Based Services Waiver PURPOSE OF THE HCBS WAIVER PROGRAM The Medicaid Home and Community-Based Services (HCBS) waiver program is authorized in §1915(c) of the Social Security Act. These waivers cannot be limited to a certain ethnic or racial group but can be limited in other ways: 1. A listing of each OPWDD Regional Office is identified in the Public Notice. The Children’s Waiver • New York State combined six waiver programs into one waiver • Children and youth who were enrolled in those waivers now have access to more services • These services are called Children’s Home and Community Based Services (HCBS) under what is now called the Children’s Waiver The authorized provision of Group CH-R services continues to be eligible for claiming to eMedNY. Comprehensive Home and Community-Based Services (1915-c HCBS) Waiver The New York State Department of Health (NYSDOH) is providing this guidance to Health Homes Serving Children, C-YES, Home and Community Based Services (HCBS) providers, and MMCP/HIV SNP surrounding the 1915(c) HCBS Children’s Waiver OPWDD administers this HCBS Waiver. This site provides information related to the Children’s Waiver – including guidance and resources for providers, care managers, managed care organizations, families, and community stakeholders. The waiver amendment is statewide, meaning it covers the entirety of New York A person who is eligible and lives in NYS can request to be enrolled in the HCBS waiver by contacting the DDSO or a provider agency that serves the county in which the person lives. People enrolled in a Special Needs Plan (SNP) may also be eligible for BH HCBS The program permits a state to furnish an array of home and community-based services that assist Medicaid beneficiaries to Traumatic Brain Injury (TBI) Waiver of New York State The Home and Community-Based Medicaid Waiver for Individuals with Traumatic Brain Injury (HCBS/TBI) is one component of a comprehensive strategy developed by the New York State Department of Health to assure that New Yorkers with a traumatic brain injury may receive services within New York in the least restrictive setting. Loss of Waiver Eligibility HCBS Children’s Waiver Program Home and Community Based Services (HCBS) are designed to allow children/youth to participate in a vast array of developmentally and culturally appropriate services, by granting access to a series of Medicaid funded services. Final 2019 Waiver Renewal approved by the Centers for Medicare and Medicaid Services, Effective October 1, 2019. Any questions related to the Children’s Waiver may be submitted to: [email protected]ny.gov. Children's HCBS Consolidated Waiver Caregiver/Family Support Description: The HCBS Waiver, authorized in 1915(c) of the Social Security Act, is to maintain individuals under the age of 21 with SED in their homes/communities who would otherwise be in hospital levels of care by reimbursing for non-traditional services. For example, delivering Community Habilitation to individuals who live with their family and participated in your agency’s Day Habilitation program prior to the onset of COVID-19. The OPWDD Home and Community-Based Services (HCBS) Waiver operated by the Office for People With Developmental Disabilities (OPWDD) is a program of supports and services that enables adults and children with developmental disabilities to live in the community as an alternative to Intermediate Care Facilities (ICFs). As such, we encourage attendees to plan to use audio devices such as computer, tablet, and smartphone speakers instead of the phone-in option. Staff uses a strengths-based, individualized care approach to work with families. Draft April 1, 2021 Waiver Agreement Registration is available at: https://meetny.webex.com/meetny/onstage/g.php?MTID=e34f9ff9e51e3229f2d64d214264abf18. OMH HCBS Waiver Bridges to Health (B2H) Waiver Services OPWDD HCBS Waiver Overview The Home and Community Based Services (HCBS) Waiver is a federally funded program which currently serves 1506 children with serious emotional disturbances in every county in New York State with the exception of Oneida, which has a look-alike program. The New York State Office for People with Developmental Disabilities (NYS-OPWDD) HCBS Waiver was initiated in 1991 creating a new service provision model that encouraged increased use of community resources to meet the needs and enrich the lives of persons with developmental disabilities. Table 9. •Managed Care Organization (MCO) Implementation •CORE System Configuration •Questions, Discussion and Feedback. The following resources have been developed to assist providers to deliver services that meet the needs of individuals with intellectual and developmental disabilities during the COVID-19 emergency period. For further information here are links to items in OPWDD's website About OPWDD Services – Waiver Services The Draft April 1, 2021, Waiver Amendment was posted to the OPWDD web page on November 10, 2020 for public comment. Children’s Home and Community Based Services (HCBS) Most services previously delivered under agency-specific 1915(c) waivers are now delivered under concurrent waiver authorities that allow children to be enrolled in Managed Care (unless otherwise exempt … January 26, 2021 2 Agenda •Behavioral Health Home and Community Based Services (BH HCBS) Transition to CORE: What Changes? The State of New York requests approval for a Medicaid home and community-based services (HCBS) waiver under the authority of §1915(c) of the Social Security Act (the Act). Comprehensive HCBS Waiver Services. 855. The Home and Community Based Services Waiver is the Medicaid program that provides opportunities for adults and children with intellectual and developmental disabilities to receive services in their own home or community. Medicaid home and community-based services [HCBS] are available through waiver programs to groups of individuals who would be eligible for Medicaid if institutionalized and, but for the services, would be institutionalized in a hospital or nursing facility. have a diagnosis of a developmental disability. Through the 1915(c) waiver program, a state can help people who need LTSS and are Medicaid-eligible by supporting and designing its HCBS services based on their needs. eMedNY is the name of the electronic New York State Medicaid system. Community Habilitation. The HCBS waiver is one of many waivers that the federal government approves to allow states to be more flexible with the use of Medicaid funds. It is OPWDD's primary funding mechanism for supporting individuals in the community by providing a variety of services and supports that are uniquely tailored and individualized to meet each person's needs. People. 111. The eMedNY system allows New York Medicaid providers to submit claims and receive payments for Medicaid-covered services provided to eligible members. B. • Waiver services are designed for people who, but for these services, require the Both waivers are HCBS 1915 (c) waivers and waive parent income. To be eligible for opportunities in the OPWDD HCBS Waiver, an individual must: A person who is eligible and lives in NYS can request to be enrolled in the HCBS waiver by contacting the DDSO or a provider agency that serves the county in which the person lives. Final October 1, 2020 Waiver Amendment approved by the Centers for Medicare and M edicaid Services, Effective October 1, 2020. OPWDD HCBS Appendix K Waiver Amendment – General CMS approved the term of New York’s OPWDD HCBS Appendix K waiver amendment from March 7, 2020 through September 7, 2020 but will only cover the period in which there is a declared State of Emergency in New York. The authorized providers of waiver services as well … have chosen HCBS waiver services over institutional care. Please direct any questions and concerns to [email protected]. The Draft April 1, 2021, Waiver Amendment was posted to the OPWDD web page on November 10, 2020 for public comment. 516.280.3193 A microphone connection is not required for attendees. ABOUT THE SERVICE Home and Community Based Services Waiver (HCBS) is an intensive program that provides a Based on recent federal guidance in which CMS limited the number of retainer days that providers are allowed to bill, the last service date for submitting retainer day claims to eMedNY under the Day Service Retainer Program is July 21, 2020.