Frequently Asked Questions

NYS Policy Top Question
back to FAQ home

Are adult Home and Community Based Services (HCBS) only made available for HARP eligible clients?

Yes, HCBS services are only available to clients that are enrolled in a HARP or an HIV SNP after they've undergone assessment and the assessment has indicated that they are eligible and for which services. For more information consult a recent workflow presentation

Source: HCBS Peer Services 7.14.15

Will Managed Care Organizations know who the designated adult Home and Community Based Services (HCBS) providers are? How do providers find out who the adult HCBS providers are?

Yes, Plans are provided this information and when available the list of the adult designated providers is also publicly available on the OMH website, and can be accessed here. 

Source: Managed Care 101 Webinar 7.21.15

How do agencies identify if an adult client is HARP/HCBS eligible?

HARP/HCBS eligiblity information is available using ePaces.

Source: HCBS Peer Services 7.14.15

Are HARPs required to have case managers? How are clients assigned to Health Home Care Managers?

Yes, HARPs are required to have case managers. The expectation is that most face to face care management will be done through the Health Homes. Each Health Home has its own assignment process.

Source: Managed Care 101 Webinar 7.7.15

How do adult BH Home and Community Based Services (HCBS) work for those between the ages of 18 and 21?

The adult BH HCBS services are only available to eligible adults ages 21 and over in HARPs or HIV SNPs. 

Source: HCBS Employment/Education 7.21.15

Can a recipient of adult Home and Community Based Services (HCBS) also receive Health Home Care Coordination without duplication of services?

Yes. All clients receiving adult HCBS are eligible for Health Home Care Coordination. 

Source: HCBS Peer Services 7.14.15

How do adult BH HCBS providers access the manual for ePaces codes?

Providers can access the ePaces manual by clicking on ePaces help. Codes start on page 259.

Source: Plan of Care 10.9.15

Will there be any standards concerning choice and conflict of interest (for the service choices the clients are making) for adult BH HCBS clients?

The federal government is very serious about conflict free choice in HCBS. Providers will need to document the choices being offered to the client and the state will collect and monitor that information.

Source: Plan of Care 10.9.15

Are Adult HCBS certification and provider qualifications, requirements or guidelines? Do all criteria need to be met? Can staff waivers be obtained and if so how?

New York State HCBS certification and provider qualifications are requirements. All criteria must be met and at this time there are no staff waivers. 

Source: HCBS Education and Employment 10.27.15

For adult BH HCBS clients, under what circumstances does the Plan of Care need to be redone?

The plan of care should be redone if the tier of eligiblity, services and/or goals have changed or may no longer be appropriate based on observation or a major life change. Contact your Health Home Care Manager for more information.

Source: Care Manager Webinars November 2015

What is HARP?

According to the NY Department of Health, "Adults enrolled in Medicaid and 21 years or older with select Serious Mental Illness (SMI) and Substance Use Disorder (SUD) diagnoses having serious behavioral health issues will be eligible to enroll in a new type of health plan, HARP. These specialty lines of business operated by the MCO will be available statewide. Individuals meeting the HARP eligibility criteria who are already enrolled in an HIV Special Needs Plan may remain enrolled in the current plan and receive the enhanced benefits of a HARP. HARPs and SNPs will arrange for access to a benefit package of Home and Community Based Services (HCBS) for members who are determined eligible. HARPs and SNPs will contract with Health Homes, or other State designated entities, to develop a person-centered care plan and provide care management for all services within the care plan, including the HCBS."

Source: OMH UM Training 10.5.15

How do providers determine who has been designated part of a HARP?

Individual HARP eligibility and enrollment are included in ePaces. Information regarding Managed Care Plans that participate in HARP is available at the MCTAC Plan Matrix.

Source: OMH UM Training 10.5.15

Who will determine if an adult is HARP eligible?

New York State determines who is HARP eligible. Individuals are eligible if they meet target risk criteria/risk factors or are identified by the service system or a service provider.

Target Criteria:
-Eligible for mainstream enrollment and Medicaid enrolled,
-21 and older,
-Serious Mental Illness/Substance Use Disorder diagnosis,
-Not dually eligible for Medicare,
-Not participating in OPWDD program

Source: Managed Care 101 Webinar 7.21.15

Are adults in HIV SNPs included in HARPS?

Individuals in HIV SNPs are eligible for all services associated with HARP/HCBS under same rules as HARP eligible individuals.

