Pre-Project Evaluation Notice

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Children's Waiver
Environmental/Vehicle Modifications (E/VMods) and Assistive/Adaptive Technology (AAT)

Pre-Project Evaluation Payment Request Form

To: Health Home Care Management Agencies (CMA), and Children and Youth Evaluation Services (C-YES)

The Children's Waiver provides a number of Home and Community Based Services (HCBS) for children and youth up to the age of 21 years old. Children and youth in the Childrens Waiver who need HCBS Environmental Modifications (EMods), Vehicle Modifications (VMods), and Assistive/Adaptive Technology (AAT) will work with the Fiscal Management Service (FMS), who is responsible for the authorization of such services in accordance with the person-centered Plan of Care for eligible and enrolled children/youth.

Since the implementation of the Children's Waiver on April 1, 2019, there have been some challenges in having EMods, VMods, and AAT projects determined, approved, and completed. One of the primary concerns is the limited number of available evaluators to assess and determine the need for these services, for the project work to be approved and started. Timely payment to evaluators is necessary to ensure the continued available use of these evaluators.

Therefore, the NYS Department of Health has developed a process for the FMS to be able to pay for evaluator's services at the time their assessment is complete, instead of waiting until the entire project has been completed. Through the Pre-Project Evaluation Payment Request Form, the FMS will be able to submit for the evaluation payment immediately upon their work being completed. The form, along with a copy of the pre-project evaluation, and any associated invoice(s) should be submitted to reconcile payment for the pre-project evaluation at the beginning stages of the project request.

The role of the CMA: The Pre-Project Evaluation Payment Request Form is to be completed by the HHCM/C-YES immediately after a pre-project evaluation is completed. The completed form, including all necessary signatures, a copy of the pre-project evaluation, and any associated invoice(s) should be submitted to the FMS within five (5) business days from the date of evaluation. The Pre-Project Evaluation Payment Request Form can be submitted before a Description and Cost Projection Form.

The role of the FMS: The FMS will review the Pre-Project Evaluation Payment Request Form on the date of receipt. The FMS will have five (5) business days to render a decision about the form. If the form is incomplete or missing information, FMS will request additional information from the submitting HHCM/C-YES within the five days. If the form is complete, FMS will submit a payment request to eMedNY.

Questions can be directed to fms@childrenshealthhome.org or call 855-209-1142.

For FAQs and other guidance visit here.