July 13, 2022

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

The Children’s Waiver Renewal that was submitted to the Centers for Medicare and Medicaid Services (CMS) in January 2022, and extended in April 2022, was approved on June 29, 2022.

This five-year renewal of the Children’s Waiver (NY.4125.R06.00) is retroactively effective from April 1, 2022 to March 31, 2027. Changes to the Children’s Waiver approved by CMS as part of this renewal are summarized below.

Service title and definition revisions

• ‘Palliative Care: Bereavement’ is now referred to as ‘Palliative Care: Counseling and Support Services’
• ‘Adaptive and Assistive Equipment’ is now referred to as ‘Adaptive and Assistive Technology’
• Broadens Children and Youth Evaluation Services’ (C-YES’) Nurse qualifications by requiring two years relevant experience. The previous requirement that was two years’ experience specifically in home care.
• Reduces the required years of experience for Palliative Care: Expressive
  Therapists from 3 years to 1 year
• Consolidated ‘Caregiver and Family Support and Services’ and ‘Community Self-Advocacy Support’ into a new service referred to as ‘Caregiver/Family Advocacy and Support Services’ to allow a broader array of providers to deliver the service.

It also broadens the definition of caregivers eligible for training to include all individuals who supervise and care for members.

Additions, Removals, and Updates

• Adds references to the Incident Reporting and Management System (IRAMS), which was implemented on April 1, 2021, and clarifies the definition of reportable incidents from Health Homes, C-YES, and HCBS providers
• Includes a temporary 25% rate adjustment consistent with the approved
  Spending Plan for Implementation of the ARPA Section 9817 to improve service capacity
• Removes the requirement to use the Licensed Practitioner of the Healing Arts (LPHA) form to document waiver eligibility for the Medically Fragile and Medically Fragile Developmentally Disabled (DD) populations
• Updates Performance Metrics to reflect actual data collection methodologies
• Removes references to the “Care at Home Waiver”

Detailed guidance regarding implementation of these changes is forthcoming. Most of these changes are the result of stakeholder feedback that the Department of Health solicited over the past year. The Department hosted seven stakeholder sessions in September and October of 2021 for participants and their families, Health Homes and Care Management Agencies, C-YES, Medicaid Managed Care Plans, HCBS providers, and MRT Children’s Subcommittee Members and Advocates and conducted a stakeholder survey. Stakeholder feedback and responses from the Department are available on the Department’s website. Future waiver amendments, which will be shared publicly for comment, will incorporate additional recommendations from
stakeholders.

The Department of Health is grateful for the feedback and suggestions to improve the delivery of Home and Community Based Waiver services to children in New York State.

If you have questions, please contact bh.transition@health.ny.gov.