Source: Managed Care 101 Webinar 7.21.15

Will each adult Behavioral Health Home and Community Based Service (BH HCBS) provider receive a copy of the individual’s Plan of Care? Will the BH HCBS Individual Service Plans be shared among providers?

The BH HCBS plan of care is completed by the Health Home Care Manager. Once complete, the BH HCBS plan of care must be signed by each of the BH HCBS designated agencies providing a BH HCBS service indicated in the HCBS plan of care. 

Source: State Released HCBS Q&A March 2016

Who will be responsible for determining if an adult assessed as eligible for Behavioral Health Home and Community Based Services (BH HCBS) lives in a Home and Community Based setting?

This should be determined by the Health Home Care Manager. Further guidance on the HCBS settings requirements is forthcoming.

Source: State Released HCBS Q&A March 2016

Can individuals who reside in OMH-licensed Community Residences receive adult Home and Community Based Services (HCBS) in off-site locations?

Community Residences are non-compliant settings for BH HCBS. Individuals residing in community residences are ineligible to receive BH HCBS. 

Source: State Released HCBS Q&A March 2016

Can Adult Behavioral Health Home and Community Based Services (BH HCBS) be provided in individuals’ homes?

The state encourages Adult BH HCBS providers to provide services in the individuals’ homes and in community locations. Determinations regarding where services will be provided should be made in partnership with the individual. It should be noted that services cannot be provided in residential settings that are not HCBS compliant (such as psychiatric centers or community residences), and individuals who reside in these settings are not eligible to receive BH HCBS. 

Source: State Released HCBS Q&A March 2016

How will determinations be made regarding settings that are subject to Heightened Scrutiny? Are individuals who reside in Scattered-Site housing considered eligible to receive adult Home and Community Based Services (HCBS)?

The housing settings that currently qualify as HCBS settings include an individual’s own apartment, scattered-site Supported Housing units, or in a family home. BH HCBS designated providers are expected to sign and submit to OMH an BH HCBS Settings Attestation form, declaring site compliance with the BH HCBS settings rule. Therefore, it is the responsibility of the providers to ensure standards are met. 

Source: State Released HCBS Q&A March 2016

What are the requirements for Education Specialists for adult HCBS?

All Education Support Staff should have a minimum of two years working in behavioral health. Education Specialists should possess a Bachelor's degree and have two years of experience supporting individuals in pursuing education goals. A supervisor may be unlicensed and requires a minimum of a Bachelor's degree (preferably a Masters in Rehabilitation or a relevant field), a minimum of three years of relevant work experience, preferably as an education specialist.

Source: State Released HCBS Q&A March 2016

If an individual has previously failed in an education program, is he or she eligible to receive adult Education Support Services? Is there a minimum number of credits or classes an individual needs to pursue?

If the individual has been assessed as eligible for BH HCBS Education Support Services, has a goal that requires the service, and wants to receive the service, it should be included in the Plan of Care. Failing to complete an educational program in the past does not preclude an individual from receiving this service in the future. There is no minimum number of courses or classes in which an individual must be enrolled. Ongoing Supported Education is provided when an individual has been admitted to an educational or training program.

Source: State Released HCBS Q&A March 2016

If an individual is eligible for ACCES-VR, how can adult Behavioral Health Home and Community Based Services (BH HCBS) provide employment and education services?

The BH HCBS Provider Manual stipulates that Education and Employment services may be provided to the extent to which they are not available under a program funded by the IDEA or available for funding by ACCES-VR. BH HCBS services and ACCES-VR services can complement each other, and whenever appropriate, the Health Home Care Manager and provider should ensure coordination with the ACCES-VR Vocational Counselor. It is important that an individual be provided the opportunity to make an informed choice between services and providers. Further guidance is forthcoming.

Source: State Released HCBS Q&A March 2016

Are adults who are actively using substances, who have a history of substance use, or who have a history of incarceration eligible for Adult BH HCBS education or employment services?

If the individual has been assessed as eligible for Behavioral Health Home and Community Based Services (BH HCBS), has a goal that requires the service, and wants to receive the service(s), it should be included in the Plan of Care. Substance use and a history of incarceration should not be used an exclusionary criteria for these services. 

Source: State Released HCBS Q&A March 2016

What would be the typical sequence(s) through which an adult would move between the various services in the Employment cluster?

