UPDATED

Referring Children in Foster Care and linking them to a Non-Voluntary Foster Care Agency (Non-VFCA) Health Home Care Management Agency (HH CMA)

  • Update is also available in Portable Document Format (PDF)

As the legal authorized representative, the LDSS has choice and may have very appropriate reasons for a child in foster care to be serviced by a non–VFCA HH CMA provider:

  • Continuity of Care with a current provider proving care management services
  • Based upon the parents Health Home and/or CMA provider
  • The child in foster care is not already connected to a VFCA provider
  • Connection to other service providers providing services to the child or family

The Medicaid Analytics Performance Portal Health Home Tracking System (MAPP) Health Home Tracking System (HHTS) was built for the LDSS to refer children in foster care and directly link to a VFCA who is also a Health Home Care Management Agency. However, the MAPP HHTS does not support the opportunity for the LDSS to choose a non–VFCA HH CMA.

(Please remember that a NYC VFCA in contract with ACS, can act in the capacity of a LDSS and would also have to follow the outline below if they wanted to assign a child in foster care to a non–VFCA).

Therefore, the following process has been developed to have a child in foster care assigned to a non–VFCA HH CMA for Health Home services:

Option 1: LDSS (NYC VFCA) contacts NYS DOH Health Home program at hhsc@health.ny.gov with the subject line of, "Child in Foster Care for Non–VFCA"

  • Within the email, include the contact name and phone number of the non–VFCA HH CMA that the LDSS wants as the HH CMA for the child in foster care
  • Within the email, confirm that the LDSS has custody and the child is in foster care
  • Reference the child in foster care within the email by the child´s initials ONLY i.e. CP
              Absolutely, No PHI should be given in an email
  • Only one child in foster care per email should be identified for tracking purposes
  • Within the email, indicate that you as the LDSS are consenting to refer the child for HH services
  • Within the email, include your name and contact information as well

The Health Home team will contact the non–VFCA HH CMA that was identified within the email, by phone to have a direct conversation with the non–VFCA HH CM, to gather the information to complete a referral and assignment of the child in foster care for the non–VFCA HH CMA. The non–VFCA HH CM should be prepared with the segment information (member CIN, segment type (outreach or enrollment), segment begin date, and consent to enroll date (if applicable)).

Then, on the monthly billing questionnaire, the non–VFCA HH CMA must indicate that the child is in foster care.

Please Note: That the non–VFCA HH CMA needs know the member´s information to assist with answering the questions to populate a HH referral and segment within the MAPP HHTS that DOH will complete while on the phone with the Non–VFCA HH CMA.

Option 2: The Non–VFCA Health Home CMA who the LDSS (NYC VFCA) has chosen as the HH CMA for the child in foster care, contacts NYS DOH Health Home program at hhsc@health.ny.gov with the subject line of, "Child in Foster Care for Non–VFCA"

  • Within the email, include your name and phone number so that the DOH can contact you directly
  • Reference the child in foster care within the email by the child´s initials ONLY i.e. CP
  • Only one child in foster care per email should be identified for tracking purposes
  • Within the email, provide the name and phone number of the LDSS (NYC VFCA) who has custody and wants to refer the child in foster care to your non–VFCA HH CMA
  • The email MUST include (an email correspondence) with the LDSS verification that they have custody of the foster care child (referenced by initials ONLY) and agree that the non–VFCA HH CMA can be assigned as the HH CMA and provide HH CM services
              (Absolutely, No PHI should be given in an email)

The Health Home team will contact the non–VFCA HH CMA by phone to have a direct conversation with the non–VFCA HH CM to gather the information to complete a referral and assignment of the child in foster care for the non–VFCA HH CMA. The non–VFCA HH CM should be prepared with the segment information (member CIN, segment type (outreach or enrollment), segment begin date, and consent to enroll date (if applicable)).

Then, on the monthly billing questionnaire, the non–VFCA HH CMA must indicate that the child is in foster care.

Please Note: That the non–VFCA HH CMA needs know the member´s information to assist with answering the questions to populate a HH referral and segment within the MAPP HHTS that DOH will complete while on the phone with the Non–VFCA HH CMA.

Health Home Serving Children
Division of Program Development and Management
New York State Department of Health
Office of Health Insurance Programs

January 20, 2017 Updated 3/29/17