Commissioner Michael F. Hogan, PhD
Governor Andrew M. Cuomo
Home and Community Based Services Waiver
Complete Listing of Changes and Revisions
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September 2011
- Section 300.5 – Roles, Qualifications, Training Requirements for Crisis Response, Intensive In-Home, Skill Building, Respite and Family Support Services Workers
- Form Updates
June 2011
- Section 300.5 – Roles, Qualifications, Training Requirements for Crisis Response, Intensive In-Home, Skill Building, Respite and Family Support Services Workers
- Section 400.1 – Service Plans
- Section 500.5 – Phase III (Steps 7, 8, 9 and 10)
- Section 600.2 – Billing For Individualized Care Coordination (ICC)
- Form Updates
- Section 400.5 – Home and Community Based Services (HCBS) Waiver Aftercare Follow–Up Plan
- Section 400.1 – Goals and Objectives (PDF)
- Section 400.1 – Initial Service Plan Narrative (PDF)
- Section 400.1 – 30 Day Review Narrative (PDF)
- Section 400.1 – 90 Day Review Narrative (PDF)
May 2011
- Section 500.8 – Termination from the HCBS Waiver
- Section 600.2 – Billing For ICC
- Form Updates
- Section 500.8 – Loss of Waiver Eligibility Form (PDF)
- Section 800 – Medicaid Application Cover Letter (PDF)
March 2011
- Site Visit Summary form (PDF)
- Section 300.3 – Roles and Responsibilities: Single Point of Access, Department of Social Services, OMH Field Offices, OMH Parent Advisors
- Section 600.3 – Billing for the Five Non– ICC Waiver Services
- Section 600.3a – Billing Rules Chart Guide
- Section 700.1 – Monitoring and Evaluation Overview: ICC Agency Site Visits, Agency Corrective Actions Plans
- Section 800 – HCBS Waiver Program Forms & Reports
- Form Updates
- Section 400.1 – Initial Service Plan Goals (PDF)
- Section 400.1 – 30 Day Service Plan Goals (PDF)
- Section 400.1 – 90 Day Service Plan Goals (PDF)
December 2010
- Form Updates
- Section 400.1 – Initial Service Plan Goals (PDF)
- Section 400.1 – 30 Day Service Plan Goals (PDF)
- Section 400.1 – 90 Day Service Plan Goals (PDF)
November 2010
- Form Updates
- Section 400.1 – Initial Service Plan Goals (PDF)
- Section 400.1 – 30 Day Service Plan Goals (PDF)
- Section 400.1 – 90 Day Service Plan Goals (PDF)
October 2010
- Form Updates
- Section 400.1 – Initial Service Plan Goals (PDF)
- Section 400.1 – 30 Day Service Plan Goals (PDF)
- Section 400.1 – 90 Day Service Plan Goals (PDF)
August 2010
- Form Updates
- Section 400.1 – Initial Service Plan (PDF)
- Section 400.1 – 30 Day Service Plan (PDF)
- Section 400.1 – 90 Day Service Plan (PDF)
- Section 100.2 – Waiver Expansion, Slot Allocations and ICC Agencies (Waiver Growth Chart)
- Section 400.2 – Safety Alert Plan (SAP) (PDF)
- Section 500.6 – Medicaid Recertification and Waiver Level of Care Recertification
June 2010
- Section 300.5 – Roles, Qualifications, Training Requirements: Subcontract Workers
- Section 500.6 – Medicaid and Level of Care Recertification
May 2010
- Form Updates
- Section 400.1 – Initial Service Plan (PDF)
- Section 400.1 – 30 Day Service Plan (PDF)
- Section 400.1 – 90 Day Service Plan (PDF)
- HCBS Waiver Safety Alert Plan (required)
- HCBS Waiver and Child Safety Contract (optional)
- Section 400.2 – Safety Alert Plan (SAP)
- Section 500.2 – Overview of HCBS Waiver Enrollment Process, Withdrawal from Waiver and Transmittals to OSU
- Section 500.3 – HCBS Waiver Enrollment Process – Phase I: Step #3: Level of Care Determinations
- Section 500.4 – HCBS Waiver Enrollment Process – Phase II: Step #4: HCBS Waiver Application/Freedom of Choice