Behavioral Health Home and Community Based Services (BH HCBS) Employment and Education services are not meant to be sequential. An individualized and person-centered approach should be used to identify the service(s) that are most appropriate to meet the individual’s needs.

Source: State Released HCBS Q&A March 2016

Are adult BH HCBS Intensive Supported Employment and Ongoing Supported Employment subject to the same 250-hour cap that includes Pre-vocational Services and Transitional Employment Services?

Pre-Vocational Services and Transitional Employment are capped together at 250 hours per year. Intensive Supported Employment and Ongoing Supported Employment are each capped individually at 250 hours per year. An assessment by the provider will determine the appropriate frequency, scope, and duration of services. The provider(s) must work with the Plan and the Health Home Care Manager to ensure appropriate utilization management. In addition to the caps on the number of hours, providers should be aware that there are utilization thresholds listed in the Billing Manual that also apply.

Source: State Released HCBS Q&A March 2016

Should Health Homes assess only HARP-enrolled individuals, or are we expected to assess all HARP-eligible individuals for Behavioral Health Home and Community Based Services (BH HCBS) eligibility?

Prior to conducting the adult BH HCBS assessments, Health Home Care Managers MUST verify HARP enrollment. See guidance at: http://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/docs/community_mental_

health_assessments_billing_guidance.pdf

Source: State Released HCBS Q&A March 2016

For the initial 3 assessment visits with an adult individual how will the Behavioral Health Home and Community Based Services (BH HCBS) provider bill for these services? Will these visits have a different rate than the service rate? Will these visits apply to the utilization cap?

BH HCBS providers have up to 3 visits to determine the scope, duration, and frequency for the individual based on their needs, goals and preferences. This is a part of the BH HCBS and should be billed the same way an individual BH HCBS is billed. The time spent during these three visits will count toward the cap on hours.

Source: State Released HCBS Q&A March 2016

If an agency provides services to both children and adults and has been approved for adult BH HCBS, do they receive automatic approval for the children's HCBS?

No, the designation process to provide HCBS services to children is a separate and distinct process from the Adult HCBS designation. 

Source: Transforming the Children's Medicaid System Webinar Part 2, 2.11.16

Is a Plan of Care required if the only BH HCBS the adult is receiving is Non-Medical Transportation (NMT)? What is an example of an appropriate NMT trip for an individual who is not receiving any other BH HCBS?

NMT is considered a BH HCBS, and therefore the HCBS requirements for Plans of Care must be met when NMT is utilized. However, the State does not expect that there will be many individuals for whom it will be appropriate to use NMT and not be engaged in other BH HCBS. An example of an appropriate NMT trip for an individual who is not receiving other BH HCBS is a trip to a job interview for an individual with an employment goal who is engaged in a Personalized Recovery Oriented Services (PROS) program and therefore is not eligible for the BH HCBS employment services.

Topic(s): System Redesign
Source: Non-Medical Transportation Q & A Spring 2017

Do adult BH HCBS providers bill for Non-Medical Transportation (NMT)?

BH HCBS providers would only provide and bill NMT if they are enrolled Medicaid transportation providers and are assigned transportation by the transportation manager. Transportation is assigned via enrollee choice within the appropriate level of service or rotation when no choice is expressed. When billing for NMT, enrolled Medicaid transportation providers must receive prior authorization from the transportation manager and bill through eMedNY through the same billing process as fee-for-service Non-Emergency Medical Transportation (NEMT).

Topic(s): Business Practices
Source: Non-Medical Transportation Q & A Spring 2017

Can adult BH HCBS providers bill for mileage for staff trips related to an individual’s goal?

Non-Medical Transportation (NMT) is a BH HCBS and is separate from Staff Transportation which is a supplemental rate add-on for some BH HCBS. BH HCBS providers can bill for mileage for staff trips, as long as the mileage is tied to a service that was provided and it is a service that qualifies for Staff Transportation. 

Topic(s): Business Practices
Source: Non-Medical Transportation Q & A Spring 2017

What is the timeframe in which the MCO must confirm the proposed adult Non-Medical Transportation (NMT) is appropriate based on the approved POC/Level of Service Determination decision and send the Grid to the Transportation Manager?

If the NMT Grid is received with the level of service determination request, the MCO should forward the Grid to the Transportation Manager at the time of the approval of the level of service. If the Grid is received after the Level of Service approval, the MCO should review and make a decision regarding the appropriateness of the proposed NMT within the timeframe for Service Authorization Requests in Appendix F of the Medicaid Managed Care/Family Health Plus/HIV SNP Model Contract.

