Children’s Health and Behavioral Health System Transformation
New York State envisions an integrated children’s healthcare system where there is “no wrong door” for children/youth experiencing complex needs.
The Children’s Health and Behavioral Health Medicaid System Transformation restructured the health care delivery system for individuals under 21 that have behavioral health (BH) needs and/or complex medical conditions.
Request to join the Children’s System Transition Listserv to get news on policy, training, and other updates.
Child/Youth and Family Education and Outreach
The NYS Children’s System Transformation; A Discussion with Children and Families
Children and Family Treatment and Support Services (CFTSS):
Children's Home and Community Based Services (HCBS)
Children’s Medicaid Managed Care Organization (MMCO) Qualifications
To ensure Medicaid Managed Care Plans can meet the needs of the children´s Medicaid populations, Plans are reviewed and qualified against new administrative, performance, and fiscal standards.
- NYS Children´s Standards Cover letter
- Children´s MC Plan Requirements and Standards
- Data Book for Children´s BH and HCBS populations
Children and Family Treatment and Support Services (CFTSS)
CFTSS meet children’s needs and increase access to services, and can work by themselves or with other services. This depends on the needs of each child/youth and family.
Any child who is eligible for Medicaid and has a behavioral health need can access services with more flexibility and choice.
Anyone can make a referral for service. A licensed practitioner must make the determination for access and service provision.
SAMPLE Recommendation Form for LPHAs
Provision in Community Residences
Unlicensed CFTSS Oversight Policy
Children’s Home and Community Based Services
HCBS offer support to children and allow them to remain at home and in the community. They provide person-centered care and value individual strengths, preferences, needs, and desired outcomes.
Children and families can choose from a collection of service options and providers. Services are provided in a flexible, complimentary package that develops over time to meet the changing needs of children.
Please contact OMH Managed Care with any questions, comments, or problems you may be experiencing with this site. If you would like to file a complaint about behavioral health managed care, please visit the Information on Filing a Complaint page. Providers, if you have any questions about the managed care implementation, please complete and send a question form.