C-SPOA Children's Waiver Eligibility Determination FAQ

  • Policy is also available in Portable Document Format (PDF)
Category Question Answer
Process Who will complete the HCBS Level of Care (LOC) Eligibility? This webinar addresses circumstances in which C-SPOA will conduct the HCBS eligibility determination. Please refer to the policy/slides for more information.
Process When will this process begin and how long prior to discharge? The process will begin March 3rd, 2025. This will take place up to 30 days prior to discharge, which is the same rule for the HHs.
Process Is this available to acute psych facilities as well, or only State Hospitals? Anyone is welcome to submit a C-SPOA URF. At this time, C-SPOAs are not conducting the HCBS eligibility determinations for private and general hospitals, but they can usher the referral to the appropriate entity.
Process Why can't C-SPOA refer directly to Care Management Agencies (CMAs) if it is known they have an immediate opening? C-SPOAs can provide information directly to the HH. The Office of Mental Health (OMH) asks HHs to receive referrals directly because they know who has capacity to provide services. This is information that the Department of Health (the Department) or OMH is not privy to. To keep the process uniform, referrals are sent to the HHs. Preferences can also be shared to the HHs. As OMH expands HFW, it will be the lead HH that will know which CMAs are doing HFW, and if they have capacity.
Process Is the HFW screening tool the same as the addendum that populates after the Child and Adolescent Needs and Strengths (CANS-NY) is completed, or is this a specific screening tool for C-SPOA's? The HFW screening tool is in development and will be shared, along with guidance, as soon as it is available.
Process How does a participant living at home qualify for the Children's Waiver? Qualifications are the same for participants living at home and HH CMAs would conduct HCBS Eligibility just as they do now for children in the community. This process is for the C-SPOAs to determine the HCBS eligibility for individuals being discharged from the intensive locations such as Residential Treatment Facilities (RTFs), Youth Assertive Community Treatment (ACT) programs, and State Hospitals.
Process What steps need to be taken when a county does not have any HCBS providers? Participants deemed eligible for HCBS should be enrolled. Even if there are not services available, the participant can be put on a waitlist and receive HH Care Management (CM). It is a requirement that CMs conduct HCBS eligibility assessments regardless of service availability.
Process Can HFW evaluations be provided simultaneously with HCBS eligibility evaluations? Yes, they can. More information/guidance on HFW will be in upcoming webinars.
Process Can CMA's still have 30-day overlap with RTF, Children's Community Residence (CCR) and Psychiatric Centers (PCs)? Is it required that the C-SPOA always determine eligibility for participants discharging from those LOC, or are there circumstances when a HH Serving Children (HHSC) provider can do it directly? HHSC providers can always determine eligibility directly. C-SPOA is one source that can complete eligibility determinations. There can still be overlap with the 30 days.
Process Assuming families and participants are offered "freedom of choice" for which CMA they want to select, what will happen if they select a CMA that is not designated to provide HFW, or is HFW designated but does not have capacity? HFW is optional to families. Enrollment in the program requires significant family participation. The C-SPOA will meet with the family to discuss all the available programs and allow the family to choose.
Process Do CMs collect the appropriate documentation if the C-SPOA doesn't send it? The C-SPOA should provide a completed packet. However, the C-SPOA and CM can collaborate to gather information as needed.
Process Can the C-SPOA continue to refer directly to CMAs, including those providing HFW/HCBS rather than requiring direct referral to HH? After determining a youth is eligible for HCBS, C-SPOAs will refer directly to a Health Home.
Process Will there be a prompt to complete a specific assessment (i.e. HFW, HCBS, CANS-NY) based on the referral received from an RTF, CR or Youth ACT program? Workflows for HFW and HCBS will be posted on the DOH Health Homes Serving Children website.
Process Will part one consents of the OMH application be updated to reflect consent for C-YES, HH etc.? The current URF Part One contains a consent page where many providers/agencies can be added.
Forms Will the Serious Emotional Disturbance (SED) attestation also suffice as the Licensed Practitioner of the Healing Arts (LPHA) attestation for HCBS eligibility? The SED attestation is contained within the URF. The LPHA is a separate form. Both are required for HCBS eligibility.
Forms Is the C-SPOA signing the 5201 or is the CMA still required to do that? The CMA is required to complete the 5201 as part of the member's enrollment
Forms For participants being released from State PCs, will the paperwork include a signed LPHA Attestation? All HCBS eligibility determination packets completed by C-SPOA will include the LPHA form signed by the treating clinician
Forms How can the C-SPOA unit assist with completing the LPHA Form if the CM is unable to obtain it from the providers? If a provider cannot get the LPHA signed by treatment provider, and the C-SPOAs have a designated license, they can attest to the LPHA Form.
Forms Do the State Hospitals know they have to complete this paperwork? OMH has ongoing communication with State Hospitals, and they are aware of this change in this process.
Forms Does the SED Attestation or LPHA Form come with a supporting evaluation that auditors will accept? If a referral is accepted, will NYSTEC hold C-SPOA accountable for this documentation, or the CMA? The SED Attestation is a checklist, which the C-SPOA signs. The LPHA form is signed by a designated person whose scope of practice allows them to attest; it may or may not come with aa supporting evaluation It is the responsibility of all CMs to collect all the necessary information.
Non-Medicaid For counties that use non- Medicaid Care Management providers to assist participants and their families with the C-YES process, can this still be used? Yes, counties can still use Non-Medicaid Care Management to assist families with the C-YES process.
Process What steps should be taken if HFW is not available in an area? If HFW is not available in the area, a referral can be made to another HH CMA.
Admin How can one attend the OMH hosted office hours? Links to office hours for C-SPOAs have been emailed to both DCSs and C-SPOAs. Please reach out to SOC. TeamSharedMailbox@omh.ny.gov if you did not receive them.
Admin Can you please provide the email address that can be used to send OMH questions? SOC.TeamSharedMailbox@omh.ny.gov
Admin How can one find the communication announcing the Children's Waiver HCBS Eligibility Determination by C- SPOAs Policy #HH0020? This policy announcement was distributed via the Department's Health Home Listserv. OMH will also send this policy via their Listserv. The policy will be posted on the Department website.
Admin Can the link for the Local Governmental Unit (LGU) contact information be shared? Contact Local Mental Hygiene Departments | NYS Conference of Local Mental Hygiene Directors, Inc.
Admin Will a copy of the slides be available? Slides will be posted on the Department website, along with the recording and transcript.