Topic(s): System Redesign
Source: Non-Medical Transportation Q & A Spring 2017

Where on ePaces can providers find the adult HCBS codes?

On ePaces, providers should be looking at the section that lists the restriction and exception codes. Providers are looking for the "H codes."

Source: Plan of Care 10.9.15

Can an agency be designated for both Adult BH HCBS and CORE?

Designation for Adult BH HCBS and CORE is by service type (e.g., PSR, PreVocational Services, etc.). An agency can be designated for individual services under BH HCBS, CORE or both.

Source: OMH & OASAS CORE FAQ Dec 2021

How do currently designated Adult BH HCBS providers become designated for CORE?

Current BH HCBS CPST, PSR, FST, and Peer Support providers will automatically be given provisional CORE designation. Provisional designation letters will be sent to all eligible providers by January 3rd, 2022.

Source: OMH & OASAS CORE FAQ Dec 2021

Can Behavioral Health Care Collaborative (BHCC) and/or Independent Practice Associations (BH IPA) be direct providers of CORE Services for adults?

No. BHCC/BH IPAs are networks of behavioral health service providers. BHCC/BH IPAs may have CORE Services designated providers within their networks.

Source: OMH & OASAS CORE FAQ Dec 2021

What will be done to ensure that adults interested in CORE are offered a choice of providers without conflict free care management?

For referrals made by Health Home Care Managers (CM) the CM will ensure that the member is offered a choice among all in network providers in accordance with the Health Home standards. The State strongly encourages other referral sources to educate members and facilitate an opportunity for an informed choice. As with any other benefit, individuals may choose to access CORE services from any in network provider.

Source: OMH & OASAS CORE FAQ Dec 2021

Will a Plan of Care (POC) be required for CORE services?

A Health Home Plan of Care will not be required for CORE services. CORE services must be documented in an Individual Service Plan (ISP) maintained by the CORE services provider.

Source: OMH & OASAS CORE FAQ Dec 2021

What is the role of Recovery Coordinators with CORE?

Recovery Coordinators do not have any formal role in referrals to CORE Services. CORE Services do not require completion of the NYS Eligibility Assessment or the BH HCBS Plan of Care. 

Source: OMH & OASAS CORE FAQ Dec 2021

Do Credentialed Alcoholism and Substance Abuse Counselors (CASACs) meet the minimum qualifications to complete the LPHA recommendation for CORE services?

No, CASACs do not meet the minimum requirement to complete the LPHA Recommendation for CORE services.

Source: OMH & OASAS CORE FAQ Dec 2021

For CORE services, what is the purpose of the LPHA recommendation?

The purpose of the LPHA recommendation is to determine and document medical necessity for CORE Services. 

Source: OMH & OASAS CORE FAQ Dec 2021

For CORE services, when does the LPHA recommendation need to be done? Before or after referral?

Referrals are not required to come in with an LPHA Recommendation. Providers should be prepared to complete or obtain an LPHA recommendation as a part of intake and evaluation process, prior to developing an ISP.

Source: OMH & OASAS CORE FAQ Dec 2021

Does the LPHA need to document a qualifying psychiatric and/or SUD diagnosis to make the LPHA recommendation for CORE Services?

No. Under the 1115 Demonstration Waiver, CORE Services are limited to HARP-eligible individuals and as such a diagnosis does not need to be confirmed or documented in the LPHA recommendation or elsewhere in the case record.

Source: OMH & OASAS CORE FAQ Dec 2021

Are designated providers required to have an LPHA assigned to CORE?

The State recommends identifying LPHAs within each organization who are able to support this work. Agencies will need to make their own decisions about the sustainability of hiring an LPHA. There are many considerations an agency should take, including whether the LPHA will also be acting as the clinical supervisor for direct service staff. Agencies may also wish to share an LPHA with other programs or services within their agencies (e.g., PROS, Clinic, and/or CFTSS). 

Source: OMH & OASAS CORE FAQ Dec 2021

What are the minimum qualifications for a Licensed Practitioner of the Healing Arts (LPHA) who can recommend CORE services?

