New York Submits Final Draft Transition Plan for the Children’s Medicaid System Transformation

December 2017 ~

New York State Departments, including the Department of Health, Office of Alcoholism & Substance Abuse Services, Office of Children & Family Services, Office of Mental Health, and Office for People with Developmental Disabilities, have released their Final Draft Transition Plan for the Children’s Medicaid System Transformation.

As seen in the final draft, the Children’s Medicaid System Transformation is intended to improve access to services for high needs children by:

  • Moving the various and disparate authorizations for home and community based services (HCBS) now provided under six separate Section 1915(c) waivers to New York State’s 1115 Medicaid Redesign Team Waiver (1115 Waiver);
  • Aligning those separate HCBS authorizations into a single array of 12 HCBS available under the 1115 Waiver or the Medicaid State Plan;
  • Unifying and providing care management for high needs children with chronic conditions under the Health Home program;
  • Leveraging the Medicaid managed care delivery system to further integrate the delivery of services;
  • Preventing escalation to higher end services and addressing needs earlier by creating six new Medicaid State Plan services for children and expanding eligibility criteria for aligned children’s HCBS1 from including only children who meet Level of Care (LOC) criteria (i.e., at risk of institutional level of care) to also include children who meet or Level of Need (LON) criteria (i.e., the child does not meet institutional level of care but does have extended impairment in functioning).

The NY state departments state the final draft reflects comments received from stakeholders till August 2017 and requests CMS’ approval of the state’s Transition Plan by the end of December, as well as the 1115 Waiver by February 1st, 2018.

See the complete draft of New York’s Transition Plan for the Children’s Medicaid System Transformation, here.

Source(s): New York Department of Health;