- Section 500.5 – HCBS Waiver Enrollment Process – Phase III: Step #10: OSU Notice of Determination and When to Begin Billing
- Section 600.1 – Introduction
- Section 600.2 – Billing Rules for ICC's; Contact Definitions; Inpatient Stays; ICC Start-Up
- Section 600.3 – Billing Rules for the Five Non-ICC Waiver Services
- Section 600.3a – Waiver Billing Chart Guide
January 2010
- Section 600.3 – Billing For The Five Non-ICC Waiver Services
- Section 600.3A – Waiver Billing Chart Guide
- Section 600.4 – Billing For Group Work For Skill Building, Respite And Family Support Services
December 2009
- Section 700.1 – Monitoring and Evaluation Overview: ICC Agency Site Visits, Agency Corrective Actions Plans: Site Visit Summary Form
- Section 500.4 – HCBS Waiver Enrollment Process – Phase II Step #5: The Medicaid Application
- Section 300.1a – Role and Responsibilities: ICC Agency: Incident Reporting
- Form Update – Group Progress Note
- Section 400.6 – Family Flex Fund Letter
- Section 400.6 – Flex Fund Worker Desk Guide for Care Coordinators
November 2009
- Section 400.4 – Progress Notes: ICC, Subcontract Worker and Group Notes
- Section 600.4 – Billing For Group Work For Skill Building, Respite And Family Support Services
- Section 400.6 – Flex Funds
August 2009
- Section 400.6 – Flex Funds
- Section 300.5 – Roles, Qualifications, Training Requirements: Subcontract Workers
July 2009
June 2009
- Section 100.2 – Waiver Expansion, Slot Allocations and ICC Agencies
- Section 400.4 – Progress Notes: ICC and Subcontract Worker
- Section 400.6 – Flex Funds
- Section 800 – HCBS Waiver Program Forms & Reports
April 2009
- Section 600.1 – Introduction
- Section 600.2 – Billing Rules for ICC's; Contact Definitions; Inpatient Stays; ICC Start-Up
- Section 600.3 – Billing Rules for the Five Non-ICC Waiver Services: Family Support Services, Skill Building Services, and Respite Services; Intensive In-Home and Crisis Response: Rules for Bundled Rates
- Section 600.4 – Billing for Group Work
- Section 800 – HCBS Waiver Forms and Reports Reference Guide
- Form Updates
- Section 100.1 – Background, Goals, Individualized Care, Target Population, Services, Stakeholders, Funding, Criteria for Serious Emotional Disturbance (SED)
March 2009
- Section 400.4 – Home and Community Based Services Waiver Progress Notes (groups added to Progress Note form)
- Section 100.1 – Background, Goals, Individualized Care, Target Population, Services, Stakeholders, Funding, (Criteria for Serious Emotional Disturbance (SED)
February 2009
January 2009
- Section 600.3 – Billing For The Five Non-ICC Waiver Services
- Section 400.1 – Service Plan Review – 30 Days (PDF)
- Section 400.1 – Service Plan Review – 90 Days (PDF)
- Section 400.1 – Home and Community Based Services Waiver Initial Service Plan (PDF)
- Section 300.5 – Roles, Qualifications, Training Requirements: Subcontract Workers
- Section 500.2 – Overview of the Enrollment Process, Withdrawal from Waiver and Transmittals to OSU
- Section 500.3 – Enrollment Phase I – Steps 1, 2 and 3
- Section 500.5 – Phase III (Steps 7, 8, 9 and 10)
- Section 500.8 – Termination and Dis-enrollment from the HCBS Waiver
- Section 600.2 – Billing Rules for ICC's; Contact Definitions; Inpatient Stays; ICC Start-Up
November 2008
- Section 400.1 – Service Plan Reviews: 30 and 90 Days
- Section 500.5 – Phase III (Steps 7, 8, 9 and 10)
September 2008
- Section 300.1a – Role and Responsibilities: ICC Agency
- Section 300.5 – Roles, Qualifications, Training Requirements: Subcontract Workers
June 2008
- Section 300.1b – ICC Agency Worker Safety Policy and Protocols
