These videos give an overview of the various Home and Community-Based Services (HCBS) available in New York for providers who want to learn how to start or operate an HCBS agency in the state. Each video explains the purpose of the service, provider requirements, licensing process, and how the program functions. Use these videos to better understand the responsibilities, standards, and steps involved in becoming or working with approved HCBS providers in New York. Explore each section to find the service that best matches your goals or area of interest.
Respite Care
RESPITE CARE SERVICES PROVIDER IN NEW YORK
PROVIDING TEMPORARY RELIEF AND SUPPORT TO CAREGIVERS THROUGH COMPASSIONATE AND PROFESSIONAL CARE SERVICES
Respite Care Services in New York provide temporary, short-term care for individuals with disabilities, chronic conditions, or age-related challenges, allowing caregivers to take a break from their duties. These services are delivered in the individual’s home or in community-based settings, focusing on safety, supervision, and personalized care. Respite Care Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Respite Care Services and manages provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for respite services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for respite care programs serving individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring Medicaid-funded Respite Care Services meet safety, quality, and person-centered care standards.
2. RESPITE CARE SERVICES OVERVIEW
Respite Care Services offer caregivers temporary relief from their responsibilities while ensuring that the individual’s care needs are met. Services can be scheduled or provided on an emergency basis.
Approved providers may deliver:
Personal Care Support: Assistance with hygiene, grooming, and daily living activities.
Supervision and Safety Monitoring: Ensuring a safe environment during the caregiver’s absence.
Medication Administration: Managing prescribed medication regimens.
Recreational Activities: Engaging individuals in activities that promote physical and mental well-being.
Companionship: Offering social interaction to reduce isolation.
Health Monitoring: Checking vital signs and observing overall well-being.
Behavioral Support: Addressing emotional and behavioral needs during care.
Transportation Assistance: Helping individuals access community activities or medical appointments.
Crisis Intervention: Providing immediate support during emergencies or changes in health status.
Documentation: Maintaining accurate records of services delivered and care outcomes.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Respite Care provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for respite care, emergency response, and safety protocols.
Ensure staff complete required background checks, health screenings, and respite care training.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Respite Care Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, respite care policies, and staff training documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including safety protocols, staff qualifications, and caregiver support plans.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Respite Care Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Respite Care Policy & Procedure Manual including:
Care planning and individualized support procedures
Safety, supervision, and health monitoring protocols
Emergency response and crisis intervention guidelines
Staff credentialing, background checks, and ongoing training records
Documentation standards for care tracking and Medicaid billing
HIPAA compliance, participant rights, and grievance handling
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Respite Care Program Director
Requirements: Bachelor’s or Master’s degree in social work, healthcare administration, or a related field; experience in program management and caregiver support.
Role: Respite Care Aides
Requirements: High school diploma or equivalent; experience in personal care assistance and caregiving; background clearance.
Role: Certified Nursing Assistants (CNAs)
Requirements: CNA certification; experience in direct patient care and supervision; background clearance.
All staff must complete:
Training in caregiver relief, safety protocols, and health monitoring
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety and crisis intervention training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Respite Care Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Children’s Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Respite Care Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK RESPITE CARE SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Respite Care Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for caregiver support and emergency response
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and caregiver outreach strategies
Quality assurance systems for respite care and compliance monitoring
Collaboration with healthcare providers and community organizations
Residential Habilitation
RESIDENTIAL HABILITATION SERVICES PROVIDER IN NEW YORK
DELIVERING PERSONALIZED SUPPORT TO PROMOTE INDEPENDENCE AND LIFE SKILLS IN COMMUNITY-BASED SETTINGS
Residential Habilitation Services in New York support individuals with developmental disabilities or other special needs in acquiring, maintaining, and improving skills necessary for living independently. These services are delivered in home-like residential settings, focusing on personal care, daily living skills, and community integration. Residential Habilitation Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Residential Habilitation Services and manages provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for residential services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for residential programs serving individuals with mental health conditions.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring Medicaid-funded Residential Habilitation Services meet quality and person-centered care standards.
2. RESIDENTIAL HABILITATION SERVICES OVERVIEW
Residential Habilitation Services are designed to enhance independence and community integration through individualized support and training in daily living skills.
Approved providers may deliver:
Personal Care Assistance: Support with grooming, dressing, hygiene, and meal preparation.
Skill Building: Training in cooking, cleaning, and managing personal finances.
Community Integration: Facilitating social interactions and community involvement.
Health and Safety Training: Teaching emergency response and personal safety techniques.
