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We will begin the presentation shortly. Thank you for your patience.
Attendees can access the presentation slides now at: MCTAC.org/page/events A recording of the event will be made available at the same event page in the next few days.
NEW YORK CHILDREN’S STATE PLAN AMENDMENT (SPA) SERVICE-BY-SERVICE OVERVIEW SERIES
July 28, 2016
Angela Keller Director, Bureau of Children’s Program Design, Policy & Planning Division of Managed Care, NYSOMH Meredith Ray-LaBatt Deputy Director, Division of Integrated Community Services for Children and Families, NYSOMH Heather Lane, LMSW OMH Family and Youth Peer Coordinator, NYSOMH
3
available soon (usually less than one week)
incorporated into future training and resources
discussion of the draft SPA manual currently available on-line. Please refer to the manual for further detail, definitions, references, and other useful information.
process about obtaining SPA designation
presentation and opportunity for designation-specific questions will also be offered.
Refresher and Update
Training Walkthrough
Care (including children in the care of Voluntary Foster Care Agencies)
to Managed Care
The main goals of the additional services in New York’s State Medicaid Plan are to:
services; and
care principles.
Manual available at MCTAC.org under Resources or on the Children’s Managed Care website (see last slide)
Proposed Medicaid State Plan Services will:
who meet medical necessity criteria (currently being refined).
informed.
settings where children and their families live and bolster lower intensity services to prevent the need for more restrictive settings and higher intensity services.
Treatment benefits (known commonly as EPSDT).
communication and coordination with the family, caregiver and/or legal guardian. Coordination with other child-serving systems should occur to achieve the treatment goals.
under Medicaid fee-for-service until transitioned to Medicaid Managed Care.
contracting process with Medicaid Managed Care Plans (starting January 2017). Further training on contracting is planned.
an EPSDT screening OR
health impairments; the ability to achieve age-appropriate growth and development; and the ability to attain, maintain, or regain functional capacity.
admission continued stay discharge
Family Peer Support Services and Youth Peer Support & Training
and supports provided by peers - individuals with lived experience
designed to support parents/caregivers for the benefit of youth
intended for child/youth
attachment to the child/youth
parenthood/caregiving for the children, even if the individual is living outside of the home
through:
OVERVIEW STAFF QUALIFICATIONS/CERTIFICATIONS SUPERVISOR QUALIFICATIONS
families caring for/raising a child who is experiencing challenges in home, school, placement, or community:
connect them with appropriate services and supports.
supporting a productive and respectful partnership by assisting the families to express their strengths, needs and goals.
full participation in services.
may be unfamiliar (e.g. placements, in crisis, and between service systems ).
their child to promote shared decision making
anxieties to promote positive shared decision making
modeling and coaching
child’s positive behavior.
clinicians
the behavioral and medical health needs of the child (i.e., training on special needs parenting skills).
Community Connections and Natural Supports
families in their own communities
already present in their lives.
new supportive relationships.
recreational activities in their community.
Qualified staff include:
(FPA).
requirements of the credential within 24 months of employment as a FPA. OR
Family Specialty
provided services to be billed if the applicant has:
NYS if person has demonstrated competencies and has relevant life experience)
(PEP) training or approved comparable training.
for the role of a Family Peer Advocate (FPA).
Ethics Provisional certificate is valid for 18 months while completing Level 2 training and acquiring 1000 hours of providing FPSS.
child serving systems on behalf of their child(ren) with social, emotional, developmental, health and/or behavioral healthcare needs.
person has demonstrated competencies and has relevant life experience)
Parent Empowerment training (or approved comparable training)
role of a FPA (including one from a FPA supervisor).
maintain/renew FPA credential
OASAS Certified Recovery Peer Advocate with a Family Specialty
disorders.
support and ethical responsibility)
work experience if they: have a BA/BS, CASAC or CASAC-T, or completed the 30-Hour Recovery Coach Academy training )
designated certifying body)
Support (option to have a separate administrative supervisor)
Peer Support (including at least 1 year as credentialed FPA); OR
Peer Support and role of FPAs and the FPSS Program moves to transition to supervision by experienced FPAs
CRPA-F supervisor for OASAS:
(CASAC) working within an OASAS certified program; AND
qualified to provide supervision
child who is struggling behaviorally at home. The family receives FPSS weekly, in the home, to practice strategies to support their child’s positive behavior.
behavioral concerns. FPSS is meeting weekly with the grandmother to assist her with implementing parenting strategies recommended by her grandson’s doctor and assist her in facilitating meetings with providers to ensure shared decision-making.
remain safely within the home. The mom is struggling with finding available resources for her daughter. The Family Peer Advocate (FPA) meets with the mom to explore available community resources, services, and supports and works with the mom to explore the family’s needs and preferences, helping to empower her to make informed choices. The FPA assists the family to facilitate appointments with potential service providers.
