Children's HCBS Referral and Authorization Portal Frequently Asked Questions (FAQs)

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

This document summarizes frequently asked questions related to the Children’s Home and Community Based (HCBS) Referral and Authorization Portal within the Incident Reporting and Management System (IRAMS).

This FAQ document is meant to serve as a resource alongside the HCBS Referral and Authorization Portal User Guide.

Note: While the Portal is new, frequent minor updates may be implemented to improve system functionality. Users who are have difficulty viewing system updates are encouraged to refresh their page and clear their cache. Users can press “Shift + Refresh” in in their browser.

If technical issues persist, please contact the BH Transition Mailbox at BH.Transition@health.ny.gov.

Table of Contents

Referral Creation
Referral Timeline
Referral Process
Agency Waitlist
Statewide Waitlist
Policy
System Access
System Features
Alerts and Notifications
Supporting Documents
Records
General

Category	Question	Answer
Referral Creation	Who can make a referral for Children's HCBS in IRAMS?	The HHCM/C-YES has the ability to make a referral in the system under the Care Manager "Manage Child Referrals" role.
	Are there required fields on the HCBS referral form? Or will CMs be able to submit a form without entering all of the information?	Yes, most fields will be required. Some, that are related to situational circumstances, are optional. The system will not allow a submission of a referral without all required fields completed.
	What should HCBS providers do if they receive referrals that are missing required information (i.e., the CM has indicated "N/A" in required fields)?	Care managers are expected to provide all information requested in required fields. Referrals with incomplete information in required fields (i.e., N/A or similar responses provided) should be denied by HCBS providers. Repeated receipt of incomplete referrals should be reported to DOH by contacting BH.Transition@health.ny.gov.
	If an HCBS provider is working with a family and the family requests a new service, will a new referral need to be made in the portal by the CM?	Yes, a new referral will need to be made for each new service requested and needed. Children's Waiver policy requires that HCBS providers communicate with CMs to refer a new service and cannot serve a member for a new service without a CM referral.
	Should medically fragile eligible children/youth or children/youth in palliative care also have referrals completed through this system?	Yes, all children/youth enrolled in the Children's Waiver and in need of HCBS must have referrals created through the Referral and Authorization Portal.
	Will CMs need to input referrals for children/youth who are currently waitlisted for HCBS or just referrals for child/youths currently/active with HCBS?	Children/youth on a current HCBS provider's Agency Waitlist for services must have the CM make a new referral in the Referral and Authorization Portal to try and connect the child/youth to services. Phase II launch of the Referral and Authorization Portal will announce an abbreviated referral process for children/youth currently in services with HCBS providers to be referred by the CM and verified by the HCBS provider.
	Will all HCBS referrals be in IRAMS without specific agency referral?	All referrals must go through the Referral and Authorization Portal from a care manager. The HHCM/C-YES must determine which HCBS providers to send the referral to in the system and select the HCBS provider, based upon the choice of the member/family's wish, to provide services. Only providers who have been selected to receive the referral will be able to view the referral.
	Would the referrals reflect if the child/youth goes to a CR/hospital?	At the bottom of the Child Case Page in the Foster Care / Facility section, the HHCM/C-YES can indicate if a child/youth is currently in a facility at the time of referral. If a child/youth enters a hospital or other facility after the referral has been sent, the system will not automatically update to include this information.
	Would CMs be able to also refer to Agencies in neighboring counties?	No, referrals can only be made to providers designated for the county where the child/youth resides. FIPS Guidance FIPS FAQ (Question 18)
	CMA can refer to multiple Agencies at the same time, correct?	Correct, the CM can refer to multiple HCBS providers and multiple Agencies may accept the referral. Then, the CM can select one provider from the list of Agencies that accepted the referral.
Referral Timeline	How long does the HCBS provider have to respond to a referral?	The provider has seven (7) calendar days to respond to the referral.
	How long does the HHCM/C-YES have to respond once an HCBS agency has accepted the referral?	The HHCM/C-YES will have seven (7) calendar days to select the HCBS provider the member/family want to provide the referred service.
	What should the Care Manager do if they cannot get in contact with the family within 7 calendar days to confirm their choice of provider?	Prior to making a Referral for services, provider options should have been discussed with the member/family as well as potential capacity issues. When the CM creates the referral, they should have the member/family's first, second, and even third choice for providers so that the Care Manager can act as soon as they receive a referral response from the HCBS provider.
