Update on Children's Waiver Home and Community Based Service (HCBS) Referrals for Children/Youth Who Opt-Out of Health Home

  • Notice is also available in Portable Document Format (PDF)

Date: December 17, 2024

To: Medicaid Managed Care Plans (MMCPs) including Mainstream Managed Care and HIV Special Needs Plans, Children and Youth Evaluation Service (C-YES), Health Homes, Health Home Care Management Agencies, and Children's Home and Community Based Service (HCBS) Providers

The New York State Department of Health Children's Waiver team launched the Referral and Authorization Portal (Portal) on June 17, 2024. With the launch of this Portal, it is now required that all Children's Waiver HCBS referrals for services be entered and managed within the Portal. Since Medicaid Managed Care Plans (MMCPs) do not have access to make referrals within the Portal, Children and Youth Evaluation Service (C-YES) will be responsible for submitting and managing all Children's Home and Community Based Service (HCBS) referrals for children/youth who opt-out of Health Home and receive care management from C-YES. This includes all children who have opted out of Health Homes, regardless of MMCP enrollment. MMCPs are not responsible for submitting or managing HCBS referrals for participants. MMCPs and HCBS providers are encouraged to collaborate with C-YES to address any updates to service needs and need for new referrals, as appropriate. All referrals must be submitted and managed in the Portal within the Incident Reporting and Management System (IRAMS). This process is intended to improve consistency with service delivery for all HCBS enrolled children/youth.

Additional information on the HCBS Referral and Authorization Portal can be found in the following resources:

Questions related to this announcement can be sent to BH.Transition@health.ny.gov.