Archived Health Homes Serving Children Documents

Health Home Serving Children Information and Guidance

Additional Health Home Guidance for OMH TCM Providers and NYC IV–E VFCAs Regarding the "Pre–population" of the CANS–NY Assessment for Health Homes Serving Children (October, 2016)

The purpose of this communication is to provide additional guidance to certain Health Homes Serving Children care managers that are authorized by the Department to have access to the Uniform Assessment System (UAS–NY) to complete the CANS–NY assessments prior to the December 2016 enrollment/launch date of Health Homes Serving Children ("Pre–populate CANS–NY").

Pre–population access to the UAS–NY begins Monday, October 24, 2016

To ensure a smooth transition to the Health Home program the following care managers, which also meet the qualifications below, are authorized to add a CANS–NY assessments in the UAS–NY prior to Health Homes beginning in December 2016.

  • OMH TCM providers that will transition to the Health Home program.
  • Voluntary Foster Care Agencies (VFCA) that are IV–E agencies in New York City, that are also standing up a downstream Health Home care coordination line of business and the CANS–NY assessment tool in the ACS´ E–CANS system is identical to the Health Home CANS–NY assessment tool in the UAS–NY.
  • The IV–E waiver is only implemented in family foster care, which is ACS´s lowest level of care placement. Therefore, the Health Home eligible children should be a small subset of the overall family foster care population.
  • OMH TCM and VFCA/NYC providers must have Business Associate Agreements (BAAs) in place with at least one Health Home serving children.
  • OMH TCM and VFCA/NYC providers must have access to the Health Commerce System (HCS) and the Uniform Assessment System (UAS–NY) to have early access to the CANS–NY for their clients.
  • OMH TCM and VFCA/NYC providers must 1) be Health Home care manager staff that will provide HH care management services in December 2016, 2) have achieved a test score of 70 or above in Learner Nation and hold a current certification to conduct the CANS–NY AND, 3) must have completed all required training associated with using the UAS–NY
  • OMH TCM and VFCA/NYC providers must obtain consent (Functional Assessment Consent) from a parent, guardian or legally authorized representative (LDSS or VFCA in NYC for a child in foster care) to conduct the CANS–NY within the UAS–NY (see Consent Webinar held on August 17, 2016 for more information).

A webinar was held on September 7, 2016 for designated Single Point of Contact (SPOC) and/or the HCS Coordinator for agencies with early access to the UAS–NY. This webinar focused on the various UAS–NY roles and how to assign them to users and assessor of Health Home Care Management Agencies. Once the OMH TCM or VFCA/NYC assessor has been assigned a role within the UAS–NY and can gain access, they can begin the on–line UAS–NY required training. All required training must be completed to be able to gain access to add a new CANS–NY tool within the UAS–NY. Additionally, the UAS–NY team provided a live on–line training for early access users, "How to maneuver within the UAS– NY" to familiars users how to navigate within the UAS–NY system.

As indicated in correspondence provided to all Health Homes, Care Management Agencies and CANS– NY certified members, that before you can conduct a CANS–NY assessment in the UAS–NY, you must enter your HCS ID to the ´External GUID´ in your Learner Nation User Prolife. This requirement is necessary for the UAS–NY to verify users have a current active CANS–NY certification. If you have any questions regarding this, please contact UAS–NY Support Desk at: 518–408–1021 (option 1) during regular business hours.

IMPORTANT! Temporary Modifications to the UAS–NY during Pre–Population

Users should note that the UAS–NY has been modified to accommodate the access to the CANS–NY prior to the December begin enroll date and the December launch of the MAPP Health Home Tracking System (HHTS) referral portal for children. This pre–population period will allow authorized users from OMH TCM and VFCA/ NYC access to conduct the CANS–NY on children/ youth who are deemed eligible and appropriate for Health Home care management services. During this initial pre– population period, the UAS–NY will not allow users to sign and finalize completed CANS–NY assessments prior to the December begin enrollment date of children when users will have access to the MAPP HHTS referral portal. The algorithm that determines the Health Home rate acuity (i.e., High, Medium, or Low) cannot be run until the completed CANS–NY is finalized and therefore will not be run during the initial pre–population months in advance of the Health Home begin enrollment in December. Users may; however, use the published algorithms to determine High, Medium, Low acuity.

