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

  • 1915c Wavier Providers (OCFS B2H, OMH SED, OPWDD CAH and DOH CAH)

As outlined in the transition in-person training, a number of resources will be provided for 1915c waiver providers to assist you and the children and families you serve to transition to Health Home care management during the transition period of January 1, 2019 through March 31, 2019.  Below is a list of each resource and a brief description.

1. In-Person 1915c Transition to HH Training

2. Talking Points for Transitioning 1915c Waiver Providers: Script for talking to families about the upcoming transition.

3. Direct Noticing Draft Schedule: Tentative schedule for messages from the State and Managed Care Plans for recipients and families.

4. FAQ for Care Managers: Frequently asked questions for CMs about 1915c children’s waiver home and community based services.

DOH Resources

  • 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: