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Psychosocial Rehabilitation (PSR) is designed to assist an individual in improving their functional abilities to the greatest degree possible in settings where they live, work, learn, and socialize. Rehabilitation counseling, skill building, and psychoeducational interventions provided through PSR are used to support attainment of person-centered recovery goals and valued life roles. Approaches are intended to develop skills to overcome barriers caused by a participant's behavioral health disorder and promote independence and full community participation. CORE PSR will incorporate allowable service components of Adult BH HCBS education, vocational, and habilitation services. CORE services are only available to individuals enrolled in a HARP or HIV SNP, and who have been recommended for CORE services by a Licensed Practitioner of the Healing Arts (LPHA).
OMH-designated Specialty Mental Health Care Management programs, administered by Specialty Mental Health Care Management Agencies (SMH CMAs), provide services to the Health Home Plus (HH+) population. HH+ is an intensive level of Health Home Care Management provided to defined high-need adult populations with serious mental illness who are enrolled in a Health Home (HH) serving adults. To ensure the intensive needs of these individuals are met, SMH CMs must assure HH+ individuals receive a level of service consistent with the requirements outlined in the Health Home Plus for High-Need Individuals with Serious Mental Illness Program Guidance. The differential monthly rate for HH+ is higher compared to the Health Home High Risk/Need Care Management and Health Home Care Management rates, and is intended to appropriately reimburse for the intense and consistent support needed for this population.
Health Home Care Managers provide comprehensive, integrated medical and behavioral health care management to Medicaid-enrolled individuals with chronic conditions to ensure access to appropriate services, improve health outcomes, and prevent avoidable hospitalizations and emergency room visits. Health Home Care Management (HHCM) services include health promotion; transitional care, including follow-up from inpatient to other settings; patient and family support; and referral to community and social support services. Agencies who are also Specialty Mental Health Care Management agencies should report under the Specialty Mental Health Care Management code (0780) and not report under 2730 program code, effective 1/1/22 (Upstate) and 7/1/22 (NYC).
A SPOA is a process, led by a SPOA Coordinator, that helps Local Governmental Units achieve community based mental health systems that are cohesive and well coordinated in order to serve those individuals most in need of services. There are three types of SPOAs - Children's, Adult Case Management and Adult Housing. The SPOA process provides for the identification of individuals most in need of services, and manages service access and utilization.
Habilitation services are typically provided on a 1:1 basis and are designed to assist participants with a behavioral health diagnosis (i.e. SUD or mental health) in acquiring, retaining and improving skills such as communication, self-help, domestic, self-care, socialization, fine and gross motor skills, mobility, personal adjustment, relationship development, use of community resources and adaptive skills necessary to reside successfully in home and community-based settings.
These services assist participants with developing skills necessary for community living and, if applicable, to continue the process of recovery from an SUD disorder. Services include things such as: instruction in accessing transportation, shopping and performing other necessary activities of community and civic life including self-advocacy, locating housing, working with landlords and roommates and budgeting. Services are designed to enable the participant to integrate full into the community and endure recovery, health, welfare, safety and maximum independence of the participant.
Programs that provide screening, diagnostic and treatment planning services for people who are experiencing acute or chronic psychiatric problems. Included is a continuum of assessment services ranging from a comprehensive psychiatric or psychological evaluation to the administration of one or a combination of psychological tests to examine a particular personality variable. Services may be provided in a variety of settings including hospitals and community-based clinics.
An apartment-based residential program which focuses on interventions necessary to address the specific functional and behavioral deficits which prevent residents from accessing generic housing. These interventions are goal-oriented, intensive, and usually of limited duration. Resident/staff contacts occur on a flexible schedule, as appropriate to the needs and desires of the resident. This is a type of Licensed Housing/Community Residential program for adults as defined in 14 NYCRR 595.
As one of the six Medicaid Funded Children's Health and Behavioral Health Services, CPST services are goal-oriented supports and solution-focused interventions intended to address challenges associated with a behavioral health need and to achieve identified goals or objectives from the child's treatment plan. CPST is a face-to-face intervention with the child/youth (required), family/caregiver or other collateral supports. Service components include intensive interventions, crisis avoidance and management, rehabilitative psychoeducation, strengths-based service planning and rehabilitative supports. Please reference the Medicaid State Plan Provider Manual for Children's BH Early and Periodic Screening and Diagnostic Testing (EPSDT) Services for definitions of service components and staffing requirements.
As one of the six Medicaid Funded Children┐s Health and Behavioral Health Services, CI services are mobile services provided to children/youth under age 21 who are identified as experiencing acute psychological/emotional change which results in a marked increase in personal distress and which exceeds the abilities and resources involved to resolve it effectively. CI is a face-to-face intervention that can occur in a variety of settings. CI is provided 24/7/365 and respond within 1 hour of the completion of the initial call to the crisis provider and upon determination that an in-person contact is required. Services are provided through a multi-disciplinary team to enhance engagement and meet the unique needs of the child/youth and family. The team must be comprised of at least two professionals and one of these two must be a licensed behavioral health professional with crisis intervention service delivery experience. Please reference the Medicaid State Plan Provider Manual for Children┐s BH Early and Periodic Screening and Diagnostic Testing (EPSDT) Services for specific service components and staffing requirements.