For the purposes of making a recommendation to CORE Services, the minimum qualifications for an LPHA are:
• Doctors (MD/DO)
• Physician’s Assistant (PA)
• Nurse Practitioner (NP)
• Registered Nurse (RN)
• Licensed Mental Health Counselor (LMHC)
• Licensed Marriage and Family Therapist (LMFT)
• Licensed Creative Arts Therapist (LCAT)
• Licensed Psychologist
• Licensed Psychoanalyst
• Licensed Clinical Social Worker (LCSW)

Licensed Master Social Worker (LMSW), under the supervision of an LCSW, Psychologist, or Psychiatrist employed by the agency.

Source: OMH & OASAS CORE FAQ Dec 2021

Do I need to send the LPHA recommendation for CORE services to the Managed Care Organization (MCO)?

Providers are not required to submit LPHA recommendation to MCOs in order to begin providing CORE services. From time to time, MCOs may request a copy of the LPHA recommendation, just as they may request any other documentation from the case record.

Source: OMH & OASAS CORE FAQ Dec 2021

Can a staff at an MCO do the LPHA recommendation for CORE services if they meet the minimum requirements for a LPHA?

At this time, the LPHA recommendation form cannot be completed by staff at the MCO. However, MCOs play an essential role in connecting their members to CORE Services by referring them to in-network providers.

Source: OMH & OASAS CORE FAQ Dec 2021

What needs to be in a CORE referral? Will there be a template?

There is no set template for CORE referrals. The CORE provider should define their own referral and intake/eval processes, including what information or documents are needed with a referral. The process should be simple and follow a “No Wrong Door” policy. Providers must establish their process in a formal Policy & Procedure.

Source: OMH & OASAS CORE FAQ Dec 2021

Who can make a referral to CORE services?

With the No Wrong Door referral pathway, anyone can make a referral including the prospective client (self-referrals). Referrals are not required to come in with an LPHA recommendation.

Source: OMH & OASAS CORE FAQ Dec 2021

Who is eligible to conduct the CORE intake and evaluation?

Any staff who is qualified to provide the specific CORE service can do the intake and evaluation for that service.

Source: OMH & OASAS CORE FAQ Dec 2021

Is there an intake/evaluation tool for CORE services?

There is no state-issued template for the intake and evaluation process, however agencies are encouraged to develop a tool/form that can guide a person-centered discussion of: the individual’s recovery goal(s), the individual’s strengths and resources, the individual’s barriers and needs, the individual’s preferences for service delivery (including days, times, staffing, etc.), and how the CORE service will be used to support attainment of their goal.

Agencies may also consider the use of standardized screening tools that can inform service plan development. For example, the Daily Living Activities 20 (DLA-20), Columbia-Suicide Severity Rating Scale (C-SSRS), CAGE questionnaire and/or Fagerstrom Tolerance Scale.

Source: OMH & OASAS CORE FAQ Dec 2021

How do CORE providers notify Managed Care Organizations (MCOs) about an individual initiating CORE Services?

CORE providers must notify an enrollee’s MCO within three business days after their first date of initiating a new CORE Service, which includes CORE Service Intake and Evaluation.

MCOs must implement a secure electronic process for receiving and responding to CORE Services initiation notifications. NYS developed a template containing the information providers must submit to MCOs. See the CORE Service Initiation Notification Form for additional information. MCOs may use this template or develop their own but can only include information contained in the template. MCOs are expected to clearly communicate and provide any necessary training to their CORE provider network about the specific MCO’s notification process.

Source: OMH & OASAS CORE FAQ Dec 2021

What will happen if the CORE Service Initiation Notification Form is submitted after the 3-business day timeframe?

CORE providers must notify an enrollee’s MCO within three (3) business days after the first date of initiating a new CORE Service. This allows for the MCO to identify any concerns regarding duplication of services. If the CORE Service Initiation Notification Form has not been submitted, an MCO may pend (or hold) the claim. The MCO will then reach out to the provider to request submission of the Service Initiation Notification Form. Providers should be aware that if the MCO identifies a duplicative service and the form was not submitted on time, claims may be denied.

Source: OMH & OASAS CORE FAQ Dec 2021

Will there be any change to the HARP eligibility algorithm as a part of the CORE implementation?

At this time there are no planned changes to the HARP eligibility algorithm as part of the CORE implementation.

Source: OMH & OASAS CORE FAQ Dec 2021

Who is eligible for CORE services?

