Home and Community Based Services Waiver
What Is
the Home and Community Based Services Waiver (HCBS Waiver)?
In 1996, the New York State Office of Mental Health (OMH) initiated the Home and Community Based Services Waiver. HCBSW is a mechanism serving the specialized needs of families with children who have been diagnosed with a severe mental illness and are at risk of out-of-home placement, (NYS Office of Mental Health, 2001).
Since its inception in 1996 with 125 slots statewide, the HCBS Waiver program has expanded to its current 610 slots and is currently operational in all five boroughs in New York City and 40 New York State counties. The HCBS Waiver utilizes the Individualized Care approach, which promotes developing service planning that is not in conflict with the norms and values of the family. Individualized Care Coordinator (ICC) agencies are encouraged to hire staff reflective of the culture and language of the families served.
The services that are integral to the HCBS Waiver were developed as a result of a survey of New York State county departments of mental health and families. The survey collected information related to the services and supports that are most needed by the target population and their families to remain at home and in the community. The six HCBS Waiver core services (as listed below) must be available in each site to enrolled children and their families.
Core Services of the HCBS Waiver
Individualized care coordination;
Intensive in-home services;
Respite care;
Family support services;
Crisis response services;
Skill building services
Family, Youth, Cultural PerspectivesThe development of the descriptions for each OMH Priority Set for Evidence-Based Practices included extensive involvement from clinical experts, mental health recipients, youth and family members, and people who represent culturally diverse viewpoints. Their perspectives are critical to the understanding of these important practices and programs in mental health.
Family Perspective
The services that are integral to the HCBS Waiver were developed as a result of a survey of New York State county departments of mental health and families. The survey collected information related to the services and supports that are most needed by the target population and their families to remain at home and in the community. The six HCBS Waiver core services as listed in this document must be available in each site to enrolled children and their families.
Youth Perspective
Young people have noted that more staff is needed for provision of services. Additionally, services should work to prevent the youth from hospitalization. If a waiting list is in effect for a particular program/service, alternative services should be offered while the young person is on the waiting list. Services need to be available and accessible at any level of need including support services. Youth support services should be included with parent support services within the waiver program.
Cultural Perspective
The HCBS Waiver utilizes the
Individualized Care approach, which promotes developing service planning that
is not in conflict with the norms and values of the family. Individualized Care
Coordinator (ICC) agencies are encouraged to hire staff reflective of the culture
and language of the families served.
It is important that mental health providers employ strategies to address access
barriers, demonstrate flexibility in meeting times and places, eliminate barriers
presented by easily misunderstood written material, establish safety nets engaging
culturally specific supports, spiritual community and naturally occurring community
networks. Bridges should be built to establish a trusted presence in the community
at large. This is particularly important for immigrants, communities of color,
historically underserved and poverty stricken communities where coordinated
efforts should be maintained to help parents feel more comfortable and connected
to service providers. Care should be taken to assure written materials are not
only translated but are at a literacy level that does not raise additional barriers
for the family members. In servicing children, care and attention needs to be
paid to develop staff's cultural knowledge as to family and community norms
and values around help seeking, secrecy and confidentiality, family roles, child
rearing and spiritual practices.
Goals and Principles of the HCBS Waiver
The goals and underlying principles of the HCBS Waiver are:
1. Enable children to remain at home, or in the community, thus decreasing institutional placements;
2. Use the individualized care approach to service planning, delivery and evaluation;
3. Expand funding and service options currently available to children and adolescents diagnosed with serious emotional disturbances and their families; and
4. Provide services that promote better outcomes and are cost-effective.
Children and Adolescent Service System Principles
All OMH Children's Initiatives are based upon the principles of the Child and Adolescent Service System Principles (CASSP). View the CASSP.
Home and Community Based Services Waiver Assistance in New York State
This link connects you to a directory of the Home and Community Based Services Waiver Assistance in New York State
NYSOMH (January 2001). Keeping children at home: New york state’s home and community based services waiver.