Completion of the CANS–NY after December 2016 Health Home Serving Children Go–Live

Beginning in December, care managers that have pre–populated a CANS–NY assessment tool for a child/youth should refer and enroll that child/youth (with consent) in a Health Home through the MAPP referral portal. Once the enrollment in a Health Home has been confirmed in MAPP, care managers must finalize the pre–populated CANS–NY in the UAS–NY. To finalize, the case manager must access the completed CANS–NY and select the name of the Health Home where the child/youth has been enrolled as confirmed within MAPP. The Health Home identified in the UAS–NY must be the same Health Home identified in MAPP to create a billable instance for the CANS–NY assessment fee.

At any time after the December 2016 Health Home Serving Children go–live date, if a signed and finalized CANS–NY within the UAS–NY identified Health Home and or member´s CIN number does not match what is in the MAPP HHTS, it will not be applied to an enrollment segment and a billable instance will not be created. In addition, a CANS–NY Assessment record will not be recorded in the Member´s Assessment Tab in the MAPP HHTS. The information in the CANS–NY assessment tool must be accurate in order to ensure compliance with MAPP.

The assessment within the UAS–NY application provides inherent checks and balances for the CANS–NY assessor to review the data prior to finalization. In the event of a Health Home name mismatch with MAPP, a new CANS–NY will have to be started and completed with the correct identifying information for a billable instance to be created. The on–line UAS–NY training will demonstrate this pre–population difference and will require pre–population assessors to update their training in December to ensure they understand the sign and finalize features that are not active during the early UAS–NY access period.

Actions required by the Pre–Population Provers when the MAPP HHTS Portal is Live
  • Effective in December 2016, OMH TCM and VFCA/NYC must refer and enroll children and youth who have a pre–populated UAS–NY CANS–NY tool through the MAPP HHTS Children´s Health Home Referral Portal for Health Home assignment. Providers must obtain verbal consent from a parent, guardian or legally authorized representative to make a referral for their members through the MAPP HHTS Referral Portal beginning in December 2016. Health Home consent forms will be posted to the website the week of October 24, 2016.
    • Please note that in cases where an OMH TCM child transitioning to Health Home care management is also currently in foster care, only the LDSS or VFCA in NYC will be able to make a referral within the MAPP HHTS Referral Portal and designate the Health Home Care Management Agency. The LDSS will provide consent to enroll the child in Health Homes and should work to provide seamless transition to the OMH TCM provider by selecting the OMH TCM Health Home Care Management Agency provider in MAPP HHTS.
  • As a reminder, the Health Home you enroll the child/youth in through the MAPP HHTS Referral Portal must align with your contracts and BAAs with Health Homes and if the member is enrolled in a Managed Care Plan, the Plan must also have an Administrative Services Agreement (ASA) contract with such Health Home. If this alignment is not present, the child should not be enrolled in that particular Health Home. The Department website has an up–to–date ASA tracker that indicates the alignment of Managed Care plans with Health Homes. Please note that Managed Care Plans are continuing to work with Health Homes to enter into ASA agreements, and this process may continue through at least November.
  • Proper consents to enroll and share information must be obtained prior to entering an enrollment segment within MAPP HHTS. (see Consent Webinar held on August 17, 2016 for more information)
  • Once the child/youth is enrolled and assigned to a Health Home, then the assessor should enter and verify the correct Health Home within the UAS–NY CANS–NY tool and matches such assignment within MAPP HHTS. The assessor can then complete the tool by signing and finalizing, which will lock the assessment and produce the outcome report with the algorithm acuity. Access to all reports will then be available.

All other care managers will have access to the CANS–NY Assessment tool in December 2016.
Beginning with the December 2016 begin enrollment date for children, all other care managers may begin to access the CANS–NY. As a reminder, to access the CANS–NY, care managers must have access to the HCS; must have completed all required training related to accessing the UAS–NY; and be CANS– NY trained and certified with a test score of 70 or above.

The DOH has shared guidance and posted to the DOH HHSC website the CANS–NY algorithm and the required types of documentation that should be obtained to assist assessors with completing the CANS–NY tool and informing the plan of care.

OMH TCM Providers, VFCA HH CM and all other care managers, LDSS and LGU/SPOAs will have access to MAPP HHTS Referral portal in December 2016. Billing for Health Home Care Management services for all providers will begin with dates of service on and after December 1, 2016.

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