HCBS Eligibility, Services, and Plan of Care (POC)

  • HCBS Service Definition and Necessity Criteria Policy #CW0020 - (Web) - (PDF) - May 16, 2025
  • Health Home Plan of Care Policy #HH0008 - (Web) - (PDF) - Updated December 2024
    • Guide to Edits for Health Home Plan of Care Policy #HH0008 - (PDF) - Updated December 2024
    • Health Homes Serving Children - 10 Elements of a Plan of Care - (Web) - (PDF) - January 2024
  • Children's HCBS POC Workflow Policy #CW0002 - (PDF) - Updated May 2022
  • Children's Home and Community Based Services (HCBS) Waiver Eligibility and Enrollment Policy #CW0005 - (Web) - (PDF) - March 2024
  • Clarification - Children's Waiver Home and Community Based Services (HCBS) Recipient Restriction/Exemption (R/RE) K-Codes for Eligibility and Enrollment - (Web) - (PDF) - March 28, 2025
  • Update on Children's Waiver HCBS Referrals for Children/Youth Who Opt-Out of Health Home - (Web) - (PDF) - December 17, 2024
  • Reminder: Children's Home and Community Based Services Medically Fragile and Serious Emotional Disturbance Target Population - (PDF) - December 6, 2024
  • GIS 24 MA-04 - Medically Fragile or Developmentally Disabled and Medically Fragile Consumers enrolled in the 1915(c) Children's Waiver and County Single Point of Access (C-SPOA) role - (PDF) - June 3, 2024
  • Medically Fragile Children's Waiver Eligibility Determination FAQ - (Web) - (PDF)
  • SED Children's Waiver Eligibility FAQ - (Web) - (PDF)
  • Extension of Deadline to Obtain Disability Determinations for Medically Fragile Children's Waiver Members - (Web) - (PDF) - October 31, 2023
  • Children's HCBS Medicaid Managed Care Plan Transfer Continuity of Care Requirements - (Web) - (PDF) - September 5, 2023
  • UPDATE: Changes to the Disability Documentation Process for the 1915c Children's Waiver - (PDF) - July 27, 2023
  • Guidance Regarding the Medically Fragile Disability Determination Requirement - (Web) - (PDF) - April 2023
  • Clarification Guidance Re: Children's Waiver HCBS Serious Emotional Disturbance (SED) Eligibility Determination Requirements - (Web) - (PDF) - April 2023
  • Updated LPHA Guidance and Instructions - (Web) - (PDF) - July 29, 2022
  • Children's HCBS Plan of Care (POC) Workflow Policy Reminder - (Web) - (PDF) - November 16, 2022
  • Children's HCBS POC Workflow FAQ - (Web) - (PDF) - Updated May 2022
  • Reminder Regarding Children's HCBS Billing and Claiming Requirements - (PDF) - April 4, 2022
  • HCBS POC Workflow Policy Requirement Reminder - (PDF) - November 2020
  • HCBS POC Workflow DESK AID, Roles and Responsibilities - (PDF) - October 2020
  • REMINDER for HCBS PROVIDERS: Children's HCBS Authorization Form and Communication with MMCP - (PDF) - March 2020
  • Medicaid Managed Care Plans' Contact Information - (PDF)
  • Services Access Documentation - (PDF) - March 2019
  • Person Centered Service Planning Guidelines - (PDF) - December 19, 2018
  • HCBS Service Definitions and Necessity Criteria Policy Pt.3 - (PDF) - June 16, 2025
  • HCBS Service Definitions and Necessity Criteria Policy Pt.2 - (PDF) - June 10, 2025
  • HCBS Service Definitions and Necessity Criteria Policy Pt.1 - (PDF) | (Recording) (YouTube) - June 5, 2025
  • Children'S Waiver HCBS Fee-For-Service Authorization Webinar - (PDF) | (Recording) (YouTube) - January 24, 2025
  • HCBS Service Referral Process & Expectations - (PDF) | (Recording) (YouTube) - October 2024
  • Considerations for Determining HCBS Eligibility for the Serious Emotional Disturbance (SED) Target Population - (Web) - (PDF) - (Recording) - April 19, 2023
  • Updates and Clarification Regarding:
    • Medically Fragile (MF) Population HCBS LOC Determination: - (Web) - (PDF) - (Recording) - April 6, 2023
    • Serious Emotional Disturbance (SED) Target Population HCBS LOC Eligibility Determination - (Web) - (PDF) - (Recording) - April 4, 2023
  • Health & Safety Planning Requirements for the Children's Waiver webinar slides - (PDF) | Recording (YouTube) - September 2021
  • Children's HCBS Planning and Plan of Care Development - (external link) - April 3, 2019
  • Webinar and Discussion with HCBS Providers regarding HCBS POC Workflow - (PDF) - October 2020
  • Webinar: Children's HCBS POC Workflow & MMCP Service Authorization for HCBS Providers - (PDF) - October 18, 2019
  • Children's HCBS POC Workflow Webinar - (PDF) | Recording (YouTube) - August 28, 2019
  • Children's HCBS Authorization and Care Manager Notification Form Instructional Guide - (PDF) - February 2024
  • Lead Health Home Serving Children's Contact Information for MMCP - (XLSX)
  • Serious Emotional Disturbance (SED) LPHA Attestation Form
DOH-5276 - Freedom of Choice - Effective October 2024

Form DOH-5287

DOH-5287 Notice of Decision For Enrollment or Denial of Enrollment in the New York State 1915(c) Children's Waiver - Updated October 2024

Form DOH-5288

DOH-5288 Notice of Decision For Discontinuance in the New York State 1915(c) Children's Waiver - Updated October 2024