High Fidelity Wraparound Eligibility and Care Manager Requirements FAQ

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Category Question Answer
Admin Where can the slides be found? The slides and policy are posted with all other HFW and Children's Single Point of Access (C-SPOA) information here.
Admin Is the HFW Agreement Form serving as the official documentation for "enrollment" in HFW? Or will there be an enrollment packet with the HFW criteria checklist? All HH documents must be completed. The HFW Agreement Form must also be completed and is an acknowledgement that the participant voluntarily enrolled, and that they understand what services they should receive. There is a component of the agreement that notes the fidelity will be monitored to make sure it is being implemented to the best quality for the participant/family.
Admin Will the contact information for HFW supervisors be provided? On the Department of Health (the Department) website there is a list of the HFW Care Management Agencies (CMAs) and C-SPOAs with their emails. It can be found here.
Admin When will this policy go into effect? The policy will go into effect June 1, 2025, however, if the CMA feels they can start the process prior to that, they can start once the policy is issued.
Admin When will the Office of Mental Health (OMH) issue the qualifications? Qualification, training, and other requirements will be issued in April 2025.
Admin What is the difference between the services offered by the Childrens HH and the HFW? HFW is an evidence-based practice with fidelity measures and required activities. More can be found here.
CANS If the SPOA screening shows that the participant is eligible for HFW but after completing the Child Adolescent Needs and Strengths – New York (CANS - NY) in the Uniform Assessment System (UAS) it does not indicate High Acuity, should HFW still be considered? C-SPOAs are not completing the CANS. The CANS is completed by the care manager. If the C-SPOA completes the screening and believes the participant is suitable for HFW, they can override the CANS Acuity outcome. The C-SPOA screening form has a section for the C-SPOA to share information to support the care manager in completing the CANS.
CANS Is HFW already in CANS-NY? HFW is not a separate acuity level within the CANS-NY. To be eligible for HFW, a child/youth must be determined Complex acuity on the CANS-NY and have a completed HFW Screening (within the UAS) indicating eligibility. The HFW Screening is only available in the UAS when a child/youth is determined Complex acuity, and the care manager indicates that they have SED or two (2) mental health diagnoses.
Process How would a CMA become a HFW provider? OMH will issue guidance soon.
Process If HFW is not currently offered in a county, how would the C-SPOA and CMAs be notified that HFW has started offering HFW? As new HFW CMAs are added to counties, the online contact sheet will be updated, and announcements will be sent to the field. HHs will share with their network as well.
Process How long does the lead HH CMA keep case opened once family has been transitioned to HFW? HFW can only be implemented at HH CMAs designated by OMH. HFW is a short-term intervention that is implemented across four (4) phases of effort. While the time it takes for each child/youth and family to complete the four (4) phases is individualized to them, the average length of stay is between ten (10) and eighteen (18) months.
Process Who bills during the transition month, the current CMA or HFW provider? Billing for HFW is outlined in the Eligibility and Care Management Requirements policy. HFW will not bill until the participant is officially enrolled in HFW. The current CM continues to bill until the transfer occurs by the HH.
Process Does the lead Health Home (HH) keep the case if the family has agreed to HFW and began services with them? The Lead HH role is to know the HFW CMAs availability for a current CM to discuss HFW with the participant.
Process Will the transferring CMA be contacted when the participant is ready for discharge from HFW? Yes, if the child/youth and family decide that they would like to step-down to HH care management and would like to return to the former agency.
Process Who is responsible to obtain updated consents to initiate the Currently when a member moves from one CMA to another, or one
transfer, C-SPOA or the Current CMA? HH to another, the CM obtains the new consent. This is the same process for HFW. The goal of C- SPOA is to help with timeframes and gathering documents.
Process Is this process for youth who were in residential/State hospitals? Does this apply if they are disenrolled from the CMA's if they are in patient for a certain length of time? Children's Waiver HCBS Eligibility Determination by C-SPOA Coordinators Policy covers this topic.
Process Will notice be provided by the residential/hospital facility to allow for this referral? Children's Waiver HCBS Eligibility Determination by C-SPOA Coordinators Policy covers this topic. The State is working with States hospitals and residential placements so as referrals come in they are considering HFW the same way they do for HCBS.
Process For participants that are not involved in multi-systems, should the enrollment still be completed? if it came from C-SPOA? A child/youth must be involved in multi-systems to be eligible for HFW. This is included on the C- SPOA screening form.
Process If a family decides to participate in month 11, does a new determination need to be done? The HFW determination produced from the HFW screening will remain valid for one (1) year. A child/youth and family can request to participate in HFW at any time during that year. Participation should be reassessed based on need and choice.
Process Can you explain the timeline for the HFW model? The HFW model is intended to help the participant and family as fast as possible. Research shows that HFW produces more positive outcomes for children/youth and family when implemented to fidelity, which includes the time frames. Reference (www.nyssoc.com) for more information.
Process Is there a defined process for participant/families enrolled in non- Medicaid Care management, would they would require MA eligibility to enroll in HH? HFW, as an evidence-based practice model, can be implemented in non-Medicaid Care management by a NYS HFW-certified care manager. However, there is not currently a funding stream to support this work.