Behavioral Support: Implementing positive behavior support plans as needed.
Self-Advocacy Skills: Encouraging decision-making and self-determination.
Recreational Activities: Organizing community outings and group activities.
Transportation Support: Assistance with accessing community services and events.
Documentation: Maintaining records of individualized service plans (ISP) and progress reports.
All services are delivered according to the Individualized Service Plan (ISP) to meet the participant’s specific goals and support needs.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Residential Habilitation provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for residential care, community integration, and person-centered planning.
Ensure staff complete background checks, health screenings, and habilitation training.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Residential Habilitation Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, habilitation policies, and staff training documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including residential safety protocols, staff qualifications, and care standards.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Residential Habilitation Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Residential Habilitation Policy & Procedure Manual including:
Daily living skills training and support procedures
Community integration and socialization guidelines
Safety and emergency response protocols
Staff credentialing, background checks, and ongoing training records
Documentation standards for care tracking and Medicaid billing
HIPAA compliance, participant rights, and grievance handling
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Residential Program Director
Requirements: Bachelor’s or Master’s in social work, human services, or healthcare administration; experience in residential care and program management.
Role: Direct Support Professionals (DSPs)
Requirements: High school diploma or GED; habilitation training preferred; experience working with individuals with developmental disabilities; background clearance.
Role: Habilitation Specialists
Requirements: Bachelor’s degree in human services or related field; experience with skill building and community integration.
All staff must complete:
Training in person-centered planning, habilitation techniques, and community engagement
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety, crisis intervention, and emergency response training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Residential Habilitation Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Residential Habilitation Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK RESIDENTIAL HABILITATION SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Residential Habilitation Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for residential care and community integration
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and community outreach strategies
Quality assurance systems for residential care and compliance monitoring
Collaboration with healthcare providers and community organizations
Pre-vocational Services
PRE-VOCATIONAL SERVICES PROVIDER IN NEW YORK
PREPARING INDIVIDUALS FOR EMPLOYMENT THROUGH SKILL DEVELOPMENT AND WORKPLACE READINESS TRAINING
Pre-Vocational Services in New York support individuals with disabilities by providing training and skill development to prepare them for employment. These services help participants gain the soft and hard skills necessary for competitive or supportive employment, enhancing their independence and self-sufficiency. Pre-Vocational Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Pre-Vocational Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for pre-vocational services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for programs that support employment readiness for individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Pre-Vocational Services meet quality, safety, and person-centered care standards.
2. PRE-VOCATIONAL SERVICES OVERVIEW
Pre-Vocational Services are designed to help individuals develop general skills that contribute to employment readiness. These skills are not specific to a particular job but are foundational for workplace success.
Approved providers may deliver:
Job Readiness Training: Developing punctuality, time management, and workplace etiquette.
Skill Building: Enhancing communication, teamwork, and problem-solving abilities.
Work Simulation: Practicing tasks commonly encountered in various employment settings.
Career Exploration: Assisting individuals in identifying career interests and job goals.
Social Skills Training: Building interpersonal skills for workplace interactions.
Personal Development: Boosting confidence, self-advocacy, and motivation.
Resume and Interview Preparation: Assisting with job applications and interview practice.
Community Integration: Engaging in volunteer work or internships to build experience.
Documentation: Maintaining records of progress, skill assessments, and training outcomes.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Pre-Vocational Services provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for vocational training, skill development, and community integration.
Ensure staff complete required background checks, health screenings, and vocational training certification.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Pre-Vocational Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, vocational training policies, and staff training documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including training curricula, safety measures, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Pre-Vocational Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Pre-Vocational Services Policy & Procedure Manual including:
Training plans and job readiness curricula
Skill assessment and progress tracking procedures
Staff credentialing, background checks, and ongoing training records
Documentation standards for training activities and Medicaid billing
HIPAA compliance, participant rights, and grievance handling
Safety protocols for community-based training and work simulation
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Pre-Vocational Program Director
Requirements: Bachelor’s or Master’s degree in vocational rehabilitation, human services, or education; experience in workforce development and program management.
Role: Job Coaches/Vocational Trainers
Requirements: Certification in job coaching or vocational training; experience in workforce development and client advocacy.
Role: Career Specialists
Requirements: Bachelor’s degree in counseling, human resources, or a related field; experience in career planning and job placement.
