Children's Consolidated Waiver Services (HCBS)

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

Extension of Deadline to Obtain Disability Determinations for Medically Fragile Children's Waiver Members

To:      Health Homes Serving Children (HHSC), Health Home Care Managers (HHCMs), and Child and Youth Evaluation Services (C-YES)

Date:   October 31, 2023

The deadline to obtain a Social Security Income (SSI) or a State Department of Health Disability Determination for Children's Waiver enrollees in Medically Fragile (MF) and Developmentally Disabled and Medically Fragile (DD/MF) Target Populations has been extended to April 1, 2024.

The Department of Health (DOH) provided guidance on April 7, 2023, requiring HHCMs/C-YES to obtain an SSI or Disability Determination for all Children's Waiver participants enrolled under the MF or DD/MF Target Populations by November 1, 2023.

HHCMs/C-YES should continue to request SSI or Disability Determinations for members of these two Target Population for HCBS reassessments; however, if the SSI or Disability Determination cannot be obtained timely, this should not delay the annual HCBS Eligibility Determination. In these instances, care manager should utilize the DOH 5151, DOH 5152 (if applicable), and DOH 5153 as documentation to support the HCBS Eligibility Determinations.

Additional information on the requirement to obtain a Disability Determination can be found in the following:

  • UPDATE: Changes to the Disability Documentation Process for the 1915c Children's Waiver - (PDF) - July 27, 2023
  • Guidance Regarding the Medically Fragile Disability Determination Requirement - (Web) - (PDF) - April 20231

Questions on this update can be directed to BH.Transition@health.ny.gov

___________________________

1. This document will be updated to reflect an April 1, 2024, deadline for obtaining the Disability Determination