Eligibility for CORE Services is based on three criteria:
1. The individual must be HARP Eligible,
2. The individual must be enrolled in a HARP or HIV-Special
Needs Plan (SNP); and
The services must be recommended by a Licensed Practitioner of the Healing Arts (LPHA).

Source: OMH & OASAS CORE FAQ Dec 2021

Will the settings restrictions in the Adult BH HCBS Final Rule apply to CORE services as it did BH HCBS?

No, the HCBS Settings Final Rule does not apply to CORE services.

Source: OMH & OASAS CORE FAQ Dec 2021

Can staff provide both Adult BH HCBS and CORE? If so, how do we determine caseloads for staff providing both BH HCBS and CORE?

Staff can provide both BH HCBS and CORE Services. There are no caseload restrictions for CORE. For mixed caseloads, BH HCBS caseloads must be representative of the staff time dedicated to BH HCBS. For example, if your agency has a full-time staff who is half-time CORE and half-time BH HCBS, then their BH HCBS caseload should not exceed 10 individuals. This is because the BH HCBS caseload maximum is 20 individuals.

Source: OMH & OASAS CORE FAQ Dec 2021

Will CORE Providers be eligible for permanent approval to deliver services via telehealth?

Yes, designated providers are eligible to apply for permanent approval to deliver services via telehealth. Additional clinical and programmatic guidance regarding CORE and telehealth is forthcoming.

Source: OMH & OASAS CORE FAQ Dec 2021

If a provider has received permanent approval to deliver BH HCBS via telehealth will that approval transfer over to CORE Services?

Yes, if a provider has been approved to deliver BH HCBS via telehealth that approval will transfer over to CORE Services. Updates may need to be made to the agency’s policies and procedures to reflect the change in language.

Source: OMH & OASAS CORE FAQ Dec 2021

How do we determine scope, intensity, duration, and frequency of services for CORE?

The CORE provider will conduct an intake and engage the individual through person-centered planning (PCP) to determine frequency, scope, intensity, and duration of recommended services to move the person towards their goal. The clinical supervisor can be a resource to staff in formulating the service plan. See the Operations Manual for additional information about the PCP process.

Source: OMH & OASAS CORE FAQ Dec 2021

How long is a unit in CORE? What are the recommended unit ranges?

A unit is 15 minutes. Under BH HCBS, services were subject to daily unit limits. These limits have been removed for CORE and replaced with recommended unit ranges, which are intended to illustrate the scope of services. See the Operations Manual for recommended programmatic unit ranges by service type.

Source: OMH & OASAS CORE FAQ Dec 2021

What happens if a person wants to do additional CORE Services after their initial referral and intake?

If the LPHA recommendation does not include the additional service(s), an updated LPHA recommendation is necessary. An intake & evaluation for the new service(s) must be done and the service added to their ISP. The MCO must be notified of the additional service(s) as well.

Source: OMH & OASAS CORE FAQ Dec 2021

Has “progress made/follow up” been eliminated from the progress notes for CORE? If so, how do we document progress made as well as follow-up/next steps?

Yes, this section of the progress note is no longer required. Progress made should be regularly monitored and documented in the ISP review summaries.

Source: OMH & OASAS CORE FAQ Dec 2021

What are non-billable contacts related to CORE, do I need to document those?

Non-billable contacts, for example outreach to disengaged members, appointment reminders, or contacts that do not reach minimum service duration, are critical to engaging the person in CORE services. These contacts are documented in a contact log, case note, or non-billable progress note. Providers have some discretion in which non-billable contacts are documented. For example, routine appointment reminder calls or texts might not be documented, but a letter attempting to outreach to a disengaged individual should be noted.

Documentation on non-billable contacts helps demonstrate the quality of services provided and is particularly helpful during times of staff-turnover.

Source: OMH & OASAS CORE FAQ Dec 2021

Do supervisors need to sign off on CORE encounter/progress notes?

The service encounter note needs to have the name, qualifications, dated signature of the staff person delivering the service. Although it is not required for a supervisor to sign off, an agency can choose to do so to ensure notes meet billing requirements.

Source: OMH & OASAS CORE FAQ Dec 2021

Do we need to make changes in our Electronic Health Record (EHR) or Electronic Billing Software (EBS) in order to meet the documentation requirements for CORE?

In developing documentation requirements for CORE Services, the State used the 2016 BH HCBS Behavioral Health Information Technology (BHIT) technical specifications as a guide. The intent was to minimize disruption or changes to existing software. The State will issue updated technical specifications that will support agencies in making any needed changes, including new modifiers and rate codes that will need to be added for certain services.