All staff must complete:
Training in vocational assessment, skill building, and client interaction
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety, emergency response, and community engagement training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Pre-Vocational Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Pre-Vocational Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK PRE-VOCATIONAL SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Pre-Vocational Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for vocational training and job readiness
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and community outreach strategies
Quality assurance systems for vocational services and compliance monitoring
Collaboration with employers, community organizations, and support agencies
Personal Care
PERSONAL CARE SERVICES PROVIDER IN NEW YORK
SUPPORTING INDIVIDUALS IN MAINTAINING INDEPENDENCE THROUGH PERSONAL ASSISTANCE AND DAILY LIVING SUPPORT
Personal Care Services in New York assist individuals with disabilities, chronic conditions, or age-related challenges by providing hands-on support with daily living activities. These services help individuals remain in their homes while maintaining their independence and quality of life. Personal Care Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Personal Care Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for personal care services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for personal care programs serving individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Personal Care Services meet quality, safety, and person-centered care standards.
2. PERSONAL CARE SERVICES OVERVIEW
Personal Care Services involve hands-on assistance and supervision to support individuals with daily living activities, personal hygiene, and household tasks.
Approved providers may deliver:
Personal Hygiene Assistance: Bathing, grooming, oral care, and dressing.
Mobility Support: Assisting with transfers, walking, and positioning.
Meal Preparation and Feeding: Planning, cooking, and assisting with eating.
Medication Reminders: Ensuring adherence to prescribed medication schedules.
Household Tasks: Light housekeeping, laundry, and maintaining a clean environment.
Toileting Assistance: Helping with bathroom needs and continence care.
Companionship: Providing social interaction and emotional support.
Escort and Transportation: Accompanying individuals to medical appointments or community activities.
Safety Monitoring: Ensuring a secure environment to prevent accidents and falls.
Documentation: Maintaining records of care provided and daily activities.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Personal Care provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for personal care, client safety, and daily living support.
Ensure staff complete required background checks, health screenings, and personal care training.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Personal Care Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, care policies, and staff training documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including client safety protocols, staff qualifications, and care standards.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Personal Care Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Personal Care Policy & Procedure Manual including:
Personal hygiene and daily living assistance protocols
Safety and mobility support procedures
Medication reminders and adherence guidelines
Staff credentialing, background checks, and ongoing training records
Documentation standards for care tracking and Medicaid billing
HIPAA compliance, participant rights, and grievance handling
Emergency response and safety protocols
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Personal Care Services Program Director
Requirements: Bachelor’s or Master’s degree in social work, healthcare administration, or a related field; experience in program management and client care.
Role: Personal Care Aides (PCAs)
Requirements: High school diploma or equivalent; completion of approved personal care training program; experience in direct client care; background clearance.
Role: Certified Home Health Aides (HHAs)
Requirements: Completion of a state-approved HHA training program; certification; experience in personal care and health monitoring.
All staff must complete:
Training in personal care, safety, and client interaction
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety, emergency response, and infection control training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Personal Care Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Personal Care Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK PERSONAL CARE SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Personal Care Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for personal care and client safety
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and community outreach strategies
Quality assurance systems for personal care and compliance monitoring
Collaboration with healthcare providers and community organizations
Adaptive Equipment
ADAPTIVE EQUIPMENT SERVICES PROVIDER IN NEW YORK
ENHANCING INDEPENDENCE AND MOBILITY THROUGH CUSTOMIZED ADAPTIVE EQUIPMENT SOLUTIONS
Adaptive Equipment Services in New York provide individuals with disabilities or mobility challenges access to specialized devices that promote independence, safety, and enhanced quality of life. These services include the assessment, acquisition, customization, and maintenance of equipment tailored to meet individual needs. Adaptive Equipment Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Adaptive Equipment Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for adaptive equipment services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for adaptive equipment programs serving individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Adaptive Equipment Services meet quality, safety, and person-centered care standards.
2. ADAPTIVE EQUIPMENT SERVICES OVERVIEW
Adaptive Equipment Services involve evaluating an individual’s needs, acquiring the necessary equipment, customizing it for usability, and maintaining it for long-term use.
Approved providers may deliver:
Needs Assessment: Identifying the individual’s physical, mobility, and environmental needs.
Equipment Selection: Recommending appropriate adaptive devices based on assessment outcomes.
Customization: Modifying equipment to ensure comfort, usability, and safety.
Installation and Setup: Placing and configuring equipment within the individual’s home or community setting.
Training and Education: Instructing individuals and caregivers on proper use and maintenance.
Maintenance and Repair: Providing ongoing technical support and equipment repairs.
Safety Inspections: Ensuring that adaptive devices remain safe and functional.
