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:
- Maintain people safely in the community;
- Reduce unnecessary emergency room visits and inpatient hospitalizations;
- Reduce risk of future crises; and
- 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
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
Mobile Crisis Services
Mobile Crisis Rates
Mobile Crisis Program Guidance
Changes to Billing for Mobile Crisis Intervention Services (December 27, 2019)
Residential Crisis Services
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
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
Suggested rates for crisis residential services for individuals over 21
Mandated rates for crisis residential services for individuals under 21
Crisis Stabilization Centers
Crisis Stabilization Centers are an important part of the statewide crisis service system. They provide voluntary support and urgent treatment to anyone experiencing mental health and/or substance use crisis symptoms.
There are two types of Crisis Stabilization Centers:
- Supportive Crisis Stabilization Center
- Intensive Crisis Stabilization Center
Crisis Stabilization Center Program Guidance
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
Crisis Follow-up Services for CPEPs (May 24, 2022)
1115 Waiver Mobile Crisis Services Provided by CPEPs (May 4, 2023)
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.