1. Issues Impacting OMH HCBS Waiver Programs NYS Coalition for Children’s Mental Health Services Full Coalition Meeting Thursday, April 3, 2014

2. Key Change Factors  OMH Regional Center of Excellence (RCE) Plan lead to Waiver Expansion to ease bed-downsizing – used BIP funds  Waiver anticipated under Medicaid Managed Care to provide both existing 1915c and 1915i services  New CMS Rule – must comply with new rule within 5 years; transition plan from NY to be submitted by August 1  NYS’s Renewal Application to CMS –going for short term renewals so they can address CMS concerns (provider choice, incident reporting and performance measures were mentioned)  Health Home – care coordination for all; does this force unbundling?  BIP – conflict free care coordination – SPOA being referral source and provider mentioned as issue because the firewall between Level of Care determination and provision of service doesn’t meet federal test

3. OMH Plans to Work with the Field  A communications plan is under development and will include:  Real-time communication about changes  Listserv  Regularly scheduled webinars (May 2 notification coming soon)  Opportunities for open dialogue and shared experiences  Regional meetings, if needed, to address local issues  County and/or program specific supports for regional impact response  Access to technical assistance and support through the Clinic Technical Assistance Center (CTAC) for compliance and operational change

4. Coalition Next Steps 1. RCE/Expansion of Waiver Slots (150 total slots) 2013-2014  Streamlining referral process  Reducing Wait Lists  Adjustments to LOS 2. CMS Application (Renewal)  Recommendations to OMH need to be developed and tied to #4 3. New CMS Rule  Involvement of QA staff on OMH listserve and calls imperative to shape transition/compliance proposal 4. Health Homes and Medicaid Managed Care Transition