	How long does the HCBS provider have to schedule the first appointment once they have been selected?	The HCBS provider will have ten (10) calendar days from the day they were selected by the HHCM/C-YES to schedule the first appointment with the child/youth and their family/guardian.
	What if the provider cannot schedule an appointment with the child/youth within 10 days of being selected?	An HCBS provider should only accept the referral if they can begin serving the child/youth. If the HCBS provider is having difficulty scheduling due to the member/family , these efforts should be documented in a progress note and the HCBS provider should reach out to the CM for assistance in scheduling.
Referral Process	If multiple Agencies are selected to receive a referral, and one Agency "accepts", is the referral automatically rescinded from the other Agencies?	All Agencies who received a referral have the ability to accept the referral, as long as they do so within the required timeframe, and prior to the HHCM/C-YES closing the referral. All provider responses to the referral are sent back to the HHCM/C-YES. The HHCM/C-YES will select a provider based on the child/youth/family's choice and HCBS providers' response. Once the HHCM/C-YES selects an HCBS provider in the system, the other HCBS providers can continue to see the Child Summary Page for up to 15 days, however, no action can be taken by the HCBS provider.
	Is there a limit as to how many children in the same household are accepted to a single HCBS provider/agency?	Every child/youth has their own Child Case Page, and each child/youth has their own referral. The system does not "limit" the number of referrals to an HCBS provider.
	We don't see the Care Manager's information on the referral. In the place of "referred by" it shows the name of the person who opened the referral, so usually the HCBS Supervisor.	To view the referral, click "View Referral" from the Child Case Page to open the referral display. In the referral section, you will see the organization and user that created the referral along with their contact information under "Referred By". If the referral display does not open, please press "Shift + Refresh" in your browser.
	What happens if the HCBS provider places a child/youth on their waitlist and another agency accepts them? Does the child/youth get removed from the original agency's waitlist?	Once a CM selects an HCBS provider to provide services, other HCBS providers will be notified and will have access to the information for a limited period of time, however, no action can be taken by the other HCBS providers. If an HCBS provider has been selected to provide services, then the child/youth will not be on other HCBS providers' Agency Waitlists for that particular service.
	Will Care Managers be expected to enter all children/youth in the IRAMS system that are already in receipt of HCBS or on a provider's waitlist Prior to the launch of the electronic Referral Portal?	Children/youth on an HCBS provider's Agency Waitlist for services prior to the launch of the Referral and Authorization Portal will require new referrals in the Referral and Authorization Portal. Phase II of the system development will include an abbreviated referral process to refer children/youth already in receipt of HCBS. Additional information about this process will be shared shortly.
	What happens if an Agency accepts the referral but later can't serve the individual, is there a way to waitlist or reject the referral after accepted?	If after accepting a referral, an Agency determines that they cannot serve the child/youth, they can decline or waitlist the referral if it is prior to the CM selecting a provider. If your agency is selected but cannot provide the service, then your agency would "discharge" the child/youth selecting the reason why you cannot serve the child/youth in the system. The Care Manager will need to send new referrals to other providers if the service is still needed.
	Can HCBS providers accept the referral after having waitlisted the child/youth?	A child/youth can remain on an Agency's Waitlist for up to 90 days. The HCBS provider agency can "accept" that referral at any time within the 90 days, as long as the CM has not taken an action of selecting another HCBS provider, closing the referral, or withdrawing the referral from the provider agency.
	To clarify, once the HCBS provider accepts the referral, the HCBS provider cannot move forward until the CMA does something in the system?	Correct. All provider responses to the referral are sent back to the CM who will need to select the provider to serve the member based upon the choice of the member/family. Once the CM selects an HCBS provider in the system, the selected HCBS provider can proceed with contacting the family and scheduling an initial service appointment.
	Does a provider need to pick why they declined a referral?	Yes, providers will need to select from a drop-down menu their reason for declining a referral.
	Do provider agencies see that a youth was referred to multiple agencies?	The HCBS provider will be unable to see if the child/youth was referred to multiple agencies.
	If the family is currently served by a HCBS Agency and wants to switch to a different one, what is the process?	At this time, the child/youth/family or current HCBS provider can contact the HHCM/C-YES and make this request. The HHCM/C-YES will then enter the portal and create a new referral to refer to the desired new HCBS provider(s). The service for the previously active provider will be discharged. The HHCM/C-YES should be in communication with the HCBS provider when this situation occurs.