Juan’s parents for the past two months to help them stay actively involved with Juan while he is in placement, obtain the support they need during home visits, and prepare for a smooth transition home.
Juan, his parents and Juan’s service provider;
that are a priority for Juan; and
and behavioral supports are in place.
Connor and Haley (twins, age 7) were born prematurely. Both children have serious asthma. Their mother, Lauren, is raising the children alone without any relatives nearby. She has missed numerous days of work and is worried about losing her job. The school keeps calling about her son’s behavior. Lauren has always been able to handle everything, but she confides in a colleague that things are starting to unravel. Her colleague suggests that she call a Family Peer Support Program. The FPA helps Lauren work with the school district to start the process of
the clinic as well. The FPA helps Lauren contact a free legal services clinic so she can work to obtain child support which might allow her to cut back on her hours at work. They are also working on some strategies to support Connor’s behavior at home. Over time, Lauren shared with the FPA that she was struggling with depression herself. The FPA is helping Lauren take steps to take care of herself.
OVERVIEW STAFF QUALIFICATIONS/CERTIFICATIONS SUPERVISOR QUALIFICATIONS
– someone with “lived experience”
participation of the youth in the treatment planning
developing:
symptoms, trauma, and substance use disorders
levels of care and into adulthood
service systems
independent choices and assist youth in playing a proactive role in their own treatment
connection to peer support groups
issues
from others who have been through similar experiences
groups
Staff Qualifications:
services, special education services, or foster care
requirement can be waived by NYS if the person has demonstrated competencies and has relevant life experience)
and a minimum of three consultation calls
suitability for the role of a Youth Peer Advocate, including one from a YPA supervisor
within 18 months
peer-to-peer groups or activities
juvenile justice, special education, substance use disorder, and/or foster care to assist in other youth in their resiliency/recovery and wellness
exception of the following:
and suitability for the role of a YPA
Support services
approved comparable training)
Certified Recovery Peer Advocate with a Youth Specialty
disorders.
and ethical responsibility)
experience if they: have a BA/BS, CASAC or CASAC-T, or completed the 30- Hour Recovery Coach Academy training )
certifying body)
credentialed FPA or YPA with access to clinical consultation as needed OR
role of YPAs b) with access to discipline specific clinical consultation on a planned, regular basis.
Johnny is a high school junior who has an upcoming Committee on Special Education (CSE) meeting. Johnny invited his Youth Peer Advocate (YPA) to support him. The YPA may attend the CSE meeting with the parent and Johnny to support and assist him in verbalizing his goals and practice self-advocacy skills that they have been working on.
to a Youth Peer Advocate by her therapist to assist her in recognizing triggers.
could start to get involved in her school’s basketball team.
there are many similar aspects of Family Peer Support Services and Youth Peer Support & Training within:
cannot exceed more than six families -- no more than 12 individuals in total.
cannot exceed 12 individuals total.
the Medicaid eligible child/youth are not eligible for Medicaid reimbursement.
including community locations where the child/youth/family lives, works, attends school, engages in services (e.g. provider office sites), and/or socializes.
families with an emphasis on successful outcomes, individual satisfaction, and meeting the needs identified in the individual treatment plan.
developed by a licensed practitioner of the Healing Arts (LPHA).
specific outcome(s)
the unique needs of the youth/family.
to expand their skills and learn strategies to meet goals.
process.
providers
the stated goals.
functioning, new intervention plan should be developed
strategy with revised goals and services
health and health experience that is licensed, certified, or approved
comparable and appropriate services
provide services
certification/credentialing providers are also recommended to have training in:
Training specific:
Once finalized, these will be incorporated into the SPA Provider Manual and shared widely.
Peer Support and Training
Treatment
State-led training on the Child and Adolescent Needs and Strengths (CANS-NY):
process, billing rules when available
eligibility/medical necessity, deficit funding, EHR help (in-person)
enrollment rules, exclusions, health home interaction, reporting requirements (web-based)
service (full-day statewide in-person and web-based supplements)
and training responsive to areas of provider need supporting implementation
Please specify if kids system/managed care specific in subject line:
NYS OMH Managed Care Mailbox OMH-Managed- Care@omh.ny.gov NYS OASAS Mailbox: PICM@oasas.ny.gov NYSDOH Health Homes for Children: HHSC@health.ny.gov NYS OCFS Mailbox: OCFS-Managed- Care@ocfs.ny.gov
Children’s Managed Care Design:
http://www.health.ny.gov/health_care/medicaid/redesign/behavioral_health_reform.htm
Family Peer Advocate Credentialing: Families Together www.ftnys.org
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