibility for the two Target Populations of Developmental Disability (DD) and Medically Fragile & DD in Foster Care.
- Draft OPWDD DDRO Manual Eligibility Process for Children's Waiver
Children's HCBS Capacity Management Refresher - Webinar - Sept 25, 2019
- Provides a reminder and update regarding Statewide Children's HCBS Capacity Management processes and the interaction/communication needed with Health Home care managers.
Children's Aligned HCBS Capacity Management Webinar - March 27, 2019
- Covers how capacity will be managed for the consolidated 1915c HCBS Children’s Waiver beginning April 1, 2019 and the interactive process between the Health Home care managers, the DDRO and C-YES with the DOH Capacity Management Team.
Children's HCBS Planning and Plan of Care Development Webinar - April 3, 2019
- Covers person-centered care planning and the creation of a Plan of Care for the consolidated Children’s HCBS Waiver.
Children and Youth Evaluation (C-YES): the State-designated Independent Entity (IE) for Children's HCBS - January 31, 2019
- Provides overview of how C-YES will support transitioning HCBS waiver children who opt out of HH Care Management from Feb 1st through March 31st.
Children and Youth Evaluation (C-YES): the State-designated Independent Entity (IE) for Children's HCBS Part 2 - March 25, 2019
- Provides an overview of the April 1, 2019 expanded role of C-YES; C-YES will deliver HCBS Eligibility Determinations to children who are not Medicaid-enrolled and assist those children/families with the Medicaid application process as well as continue to accept Health Home opt-outs for HCBS plan of care development and annual re-assessment.
Documents/Guidance
Manual: Home and Community Based Services Provider Manual
Children's HCBS Enrollment Policy - Jan 2021
Children's HCBS Disenrollment and Discharge Policy - Jan 2021
Complaint and Grievance Policy for Children's HCBS Providers - Jan 2021
Children's HCBS Provider Background Check Policy - Dec 2020
Children's HCBS Plan of Care Workflow Policy Reminder - Nov 2020
Children's HCBS Plan of Care Workflow - Sept 2019
Children's HCBS Referral Form to HCBS Provider - August 2019
- Completed by Health Home Care Manager or C-YES as part of referral process.
Children's HCBS Authorization and Care Management Notification Form - August 2019
- Completed by HCBS Provider for services beyond initial period.
Children's HCBS Waiver Eligibility Service Requirements State Guidance - Oct 2019
Medicaid Eligibility Status Impact on HCBS Eligible Children State Guidance - Oct 2019
- Includes guidance on Family of One Medicaid Eligibility.
Children's HCBS Provider Reportable Incidents Policies and Procedures - Oct 2019
HCBS versus State Plan Services Delivered During School/Day Time State Guidance - Sept 2020
Provider Designation for Children and Family Treatment Support Services/Home and Community Based Services
Children's HCBS De-designation Policy - Sept 2020
Children's CFTSS/HCBS Provider Designation Webinar - April 19, 2018
- Covers the provider designation process and authorized processes for new populations/services.
Children and Family Treatment and Support and Children's HCBS Designation
- Includes information on designation process as well as a regularly updated list of providers that are designated (located under Find a Designated Provider).
Medicaid Enrollment for Children and Family Treatment Support Services/Home and Community Based Services
- Tells how to get a NPI number as the first step to billing Medicaid managed care
Medicaid Provider Enrollment for New Children's SPA and HCBS Providers - Sept 29, 2017
- Walks through the steps necessary to enroll as a Medicaid Provider and be able to bill and be reimbursed by Medicaid.