Children’s System Transformation

Children’s Medicaid Health and Behavioral Health System Transformation

Transformation of the Children’s Medicaid Health and Behavioral Health System is scheduled to begin on January 1, 2019.  Key Components of the Transformation, pending federal approval, include:

• Transition of six 1915(c) waivers to 1115 Waiver authority

• Office of Mental Health (OMH) Serious Emotional Disturbance (SED) Waiver;
• Department of Health (DOH) Care at Home (CAH) I/II waiver
• Office for People with Developmental Disabilities (OPWDD) Care at Home Waiver
• Office of Children and Families (OCFS) Bridges to Health (B2H) SED, Developmental
Disability (DD) and Medically Fragile Waivers

• Alignment of 1915(c) HCBS under one array of Home and Community Based Services (HCBS) authorized under 1115 Waiver

• Transition to Health Home Care Management

• Current 1915(c) Waiver Providers Transition to Health Home
• Care Management provided under 1915(c) Transition to Health Home Care Management

DOH Resources

• Webinar recording for the Children’s Behavioral Health Provider Readiness Funds – August 2, 2018
• NYS Children’s Health and Behavioral Health Services Billing and Coding Manual - July 26, 2018
• NYS Children’s Health and Behavioral Health Services Transitional Billing Supplement - July 26, 2018
• Children’s Medicaid System Transformation: SPA Rate Review - July 2, 2018
• Children´s Medicaid and Behavioral Health System Transformation Updates #3 – July 2018
• Designated Children’s providers for the new Children and Family Treatment and Support Services and Aligned Home and Community Based Services – June 27, 2018
• Children’s MRT Subcommittee Quarterly Meeting – June 25, 2018
• Children´s Medicaid and Behavioral Health System Transformation Updates #2 – June 2018
• Children’s Medicaid System Transformation Draft HCBS Workflow for Stakeholder Comment - May 23, 2018
• Children’s Medicaid System Transformation: SPA Rate Review - May 14, 2018
• Children´s Medicaid and Behavioral Health System Transformation Updates #1 – May 2018
• New Background Checks and Other Requirements for Health Home Care Managers and Children’s 1115 Waiver HCBS Providers - April 2018
• DRAFT Transition Plan for the Children’s Medicaid System Transformation - August 2017

• Additional details on the Transformation are available on the DOH Web Site.

NYS Council Advocacy

The NYS Council has been an active member of the Children’s Behavioral Health MRT Committee and has been providing comments all along the way related to the transformation.  Specifically, we have submitted the following comment letters:

• July 27, 2018 – Comments on Children’s Transformation Training Plan
• July 18, 2018 - Comments on Updated Provider Manual for Children and Family Treatment and Support Services
• July 18, 2018 – Comments on Updated SPA Rates
• May 30, 2018 – Comments on HCBS Work Flow and Proposed SPA Rate Revisions
• April 4, 2018 – Comments on Children’s Reform
• October 16, 2017 – Comments on NYS Value-Based Payment for Children
• April 5, 2017 – Comments on Draft Children’s System Transition Requirements and Qualification Standards for Mainstream Medicaid Managed Care Organizations (MMCOs)