	What is the process for an HCBS staffing change and ensuring the CM is notified to refer the child/youth elsewhere?	When staff are no longer available at the agency, the HCBS provider should discharge the child/youth with the reason "staff not available for location" within 7 days of the staff change. The Care Manager will receive a notification of this status change within the system. The HHCM/C-YES then has the ability to create a new referral for the child/youth and may include the previous HCBS provider so that the HCBS provider may place the child/youth onto their Agency Waitlist.
	Will the child/youth still be able to get an HCBS service from one agency and choose another agency for the second service?	The HHCM/C-YES MUST complete a new referral for EACH HCBS service the child/youth is being referred for. It is permissible for a child to receive different HCBS from different HCBS providers. A child/youth cannot receive the same HCBS from different HCBS providers.
	If a child/youth is receiving one service and CM identifies an additional service that is needed, does the CM need to send another referral through IRAMS for the added service?	Yes, it is the case manager's responsibility to submit a referral through the Referral and Authorization portal for each identified needed service. Each HCB service is requested individually on its own referral.
	Will submission of the referral within IRAMS be communicated to MAPP?	No, the submission of the referral will not be communicated to MAPP.
	If a child/youth loses HCBS eligibility or is closed from HHCM, are the HCBS referrals automatically withdrawn/closed or does the CM need to do something in the system to remove them?	The system will not automatically close/withdraw a referral, but an alert will show in the system indicating the child/youth's circumstances (i.e., no Medicaid, no K1, etc.). HCBS providers cannot serve a participant who does not have active Medicaid or HCBS enrollment. The CM and HCBS provider should communicate about the child/youth's circumstance. If the child/youth is leaving the Waiver, the CM can discharge the child from services within the system. If the child/youth is transferring from the CMA/C-YES, to a CMA/C-YES, the new HHCM/C-YES will inherit the child/youth's case in the system. Once the case is transferred from one CMA/C-YES to another in HHTS, the child/youth's case and referrals will then transfer in the Referral and Authorization portal within 24 hours. Care managers won't receive a notification within the system, however any action needed on the case will appear in the HHCM/C-YES's Daily Digest notification.
	Will the HCBS providers be filtered to choose from contracted/ credentialed with MCOs? Or will that responsibility fall to the HCBS provider to confirm contracting status when accepting the request?	The HCBS provider is responsible for confirming Medicaid Managed Care Plan (MMCP) contracting status when determining ability to accept the referral request, as the system is unaware of MMCP contracting relationships.
	Does the HCBS provider need to receive a copy of the DOH 5201 Health Home consent form along with an HCBS referral?	No. The DOH 5201 provides the HHCM permission to share information about the member and is maintained in the HHCM's case file. Once the HCBS provider has been selected by the care manager as the HCBS provider, the HCBS provider will meet with the member/family and sign their own HCBS consent form that allows the HCBS provider to share information about the member. This form must be maintained in the HCBS provider's child case file.
Agency Waitlist	Can a child/youth stay on a waitlist with an HCBS Agency while also being referred to another HCBS agency?	A child/youth can be referred to multiple providers until one is selected and active. Once a referral becomes active for a service with a provider, the referral will be removed from all other waitlists for that service.
	When accepting a referral, if there is a waitlist due to staffing, should we not accept the referral?	Referrals should only be accepted if there is staff identified to provide the requested service(s). If the agency doesn't immediately have staff but believes they will have staff available to serve the child/youth within the next 90 days, the agency may choose to "waitlist" the child/youth and add the child/youth to their Agency Waitlist.
	Once the waitlist is merged to the new system, will the HCBS provider be able to update the waitlist, or will that only be able to be added/edited by the HHCMs?	The previous Capacity Waitlist will not be transferred to the new Referral and Authorization Portal. Children/youth who are not currently being served that were previously on a waitlist must have a new referral made within the Referral and Authorization Portal for an HCBS provider to respond to.
	Can Care Managers see where the child/youth is waitlisted?	Yes, HHCMs/C-YES and HH staff with proper permissions granted within the Referral and Authorization Portal can see responses to referrals and those referrals waitlisted.
