Update to Children and Youth Evaluation Services (C-YES) Transition

  • Update also available in Portable Document Format (PDF)

Referral for Children's Waiver Eligibility Determination Process for Children/Youth Without Medicaid

January 29, 2026

The New York State Department of Health (the Department) notified stakeholders of changes to Children's Waiver care management services through an announcement issued on December 5, 2025. This notice provides additional information on how local departments of social services, school districts, service providers, care management agencies, families, and other community partners can refer a child/youth for the Children's Waiver, as of January 1, 2026.

Children/Youth Currently Enrolled in Medicaid

Children and youth currently enrolled in Medicaid who are at risk of institutionalization or who are being discharged from an institution, should be referred to a Health Home Serving Children (HHSC) in their area for a Children's Waiver eligibility determination. The HHSC will meet with the child/youth/family to learn about their needs and assist to determinate the appropriate services. and complete the Children's Waiver Home and Community Based Service (HCBS) eligibility determination, if appropriate. The HHSC can also provide ongoing comprehensive care management services to children/youth, if eligible.

If the child/youth is already enrolled with an HHSC, contact the HHSC to request an HCBS eligibility determination.

If the child/youth is not already enrolled in HHSC, locate an HHSC in your area using the Find a Health Home matrix. Once an appropriate Health Home has been identified, contact them by phone or email to request an HCBS eligibility determination. The HHSC will respond to provide instructions on submitting a referral.

Children/Youth NotCurrently Enrolled in Medicaid

Children and youth who are not currently enrolled in Medicaid who are at risk of institutionalization or who are being discharged from an institution, may be eligible for Medicaid enrollment under "Family of One" Medicaid budgeting criteria, if they also meet criteria for Children's Waiver enrollment. "Family of One" allows that only the child/youth's income (and resources if certified disabled) be considered in determining financial eligibility for Medicaid. A qualified individual identified by the Department operated Children and Youth Evaluation Services (C-YES) can determine Children's Waiver eligibility and assist with the Medicaid application.

To refer a child/youth who is not enrolled in Medicaid, who is at of risk of institutionalization or is being discharged from an institution, complete and submit a C-YES Online Referral. Any previous versions of a C-YES referral form are no longer valid. Once the referral is received, the Department C-YES team will review and connect with the child/family to learn more about the child/youth and determine appropriate next steps.

Contact the Department C-YES team for additional information about the Children's

Waiver and HCBS eligibility determination process:

Stakeholders are asked to share this information with other community members, service providers, and families who may be interested in connecting children/youth to Children's Waiver Home and Community Based Services (HCBS).

Any questions related to the Department's C-YES can be directed to CYESConnect@health.ny.gov