Documentation: Maintaining records of assessments, equipment installations, and follow-up services.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Adaptive Equipment provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for equipment assessment, installation, and maintenance.
Ensure staff complete required background checks, health screenings, and training in adaptive equipment handling.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Adaptive Equipment Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, equipment policies, and staff training documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including equipment safety protocols, customization standards, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Adaptive Equipment Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Adaptive Equipment Policy & Procedure Manual including:
Needs assessment and equipment selection protocols
Installation, customization, and safety inspection procedures
Staff credentialing, background checks, and ongoing training records
Documentation standards for service tracking and Medicaid billing
HIPAA compliance, participant rights, and grievance handling
Maintenance, repair, and quality assurance procedures
Emergency response and equipment failure protocols
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Adaptive Equipment Program Director
Requirements: Bachelor’s or Master’s degree in rehabilitation technology, biomedical engineering, or healthcare administration; experience in adaptive technology and program management.
Role: Adaptive Equipment Specialists
Requirements: Certification in rehabilitation engineering or assistive technology; experience in device customization and installation.
Role: Maintenance Technicians
Requirements: Experience with adaptive equipment maintenance, safety inspections, and repairs; technical certification preferred.
All staff must complete:
Training in adaptive device handling, safety protocols, and user education
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety, emergency response, and troubleshooting training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Adaptive Equipment Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Adaptive Equipment Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK ADAPTIVE EQUIPMENT SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Adaptive Equipment Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for equipment assessment and customization
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and client outreach strategies
Quality assurance systems for adaptive equipment management and compliance monitoring
Collaboration with healthcare providers, rehabilitation specialists, and community organizations
Skilled Nursing
SKILLED NURSING SERVICES PROVIDER IN NEW YORK
DELIVERING COMPREHENSIVE AND HIGH-QUALITY SKILLED NURSING CARE FOR INDIVIDUALS IN HOME AND COMMUNITY SETTINGS
Skilled Nursing Services in New York support individuals with complex medical needs by providing clinical care, health monitoring, and rehabilitative services in home and community environments. These services are essential for individuals requiring long-term medical support, post-hospitalization care, or ongoing management of chronic conditions. Skilled Nursing Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Skilled Nursing Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: New York State Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for skilled nursing services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance with mental and behavioral health regulations within skilled nursing care.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Offers federal oversight to ensure Medicaid-funded Skilled Nursing Services meet quality standards, patient safety, and person-centered care practices.
2. SKILLED NURSING SERVICES OVERVIEW
Skilled Nursing Services include the delivery of clinical care by licensed healthcare professionals, focusing on health maintenance, rehabilitation, and preventive care.
Approved providers may deliver:
Wound Care: Monitoring and managing wound healing, including pressure ulcers and surgical sites.
Medication Administration: Ensuring safe and accurate medication delivery, including injections and infusions.
Chronic Disease Management: Providing ongoing care for conditions such as diabetes, hypertension, and respiratory disorders.
Health Assessments: Conducting comprehensive physical exams and health evaluations.
Rehabilitative Nursing: Supporting mobility, physical therapy, and post-operative recovery.
Patient and Family Education: Teaching self-care techniques and health management strategies.
Vital Sign Monitoring: Tracking blood pressure, glucose levels, heart rate, and respiratory function.
Care Coordination: Collaborating with healthcare teams to maintain continuity of care.
End-of-Life Care: Offering palliative and hospice care, ensuring patient comfort and dignity.
Documentation: Maintaining accurate health records and care plans.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Skilled Nursing provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general and professional liability insurance.
Develop policies for clinical care, medication management, and patient safety.
Ensure nursing staff complete required background checks, health screenings, and licensure verifications.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Skilled Nursing Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, clinical policies, and staff licensure documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including clinical protocols, patient safety measures, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Skilled Nursing Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Skilled Nursing Policy & Procedure Manual including:
Clinical care protocols and medication management
Infection control measures and hygiene standards
Staff credentialing and training records
Documentation standards for care and Medicaid billing
HIPAA compliance, patient rights, and safety protocols
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Nursing Director
Requirements: Registered Nurse (RN) license, Bachelor’s or Master’s in Nursing; experience in clinical supervision.
Role: Skilled Nurses (RNs and LPNs)
Requirements: Active state license, clinical experience in home health care or long-term care; CPR and BLS certifications.
Role: Nursing Assistants
Requirements: Certified Nursing Assistant (CNA) certification; experience in patient care and safety.
