Common Questions, Helpful Answers

Health Home FAQs

  • What is a Health Home?

    The DOH defines it as "A ‘Health Home’ is not a place; it is a group of health care and service providers working together to make sure you get the care and services you need to stay healthy." In a Health Home, the caregiver and child are given a Care Manager.

  • What does a Care Manager do?

    The Care Manager is the dedicated point person helping connect the child/caregiver to supports and resources across a variety of domains. Care Managers generally meet their members face to face every month, while helping the caregiver throughout the month. Domains where a Care Manager may provide resources include: food insecurity, medical care coordination, school advocacy, and housing, access to transportation, and referrals to other community programs that will support and assist families with their specific needs.

  • What does the Enrollment process entail? How long is it?

    For eligible children, our friendly intake team helps the caregiver sign consent forms, collect documentation proving eligibility, and prepare the documents for submission. Eligible children who are on Medicaid can often be enrolled in a Health Home and assigned a Care Manager by the next month.

  • If a child is eligible for HCBS and wants to access those supports, what does the Care Manager do? 

    The Care Manager will work with the caregiver and the child's team to gather all documentation needed to prove their eligibility and will conduct a short assessment. Once the child is deemed eligible, the care manager will submit the referral to the family's HCBS agency of choice and advocate for a quick turnaround time to ensure that the child begins receiving HCBS supports immediately.

  • Do you have bilingual Care Managers?

    Yes! We have many bilingual Spanish-speaking Care Managers at this time.

  • Where do members meet their Care Manager at the monthly face to face?

    The Care Manager travels to the member's home or an agreed-upon meeting point nearby.

Health Home Eligibility

What are the requirements for Health Home Eligibility?

The Health Home program requires the following criteria for eligibility:

1. Applicant must be age 0-21 and actively enrolled in Medicaid;
2. Applicant must have a diagnosis of two or more chronic health conditions such asthma, diabetes, heart disease; or a single qualifying chronic condition such as HIV/AIDS, Serious Emotional Disturbance (adults), or Complex Trauma (children);
3. Applicant must demonstrate eligibility appropriateness criteria, such as lack of adequate family or housing support; learning or cognition issues; or recent psychiatric hospitalization.

HH Eligibility and Appropriateness Criteria

HH Eligibility: (ONE of the following. Must be diagnosed, documented and current)
-Two or more chronic conditions-Serious Emotional Disturbance-HIV/AIDS-Sickle Cell Disease-Complex Trauma

HH Appropriateness: (ONE of the following)

• Currently involved with ACS/CPS/DSS, Direct referral from school
(specific situations- suspension, truancy, grade failure etc)
• Referral from SPOA, DSS, LGU
• Inpatient admission in past 6 months
• Out of home placement in past 6 months (foster care, relative, residential facility)
• Recent diagnosis of terminal illness
• SSI/Disability Certification in past 6 months
• Unable to schedule appointments in past 3 months (unaware who their provider(s) is
and how to contact their provider(s)
• Doesn't have providers to treat HH qualifying diagnosis
• Has not seen providers in a year
• Current violence in home of member
• Food insecurity
• Currently homeless (in a shelter or living with different friends/family)
• Caregiver enrolled in a Health Home
• Member needs housing supports, Medicaid transportation/Access-a-ride, SSI, HEAP,
TANF, EI, HS, SPED
• Non adherent to medication or treatment
• Guardianship change in past 6 months

HCBS FAQs

  • What is HCBS?

    HCBS stands for Home and Community Based Services. HCBS services help families address medical, emotional, and behavioral needs, promoting the successful integration of each child into their daily routines, school, and community. Through HCBS, we support caregivers, enhance children's independence, and foster their skills, preparing them for success in community living and beyond. Some examples of HCBS services include Respite, CFASS (Caregiver Family Advocacy Supports Services), Community Habilitation, and Pre-Vocational Services.

  • Who is eligible?

    Children ages 0-21 who are medically fragile or struggling with severe mental health challenges. Please see below for all eligibility info. 

  • What does CFASS include?

    Supporting caregivers in managing their child’s condition and building pathways toward independence. Working with each individual's specific needs to foster success at home or in the community; Training in practical skills and strategies; Promoting self-advocacy with other professionals; Education on condition management and community resources.

  • What does Respite cover?

    Respite offers temporary relief to caregivers by having a provider taking care of the child’s needs, allowing families to recharge or manage other responsibilities.

  • How many hours of support can a child receive weekly?

    Each service type has a maximum allowed per week. Hours are determined based on the child's needs and schedule as HCBS services cannot be provided during school hours.

  • Who are the providers? How are they screened/trained?

    Our providers come from a large variety of backgrounds and with a wide range of skill sets. They go through rigorous screenings and background checks by the DOH to ensure they are able to work as an HCBS service provider. The Application process provides training and ongoing oversight and support.  

  • Where do sessions take place?

    Sessions can take place in a variety of settings, depending on the needs and preferences of the child. This includes the child's home, which provides a familiar and comfortable environment, or in community-based locations such as local parks, libraries, recreational centers, bowling alleys, or other public spaces. These community-based sessions allow for real-world experiences and opportunities for social engagement, skill-building, and behavior management in diverse environments. The flexibility to move between home and community settings ensures that interventions are dynamic and tailored to the child's unique circumstances and developmental needs.

HCBS Eligibility

What are the requirements for HCBS Eligibility?

The HCBS program requires the following criteria for eligibility:1. Children/youth aged 0-21;2. Applicant must be actively enrolled in Medicaid;3. Applicant must be a resident of New York State;4. Applicant must have a qualifying medical or mental health condition. 

Any one of the following 5 scenarios would make a child eligible to receive HCBS:

1. Medically Fragile (Children with SSI or Disability Certificate or who qualify for those)
2. Developmental Disability and are Medically Fragile
3. Developmental Disability and are in Foster Care
4. Have an SED (Serious Emotional Disturbance) AND be at imminent risk - Either be at risk of orapplied for or recently been in out of home placement (e.g. psychiatric hospital) - in the past 6 months.
5. Have an SED (Serious Emotional Disturbance) AND multi-system involvement as defined below (see next section)

Multi-System Involvement:

(Must be receiving clinical services and one additional service)
Clinical Services: clinic and treatment services for behavioral health (therapy, counseling, medication, OMH)Plus one of the following systems:
School: have an established IEP or 504 plan to address an identified disability or impairment which isimpacting the child's success in the school environment
Child Welfare: Child Protective Services, preventive services, or foster care
Juvenile Justice: arrest, PINS petition, Aftercare, Probation, or Parole
Department of Homeless Services: preventive services, housing assistance services or in a shelter
OASAS: In receipt of a service/s for a diagnosed substance use need by a certified OASASprovider/program

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At Yeled Long Island, we are dedicated to empowering families with the resources, support, and services they need to help children with disabilities thrive and reach their full potential.Connect with Yeled LI and let us transform lives together.

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