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Office of Mental Health

Medicaid Managed Care Crisis Intervention

Crisis Intervention

The New York State Office of Mental Health and NYS county leadership, with input from various stakeholders, have developed a shared vision of a coordinated behavioral health crisis response system available to all New Yorkers, regardless of ability to pay.  This system will integrate existing crisis infrastructure (state-, local- and Medicaid-funded) with newly available resources in managed care, DSRIP, and VBP.

The goals of this system are to:

  1. Maintain people safely in the community;
  2. Reduce unnecessary emergency room visits and inpatient hospitalizations;
  3. Reduce risk of future crises; and
  4. Coordinate information sharing among clinicians, recipients, and involved family members to reflect recipients’ preferences.

Services are meant to be delivered in trauma-informed, recovery-oriented and culturally and linguistically competent ways.


County Mobile Crisis Response Planning

The crisis response system will vary by region due to differences in local resources and variations in local need.

Local and/or regional crisis response systems will integrate with:

  • Crisis hotlines
  • Mobile crisis services
  • Emergency rooms
  • CPEPs
  • Residential crisis programs
  • Crisis stabilization centers
  • Behavioral health services and programs

These systems will coordinate with law enforcement, community-based organizations, schools, and other entities.

OMH is developing a range of new Crisis Intervention Services for children and adults under its demonstration authority. Medicaid Managed Care Organizations (MMCOs) must reimburse for these services.


Crisis Intervention Services

Mobile Crisis Services

Mobile Crisis Rates

Mobile Crisis Program Guidance

Changes to Billing for Mobile Crisis Intervention Services (December 27, 2019)

The goals of these services are engagement, symptom reduction, and stabilization. Services are provided to an adult or child who is experiencing or is at imminent risk of experiencing a psychiatric or substance use (behavioral health) crisis.

Services include:

  • Telephonic triage and crisis response
  • Mobile crisis response
  • Telephonic crisis follow up
  • Mobile crisis follow up

Residential Crisis Services

Adult Crisis Residence Program Guidance

Adult and Children Crisis Residential Notification Letter for Medicaid Managed Care Plans (MMCP)

Adult’s Residential Crisis MMCP Guidance

Adult Crisis Residence Admissions Notification Form

Children’s Crisis Residence Program Guidance

Children’s Residential Crisis MMCP Guidance

Children’s Crisis Residence Admissions Notification Form

Short term residential support to individuals who are experiencing or are at risk of experiencing a mental health crisis.

Services include:

  • Residential Crisis Support
  • Intensive Crisis Residence
  • Children’s Crisis Residence

Suggested rates for crisis residential services for individuals over 21

Mandated rates for crisis residential services for individuals under 21


Comprehensive Psychiatric Emergency Programs (CPEPs)

CPEPs offer a full range of psychiatric emergency services and crisis outreach services to individuals experiencing symptoms of a behavioral health crisis. CPEPs provide triage, observation, evaluation, care, treatment and referral in a safe environment.

Comprehensive Psychiatric Emergency Programs (CPEP) Program Guidance


Contact

Please direct any questions related to these services to: crisis.initiative@omh.ny.gov
Please direct any billing questions related to these services to: bho@omh.ny.gov

All questions or complaints regarding Behavioral Health Medicaid Managed Care should be submitted to the OMH Division of Managed Care using the OMH MC Question/Complaint Form. This ensures all questions or complaints submitted can be reviewed and responded to by appropriate staff within OMH and/or the Department of Health.