- Section 300.2 – Role and Responsibilities: Local Government Units
- Section 400.1 – HCBS Waiver Service Plans: Strength Based Service Plans and the Child Assessment of Needs and Strengths (CANS), Timeline for Completion of Service Plans, Initial Service Plans and Budget, Service Plan Reviews: 30 and 90 Days
- Section 400.6 – Flex Funds
- Section 500.1 – HCBS Waiver Child Eligibility Criteria and Considerations, Role and Contact Information for Operations Support Unit (OSU)
- Section 500.2 – Overview of HCBS Waiver Enrollment Process, Withdrawal from Waiver and Transmittals to OSU
- Section 500.3 – HCBS Waiver Enrollment Process – Phase I Step #1: Referrals Step #2: Screening Step #3: Level of Care Determinations
- Section 500.4 – HCBS Waiver Enrollment Process – Phase II Step #4: HCBS Waiver Application/Freedom of Choice Step #5: The Medicaid Application Step #6: Health Care Options
- Section 500.5 – HCBS Waiver Enrollment Process – Phase III Step #7: The Initial Service Plan Requirement for Enrollment Step #8: Instructions for Completing the Child's Service Plan Budgets Step #9: Approval of Initial Service Plan and Budget Step #10: OSU Notice of Determination and When to Begin Billing
- Section 500.6 – Medicaid and Level of Care Recertification
- Section 500.7 – Transfers: New County and New Provider New County and Same Provider Same County and New Provider
- Section 500.8 – Disenrollment and Notice of Termination from the HCBS Waiver
- Section 500.9 – Fair Hearings Appeal Process
- 600.1 Introduction
- 600.2 Billing Rules for ICC's; Contact Definitions; Inpatient Stays; ICC Start-Up
- 600.3 Billing Rules for the Five Non-ICC Waiver Services: Family Support Services, Skill Building Services, and Respite Services; Intensive In-Home and Crisis Response: Rules for Bundled Rates
- 600.4 Billing for Group Work
- Section 800 – HCBS Waiver Forms and Reports Reference Guide
- Form Updates
- Application for Participation & Freedom of Choice
- Client Chart Index
- EMedNY Training Matrix for the HCBS
- Initial Service Plan (ISP)
- Progress Notes
- Service Plan Budget
- Rate Codes Chart
- Service Plan Reviews 30 Days (PDF)
- Service Plan Reviews 90 Days (PDF)
- Transmittal Form for New Enrollments (PDF)
- Universal Referral Form
March 5, 2008
- Section 100.1 – Background, Philosophy, Goals, Target Population, Services, Stakeholders, Funding, Serious Emotional Disturbance (SED) Criteria
- Section 200.2 – Developing a Provider Network: Criteria, Approval Process, Contracts
- Section 300.4 – Role, Qualifications, Training Requirements: Individualized Care Coordinators
- Section 300.5 – Roles, Qualifications, Training Requirements: Subcontract Workers
- Request For Services for Subcontractors
- Competencies
October 18, 2007
- Section 300.4 – Role, Qualifications, Training Requirements: Individualized Care Coordinators
- Section 400.6 – Flex Funds
August 6, 2007
- Level of Care Form
- June 2007 Flex Dollars Expenditures and Criminal History Checks Letter to HCBS Waiver Providers
- July 2007 Flex Dollars Expenditures and Criminal History Checks Letter to HCBS Waiver Providers
June 8, 2007
- Section 300.4 – Role, Qualifications, Training Requirements: Individualized Care Coordinators
- Section 300.5 – Roles, Qualifications, Training Requirements: Subcontract Workers
- Request for Services
May 17, 2007
April 23, 2007
March 21, 2007
- Section 400.3 – Authorization for Release of Information (PDF)
- Section 800 – HCBS Waiver Forms and Reports Reference Guide
Comments or questions about the information on this page can be directed to the Home and Community Based Waiver Program.