This relatively new program is designed to serve 12 (twelve) children between the ages of 5 and 17 who are identified with complex mental health needs and are at risk of requiring an institutional level of care. HCBS Waiver serves youth who are able and willing to participate in the program. The program is especially tailored for children and youth whose service and support needs cannot be met by just one agency.
Enable children to remain at home, or in the community, thus decreasing institutional placements.
Use the individualized care approach to services emphasizing a partnership with family members and service providers.
Service plans focus on the unique needs of each child and builds on the strengths of the family unit.
Expand funding and service options currently available to youth with serious emotional disturbances and their families.
Provides services that promote better outcomes, cost-effective and demonstrates a model that fosters a transition to manage care.
INDIVIDUALIZED CARE COORDINATION includes the components of intake and screening, assessment of needs, service plan development, linking, advocacy, monitoring and consultation.
CRISIS RESPONSE SERVICES provides the ability to do an assessment, provide consultation, and immediate intervention wherever necessary, for example, in schools, at home, at work sites, or in clinic programs.
INTENSIVE IN- HOME SERVICES includes interventions such as psycho-education, crisis de-escalation, parent-child relationship building, and parenting skills training.
RESPITE CARE includes activities that provide a needed break for the family and the child to ease the stress at home and improve family harmony.
FAMILY SUPPORT SERVICES provides activities designed to enhance the ability of the child to function as part of a family unit to increase the family’s ability to care for the child in the home and in community based settings.
SKILL BUILDING SERVICES includes activities designed to help children acquire functional skills to increase potential for success in the community.
INDIVIDUALIZED CARE COORDINATOR
In each HCBS Waiver site there exists an Individualized Care Coordinator (ICC) Agency, or lead agency. BHSN has been designated the lead agency and is required, in consultation with Clinton County Mental Health Services, to ensure that a network of services providers is available and to guarantee access to the full array of HCBS Waiver services to enrolled youth. This includes recruiting additional providers should a service area not be available or accessible, as the population requires.
Costs incurred for each child enrolled in the HCBS Waiver are collected and monitored through reports generated from the Medicaid Management Information System (MMIS). The NYS Department of Health provides all Medicaid adjudicated claims for each child enrolled in the HCBS Waiver. These data are summarized and reports produced which identify total Medicaid expenditures for each child and site. Annualized year-to-date amounts are compared to the agency’s budgeted amounts per service category. One of the premises of receiving approval for an HCBS Waiver is the expectation that the provision of services in this matter will not cost more that institutional level of care.
Implementation of the Home and Community-Based Services Waiver has been an important step in providing a continuum of care for the seriously emotionally disturbed children and adolescents of Clinton County. The community will indeed benefit from this service as data begin to reveal the best complement of services and support for this high needs population.
In Chapter 170 of the Laws of 1994, the NYS Legislature provided the authority for the NYS Department of Social Services to apply for a general waiver on behalf of the Office of Mental Health, pursuant to section 1915(c) of the Federal Social Security Act. The general waiver provides Medical Assistance to children and adolescents who meet the eligibility criteria and reimbursement of several home and community-based services not previously included in the Medical Assistance program. The children and adolescents that the Home and Community Based Services (HCBS) Waiver is designed to serve are those who, if not for the Waiver, would be admitted to institutional levels of care and Long Term Group Care Facilities.
The Federal Health Care and Finance Administration approved New York’s request to waive three statutory requirements of Section 1915(c) of the Social Security Act on January 1, 1996. The STATEWIDENESS AND COMPARABILITY requirements were waived to allow the implementation of the HCBS Waiver on a demonstration basis in 7 counties and the five boroughs of New York City. Secondly, the requirements relating to AMOUNT, DURATION AND SCOPE OF SERVICES were waived which made it possible to offer six new Medicaid services (individualized care coordination, respite care, skill building services, intensive in-home services, crisis response services and family support services) in addition to existing State Medicaid Plan services. The third statutory requirement waived was PARENTAL DEEMING. For children who are enrolling in the HCBS Waiver, their parents’/guardians’ income and resources are not considered when determining a child’s eligibility for Medicaid. The enrollee is considered a "family of one" status.
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