For the CORE Case Record, form fields can be named/labeled differently as long as all required elements are included in the content of the documentation to support appropriate billing.

Source: OMH & OASAS CORE FAQ Dec 2021

What trainings do supervisors/staff need to take for CORE Services? Do staff need to retake trainings if they have done those trainings in the past for BH HCBS?

All CORE training requirements for staff and supervisors will be indicated in the CORE Staff Training Memo. There are overlapping trainings from BH HCBS that apply to CORE trainings. Staff will not have to repeat previously completed trainings that are required for both BH HCBS and CORE.

Source: OMH & OASAS CORE FAQ Dec 2021

What is NIMRS and how do I sign up? What incidents do I have to report for CORE?

NIMRS stands for the New York State Incident Management and Reporting System. NIMRS is a secure, web-based, quality management tool used by OMH-hosted providers to report incidents. Incident Reporting and Management Guidance for CORE and BH HCBS was issued via the BH HCBS Listserv on 12/13/21 and was effective immediately. Additional information for OMH-hosted providers can be found on the Division of Quality Management website.

Source: OMH & OASAS CORE FAQ Dec 2021

What are the allowable service combinations for CORE?

CORE Services may be provided in combination with a variety of BH HCBS and State Plan services, like PROS or Outpatient Clinic. For more information on specifical allowable service combinations, please refer to the allowable service combination charts in the Benefit and Billing Guidance (pgs. 13-14).

Source: OMH & OASAS CORE FAQ Dec 2021

Can NMT be used to get a participant to a BH HCBS/CORE service at an agency site?

No, BH HCBS/ CORE Services are intended to be primarily home and community based. NMT is only available for transportation to community locations. Refer to NMT Guidance for additional information on how this benefit can be accessed.

Source: OMH & OASAS CORE FAQ Feb 2022

If the HARP eligible client is enrolled in FST under CORE can their children receive FST services as collaterals?

The only person receiving services is the HARP enrolled/eligible person. The role of the Collateral is to provide support in helping the HARP member achieve their goals. In some circumstances, the HARP member can also ask FST provider to provide psychoeducation. Ultimately the HARP member is the client, and they identify their family of choice (who do not have to be 21+). 

Source: OMH & OASAS CORE FAQ Feb 2022

Can a CORE Provider meet with an individual who is inpatient in the hospital to begin an intake? Does it make a difference if the hospitalization is for behavioral health or medical reasons?

Yes, it is appropriate to meet with an individual to begin intake if they are hospitalized for BH or medical reasons. This practice will support strong engagement through a warm handoff.

Source: OMH & OASAS CORE FAQ Feb 2022

Will OPWDD HCBS waivered enrolled individuals be eligible for CORE Services?

OPWDD HCBS waiver enrolled individuals are not able to be enrolled in a HARP/HIVSNP and therefore cannot access CORE Services. OPWDD waiver enrollees have access to similar services. For more information about the OPWDD waiver services please visit https://opwdd.ny.gov/types-services

Source: OMH & OASAS CORE FAQ Feb 2022

Can a LMSW who does not have a NPI complete the LPHA Recommendation Form for CORE?

An LMSW practicing under the supervision of an LCSW, licensed psychologist, or licensed psychiatrist is qualified to complete the LPHA Recommendation Form, even if they do not have an NPI. In this case, the LMSW should enter their license number on the recommendation and indicate on the form that a license number has been used instead. Please note that all Medicaid practitioners including Certified Peers and LMSW can apply to get an individual NPI at https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand/apply

Source: OMH & OASAS CORE FAQ Feb 2022

Is there a centralized list of current CORE Services providers?

A list of Designated CORE Service Providers is located on the CORE Website



Source: OMH & OASAS CORE FAQ Feb 2022

Will existing CORE providers have the opportunity to add new services to their designations?

The State anticipates accepting expansion applications from existing CORE providers in the coming months. Interested providers should contact the mailbox to discuss the process.

Source: OMH & OASAS CORE FAQ Feb 2022

If an agency offers Adult Behavioral Health Home and Community Based Services (BH HCBS), are they eligible to enroll as a Medicaid provider?

Adult BH HCBS is not an enrollable practitioner or agency type.

Source: OMH Medicaid Provider Enrollment Webinar 11.8.17