	After the 90-day Agency Waitlist is a new referral needed?	After 90 days, the child/youth will move to the Statewide Waitlist and the referral will remain open. At this time, the HHCM/C-YES can send the referral to additional HCBS providers and/or re- send to the HCBS provider who initially added the referral to their Agency Waitlist.
Statewide Waitlist	If the child/youth is moved to the Statewide Waitlist after the Agency Waitlist expires, how long will they remain there?	The Statewide Waitlist never expires. The HHCM/C-YES can close the referral or send the referral to an additional HCBS provider which will take the child/youth off the Statewide Waitlist.
	Can other Agencies see the referrals on the Statewide Waitlist, if they did not get the referral?	HCBS providers will not be able to see children/youth on the Statewide Waitlist.
	If a child/youth goes to the Statewide Waitlist and then the provider has staff available later will they be able to "reclaim" that referral?	Agencies will be unable to view the Statewide Waitlist. However, Agencies may communicate their availability outside the portal to the HHCM/C-YES, who can then send the referral back to the HCBS provider within the system, if they choose.
Policy	How are we proving referral sent for audits?	This information will be accessible through the portal by the audit team.
	Will providers still have to complete the service capacity survey every three weeks after the electronic HCBS Referral Portal has launched?	No, this is no longer required after 6/17/24.
System Access	Can a user see both HCBS provider information and Care Manager information if their agency has both lines of work?	No, if a user's agency has multiple lines of business (i.e., both HCBS providers and Care Managers), a user for one line cannot see the other line's information.
	Is it okay for one user to have both a View Child Referrals Role and Manage Child Referrals Role?	No, a user should not be assigned both roles. The Manage Child Referrals Role provides the same capabilities as the View Child Referrals Role plus the additional ability to manage referrals.
	Do HCBS providers all need to gain access to IRAMS?	All HCBS Provider Agencies must have access to IRAMS. Each Agency should determine which staff members should have access to the system. Not all HCBS staff require access to IRAMS.
	What is the website where the portal will be accessible?	IRAMS is accessed through the Health Commerce System (HCS). Users can search the applications within HCS.
	Will Managed Care Organizations (MCOs) have access to IRAMS?	At this time, MCOs will not have access to the Referral and Authorization Portal within IRAMS, however, it is a future plan.
System Features	Will providers and Care Managers be able to print out referral forms from the system for our records?	Yes, users will have the ability to download and print a PDF version of the Referral Form after an HCBS provider has been selected.
	If a provider accepts and the Care Manager does not select the provider, can they print the referral?	After an HCBS provider accepts a referral, the HHCM/C-YES must select an HCBS provider to start services. There may be more than one HCBS provider and the HHCM/C-YES may be waiting for other responses. Once a selection is made, the chosen HCBS provider may print the completed referral in PDF format. If the HCBS provider is not selected by the care manager, the ability to download/print the referral will not be present for the provider.
	Will users be able to see if someone made an update to the Child Case Page in IRAMS?	Yes, users with access to this information will be able to see historical data of any changes that was made or updated.
	Can HCBS providers update a child/youth's case in IRAMS?	HCBS providers with the Manage Child Referral Role who are serving the participant (i.e., have been selected by the HHCM/C-YES) and HHCM/C-YES with the Manage Child Referral Role will be able to update the child/youth's case information in IRAMS.
	Can a previous HCBS provider see the Child Case file?	An HCBS provider who previously served a child/youth, but no longer serves a child/youth will have access to limited details about a child/youth relevant to their time with the Agency.
	Will child/youth demographic information prepopulate from MAPP or UAS?	A number of fields will be pre-populated from various systems. Health Home information is auto populated from MAPP, assessment information is from UAS, and Medicaid information is from the Medicaid Data Warehouse.
	Will HCBS providers have access to information such as other HCBS providers for other services working with the child/youth or tracking information of other previous Agencies / previous authorizations, as MAPP has for HHCMs?	At this present time, these system features will not be available.
	Will the annual LOC populate in this system?	Yes, this information will be pre- populated in IRAMS, when available.
	Will this system provide HCBS providers a notification if MCOs change?	Notification of MCO change is not currently an included system feature. However, the Child's Case Page will show the current MCO information.
	Can the IRAMS portal hold updated documents such as POC, LOC Crisis plan?	At this present time, this capability is not available.
