More Good News – OASAS Programs & IMD

January 9, 2024

As you know, NYS submitted an IMD Waiver to CMS in December, 2022.   Today, CMS concurrently approved the SUD portion of that Waiver and incorporated the approval into the 1115 Waiver approval that was announced today.   Importantly, NYS will now be able to claim Federal Financial Participation (FFP) which will pay a federal share of the cost for the OASAS community based 818, 816 and 820 (all levels in the 820).  And the 820s will be able to bill Fee For Service and the state can claim FFP.

The SMI waiver proposal piece was for state operated psych hospitals only and it is pended (on-hold) with CMS.  This is due to concerns over the ability for the state to meet some of the Special Terms and Conditions and specifically, use of a nationally recognized assessment tool throughout the OMH system.

The Career Pathways Training Program (two parts):1) Assisting with healthcare career advancement, and 2) encouraging and assisting those in healthcare to advance their careers) discussed in the Workforce section of the 1115 Waiver includes the ability for nonprofits that enroll workers in the Health Careers Program to be reimbursed for backfill needs of eligible participants during training, through contracts with WIOs:
Backfill for participants in the Health System Career Advancement PipelineTo avoid reduced access to care when a participant is in training during participant working hours and recognizing the absence requires a temporary or covering worker to perform duties, the state may use funds to pay the health system employer to backfill the participant.  Backfill costs must not exceed the following rates and no more than 2 days per week for participants in the following programs: 

  • $175 per day for licensed practical nurse, associate registered nurse, credentialed alcohol and substance abuse counselor, certified pharmacy technician, respiratory therapist, certified medical assistant, community health worker, and patient care manager/coordinator. 
  • $259 per day for nurse practitioners, physician’s assistants, Master of Social Work, and licensed mental health counselor. iii. 
  • $300 per day for Registered Nurse to Bachelor of Science in Nursing  

We are still determining the definition of ‘healthcare providers’.