Is there a cap for how many family members or collaterals the person may identify to receive adult Family Support Services?
No. The individual receiving this service is the one who decides which family members and other collaterals may be engaged in the service.
What are the requirements and expectations regarding supervision of peer support specialists/advocates for adults?
Per state issued guidance, supervision of peer support must be provided by a licensed behavioral health practitioner. The frequency of supervision should be determined as clinically appropriate.
If a provider were to use a certified peer from an existing program, would it affect the staffing plan of that program, e.g. a peer from a PROS program providing an adult Behavioral Health Home and Community Based Service (BH HCBS). Will peer time for the BH HCBS be subtracted from PROS staffing plan?
Yes. Sharing staff between your adult BH HCBS and other certified programs is allowed; however, the total time (FTE) that an employee spends on BH HCBS must be separated out on the CFR, and the PROS staffing plan must account for this.
For adult CPST what are the criteria for a “licensed professional,” and does a CASAC (Credentialed Alcoholism and Substance Abuse Counselor) meet these criteria?
CPST must be provided by "Professional Staff",” as defined in the BH HCBS Manual appendix. The manual qualifies that those licenses are issued via NYSED and are focused on the provision of direct services related to the treatment of mental illnesses and SUDs. The CASAC credential is a certificate issued by OASAS, and as such should not be included.
For adults, how is CPST different from outpatient clinic or ACT (Assertive Community Treatment)?
CPST is a Behavioral Health Home and Community Based Service (BH HCBS) available to individuals who are identified as having that need via the NYS Community Mental Health Assessment. It is a stand-alone service providing clinical mental health services to individuals in the community, at the intensity that best meets the individual’s needs. As opposed to outpatient clinic, CPST must be provided off-site, in the individual’s home or a community setting.
ACT is an evidence-based treatment approach targeting people who are resistant to traditional methods of
service delivery or for whom those approaches have not proven effective. There are specific treatment modalities employed, specific staff competencies and trainings proscribed; these are provided by closely monitored consistent teams specializing in a variety of disciplines and life areas, with a focus on ongoing monitoring and communication between all members via their daily Team Meeting. There is no provision in BH HCBS, or specifically CPST, for this intensity of service. The foundation of BH HCBS is that they are consumer-driven and recovery-oriented; they are not intended to address the intense engagement needs that ACT-appropriate consumers have.
Individuals receiving ACT services are not eligible for BH HCBS while they are receiving ACT services.
Can an adult OASAS-Certified Peer provide services to a mental health client and vice-versa?
OMH and OASAS certification programs are separate. The best practice would be for a peer specialist to have the certifications that aligns with the population with which he or she is working. For those working with the dually-diagnosed population, it is recommended that they have both certifications to be fully prepared to serve that population.
Often times adult peer support specialists provide support through phone, email, and texting. Can these activities be billed under adult Behavioral Health Home and Community Based Services (BH HCBS) Peer Support?
NYS recognizes that peer support specialists provide many valuable activities beyond face-to-face interventions. However, all BH HCBS must be provided face-to-face. Phone, e-mail, and texting would not be considered billable activities.
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.
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.
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.
Are adults who are actively using substances, who have a history of substance use, or who have a history of incarceration eligible for 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.
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.
Are adult 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.
Can adult CPST services and PSR services be provided concurrently, and if so, how will two different providers ensure that the combined 500-hour cap is not exceeded?
CPST and PSR may be provided concurrently. It will be important for providers to maintain contact with the Plan and Health Home Care Manager to ensure appropriate utilization management. Following an assessment, each provider will make recommendations regarding scope, duration, and frequency of the service. All BH HCBS are subject to utilization thresholds.
How are adult Psychosocial Rehabilitation (PSR) and adult Habilitation different?
The adult BH HCBS Provider Manual provides definitions of each service. PSR services are designed to assist the individual with compensating for or eliminating functional deficits and interpersonal and/or environmental barriers associated with their behavioral health disorder. Habilitation services are designed to assist individuals in acquiring, retaining, and improving skills necessary to reside successfully in home and community-based settings.
Where can families go to access Adult Home and Community Based (HCBS) Family Support Services?
In order for an individual (and their family) to access this service, they must go through an assessment process conducted by the Health Home Care Manager. Based on the results of the assessment, the Care Manager will work with the individual to determine which BH HCBS will be received. Even if an individual is eligible to receive this service, his or her family members may only be involved at the individual’s request.
What are the training and experience requirements for adult Family Support staff? Is there a credentialing process?
There is no certification or credentialing process specific to providers of Family Support and Training. This service may be provided by unlicensed staff who have at least a high school diploma or equivalent and 1-3 years of relevant experience working with individuals with behavioral health disorders. OMH-certified Peer Specialists and OASAS-certified Peer Advocates, CASACs, CASAC-T’s, and Certified Psychiatric Rehabilitation Practitioners (CPRPs) may also provide this service.
For adults, can Family Support & Training be offered to the individual alone to review and assess the plan, or does a family member need to be present in order to bill?
Family Support and Training is provided to family members at the individual's request. In order to bill for this service, a family member must be present.
Can you explain the group ratios for adult BH HCBS? The fees matrix has rates for groups of 2 or 3, but the HCBS Provider Manual indicates that you can have up to 16 individuals in a group.
Family Support and Training groups are limited to 2 or 3 families at a time, with no more than 16 individuals in any one group.