	Will there be a release for the data side of things, like UAS? IE seeing what information gets communicated back to MAPP	At this time, no information is being transmitted from IRAMS to other systems. Future system updates to allow certain information sharing between IRAMS and MAPP are currently in development.
	Does it list out the criteria such as MEDF or SED and will there be more availability for MEDF with this system?	Participant Target Population is listed on the Child Case Page. The Child Case Page is available to care managers and HCBS providers who have received a referral for the child/youth.
	How will the HCBS provider document the Frequency, Scope, and Duration in this system?	Frequency, Scope, and Duration will continue to be documented outside of the system at this time. The current release of the portal does not include HCBS Authorization features.
Alerts and Notifications	Is there going to be an indicator somewhere that the LOC approval is due?	An alert will show in the system indicating the child/youth circumstances (i.e., no Medicaid, no K1, etc.). HCBS providers cannot serve a participant who does not have active Medicaid or HCBS enrollment. The CM and HCBS provider should communicate about the child/youth's circumstance.
	What notifications are sent to the CM and providers?	A daily digest will be emailed out with the following information: HHCM/C-YES selections available, due within 3 days, or late HCBS responses due within 3 days, expiring in 3 days, or late Waitlists expiring within 5 days Counts of Statewide Waitlist Counts of Agency Waitlist In addition to the daily digest, HCBS providers will receive a notification when they receive a new referral.
	What alerts are within the system?	Alerts on Child Records within the system will include Late action, Action due soon, and Expiring record. Alerts are also present in the record to indicate if a child/youth has an expired LOC, is not enrolled in Medicaid, or is missing K Codes.
	If providers are serving a child/youth and the LOC/HCBS eligibility is lost/lapses will providers get a notification?	No, providers will not receive a notification in this instance. However, the system will include an icon on the child/youth's page to indicate that their LOC has expired and/or that they are missing K Codes.
	Is there going to be an indicator somewhere that the LOC is current?	Yes, CMs and providers will be able to see that LOC is current on the Child Case Page.
	Will the Release of Information (ROI) info from the Care Manager be provided on the referral information in the system?	No, ROI information will not be provided through the system.
Supporting Documents	Can supporting documents be sent to the providers immediately to send to the MCO to get authorization?	It is the responsibility of the HCBS provider to obtain documentation necessary to support an HCBS Authorization request. This documentation is not currently able to be obtained through the portal.
	Will HCBS providers be eligible to request information from CMA about needs of the youth in addition to what is provided on the electronic referral to make sure we are a good fit for the child/youth?	The electronic referral is intended to capture all required information to allow an HCBS provider to determine whether or not they can accept a referral. If the HCBS provider has additional questions, they should contact the HHCM/C-YES directly, outside of the portal.
	When a HCBS Provider Agency requests additional documents from the HHCM/C-YES (POC, NOD, etc.) can those documents be sent through the IRAMS system to the HCBS Provider Agency? Or will those documents still need to be sent via email/fax?	NYSDOH does not require HHCM/C-YES to share the child/youth's POC or NOD with the HCBS provider. If, for some reason this information is needed by the HCBS provider, this documentation would need to be provided outside of IRAMS. The uploadno function is a future build of the system.
	For an audit/per our compliance team we need all forms such as LPHA, LOC and POC. Since the dates are on IRAMS we are allowed to accept the referral before obtaining the actual hard copies? will there be a protocol for HCBS Agencies to get these documents?	The forms are not required to be on file for HCBS providers.
	What if providers want to request additional information/documents about the child/youth?	Care Managers should be including enough information in the referral so that providers can make a decision about whether or not they can provide service without needing additional information. The portal currently does not support the upload of additional documents. If there is a need to obtain additional information, this request would need to be fulfilled outside of the system.
	Are we able to link the DSPs/Staff to the child/youth's case to show who is the staff providing the service to the child/youth?	This feature is not currently available in the system but will be added in future updates.
Records	Will the Child Case Page update if the child/youth moves from straight Medicaid to an MCO or if they change MCO's?	Yes, Medicaid enrollment information will be updated automatically on the Child Case Page once an update is available.
	How can updates to the child/youth's information be made?	The Child Case Page can be updated by the CM and/or the selected HCBS provider. The user must have the Manage Child Referrals role in the system in order to make these updates.
General	Where will webinar slides be posted?	Slides from the Overview of the Children's HCBS Electronic Referral Portal webinar can be accessed here. A posting of the Webinar recording will follow.