Can Other Licensed Practitioner (OLP) be provided under a limited permit license?
Yes, this is planned. Materials will be developed and shared for providers to use for outreach to families and referral sources.
There are multiple examples of pathways into services including:
A Health Home Plan of Care (POC) is a plan for how the care manager helps to arrange for and manage the provision of services by others to assure the various needs of the child are being met.
A Treatment Plan is a document developed by a professional on how they will work with the child and family directly to address their needs based on goals and objectives which are identified by the family, and child, along with the practitioner.
For more information about the differences between treatment/service plans and Plan of Care, see state guidance.
The pediatrician can make a recommendation for a service based on their determination of medical necessity. The specific service provider, which may be a pediatrician in some instances, then develops the detailed treatment plan as it relates to the service they are providing.
It is possible a child may have more than one treatment plan if they are receiving multiple services from various providers. However, one treatment plan can be developed for the provision of multiple services when provided by one agency, if their EHR system supports a coordinated treatment case record.
Yes, you need to receive designation to provide Children and Family Treatment and Support Services (formerly SPA) and/or Children's HCBS before you enroll for a provider number such as the Medicaid Management Information System (MMIS).
Yes, supervisors and managers can be shared across CFTSS. If you are sharing individuals across CFTSS make sure that staff charges/expenses are appropriately allocated. There are not conflict-free requirements restricting supervisors from being shared across CFTSS providers and care managers (this restriction only applies to HCBS), however this is not a recommended practice.
This is not considered a conflict for CFTSS, however it is recommended that individuals be given a choice and only Licensed Practitioner of the Healing Arts (LPHA) can make a recommendation.
Providers already enrolled in Medicaid do not need to re-enroll. The State will add the appropriate Category of Service code for the providers who have been designated for children’s services.
The only time an agency would need to complete a Medicaid application is if the agency is brand new.
NP LBHP is specific to those practitioner categories that can provide services under OLP. They can make recommendations for any of these services. LPHA is a broader definition and includes additional treating practitioners (i.e. primary care doctor) who can make a recommendation for one of these services.
Please refer to the CFTSS manual for a list of these practitioner types at:
No. The Health Home Care Manager determines what services are needed, facilitates referrals, and develops a HH Plan of Care. The treatment plan is developed by the treating practitioner who provides the direct services. The Agency/practitioner providing direct services is responsible for maintaining the treatment plan.
For more information on the differences between treatment/service plans and Plan of Care, see state guidance.
Yes. Non-licensed providers for CFTSS and HCBS that do not have a NPI can use the OMH unlicensed provider number 02249154 or the OASAS unlicensed provider number 02249145
More information on filling out clean claims can be found on MCTAC Billing tool.
The new OLP services are intended for children who have not or are not well suited for clinic based treatment, and would be better served in their home or community. OLP services only include assessment, treatment planning, psychotherapy and some crisis interventions. OLP can only be billed for children admitted to the service.
Clinics can offer a full array of clinical treatment interventions, including but not limited to medication management and psychiatric evaluation. Clinic services are to be billed for any child enrolled in clinic.
Non-licensed staff do not require an NPI. Practitioners who are able and required to enroll in Medicaid will need an NPI to enroll.
Page 91 of the CFTSS Provider Manual outlines which LPHA can make a recommendation for CFTSS:
An individual professional who is licensed as a Registered Professional Nurse, Nurse Practitioner, Psychiatrist, Licensed Psychologist, Licensed Psychoanalyst, Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW), Licensed Marriage & Family Therapist, Licensed Mental Health Counselor, Licensed Creative Arts Therapist, or Physician (per OMH 599 regulations) and practicing within the scope of their State license to recommend Rehabilitation services.
Please note: While all listed LPHA can make a recommendation, not all have the ability to diagnose a child independently, if needed, within their scope of practice without being under the supervision of another qualified licensed practitioner or physician.
A family, teacher, or other non-clinician may refer directly to an OLP without first going to another LPHA.
When a non-clinician refers directly to OLP, the OLP provider will determine whether the child meets the medical necessity criteria to continue receiving OLP and/or recommend for other CFTSS.
FPSS work to improve the situation of the family in relation to the needs of the child. Family peers have lived experience as a parent of a child with mental health needs or substance use needs and the corresponding certification or credentialing. Therefore, the use of a family peer should take into consideration the needs and diagnosis of the child.
Typically, the CRPA-F would assist the parent or caregiver to address the needs of their child with a substance abuse issue. Whereas, the credentialed FPA would work with a parent or caregiver of a child with a mental health need.
Yes, they create the treatment plan based on the needs of the child and family. The FPSS would engage in a conversation with the child and family and use the information provided by the LPHA to determine what intervention/activities would take place within the scope of the service to support the goals and objectives developed.
Although there is no specific assessment for this, OMH does endorse the use of the Family Assessment of Needs and Strengths (FANS) which will assist FPSS providers in honing-in the on a family’s strengths and needs. This conversation would result in the development and implementation of a treatment plan.
More information on the FANS can be found at: https://www.ftnys.org/training-credentialing/family-needs-strengths-fans/
These checks are not transferable, all HCBS and Care Managers will require CHCR, SCR and SEL checks even if they were performed previously. See Background Check Guidance document for more information.
Yes, a child may meet criteria for both based on medical necessity for CFTSS and meeting HCBS threshold criteria. The Health Home Plan of Care should identify what goals each service is intended to address. Each service would have its own service or treatment plan.
The Crisis/Safety plan is written by the service provider who is delivering the service. This provider must be a designated entity and meet the necessary qualification as identified in the CFTSS Provider Manual.
POCs for children/youth who are enrolled in HCBS need to be sent to the MMCP. POCs for Health Home-only enrollees are typically sent to the MMCP upon the MMCP’s request.
The maximum number of individuals that can participate in a group session is 12, regardless of insurance type.
Yes, it includes all active participants, including children and parents.
No, if other children are present due to, for example, lack of babysitting and not actively involved they do not count towards the group number.
There should only be 1 note per client/child per session.
The family/caregiver is not a collateral in this instance; others like the school, community members, etc. would be collaterals. Sessions with only collaterals are not allowed for FPSS. Instead, the State encourages FPSS staff to include the family/caregiver in conversations with the school or other collaterals to promote empowerment and skill development.
Family should always be present for the provider to bill for FPSS.