All staff must complete:
Training in infection control, medication administration, and chronic disease management
HIPAA compliance and patient rights education
Annual competency evaluations
Safety and emergency response training
Documentation and care coordination best practices
7. MEDICAID WAIVER PROGRAMS
Skilled Nursing Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Home and Community-Based Services (HCBS) Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Skilled Nursing Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK SKILLED NURSING SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Skilled Nursing Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Clinical protocol development and patient safety compliance
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and patient outreach strategies
Quality assurance systems for nursing care and compliance monitoring
Collaboration with healthcare providers and community organizations
Day Habilitation
DAY HABILITATION SERVICES PROVIDER IN NEW YORK
SUPPORTING PERSONAL GROWTH AND COMMUNITY INTEGRATION THROUGH STRUCTURED DAY PROGRAMS
Day Habilitation Services in New York offer structured, community-based programs designed to support individuals with developmental disabilities or chronic conditions in achieving greater independence and community engagement. These services focus on skill development, socialization, and personal growth in a safe and supportive environment. Day Habilitation Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Day Habilitation Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for day habilitation services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for day programs serving individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Day Habilitation Services meet quality, safety, and person-centered care standards.
2. DAY HABILITATION SERVICES OVERVIEW
Day Habilitation Services provide individuals with opportunities to develop essential life skills, engage in social and recreational activities, and participate in community integration.
Approved providers may deliver:
Skill Development: Focusing on communication, socialization, and daily living skills.
Personal Enrichment: Activities that build self-confidence and independence.
Community Participation: Outings and group activities to encourage social inclusion.
Health and Wellness Programs: Promoting physical activity and healthy habits.
Recreational Activities: Arts, crafts, music, and other therapeutic engagements.
Behavioral Support: Addressing challenging behaviors with positive interventions.
Life Skills Training: Cooking, budgeting, and using public transportation.
Self-Advocacy Training: Encouraging participants to express their needs and preferences.
Safety and Supervision: Ensuring a secure environment for daily activities.
Documentation: Maintaining accurate records of progress, participation, and outcomes.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Day Habilitation provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for daily programming, safety procedures, and community integration.
Ensure staff complete required background checks, health screenings, and training in habilitation techniques.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Day Habilitation Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, habilitation policies, and staff training documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including safety protocols, habilitation standards, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Day Habilitation Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Day Habilitation Policy & Procedure Manual including:
Daily programming and community engagement guidelines
Skill development and personal enrichment procedures
Safety, supervision, and behavioral support protocols
Staff credentialing, background checks, and ongoing training records
Documentation standards for care tracking and Medicaid billing
HIPAA compliance, participant rights, and grievance handling
Emergency response and safety protocols
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Day Habilitation Program Director
Requirements: Bachelor’s or Master’s degree in social work, human services, or healthcare administration; experience in day habilitation program management.
Role: Habilitation Specialists
Requirements: Bachelor’s degree in human services or a related field; experience in skill development and community integration.
Role: Direct Support Professionals (DSPs)
Requirements: High school diploma or GED; training in habilitation support; experience working with individuals with developmental disabilities; background clearance.
All staff must complete:
Training in habilitation practices, community engagement, and client interaction
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety, emergency response, and behavior management training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Day Habilitation Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Day Habilitation Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK DAY HABILITATION SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Day Habilitation Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for daily programming and community integration
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and community outreach strategies
Quality assurance systems for day habilitation and compliance monitoring
Collaboration with healthcare providers and community organizations
Assistive Technology
ASSISTIVE TECHNOLOGY SERVICES PROVIDER IN NEW YORK
ENHANCING INDEPENDENCE AND ACCESSIBILITY THROUGH TECHNOLOGICAL SUPPORT IN HOME AND COMMUNITY SETTINGS
Assistive Technology Services in New York help individuals with disabilities or chronic conditions improve their independence and quality of life by providing technology-based solutions. These services support daily living, communication, mobility, and environmental control. Assistive Technology Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Assistive Technology Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for assistive technology services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for assistive technology programs serving individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Assistive Technology Services meet quality, safety, and person-centered care standards.
2. ASSISTIVE TECHNOLOGY SERVICES OVERVIEW
Assistive Technology Services involve the assessment, acquisition, customization, and training related to devices that enhance functional capabilities and accessibility.
Approved providers may deliver:
Technology Assessment: Evaluating individual needs to identify suitable assistive devices.
Device Acquisition: Procuring and delivering the technology required to support independence.
Customization and Setup: Adapting devices to the individual’s needs and environment.
Training and Education: Teaching individuals and caregivers how to effectively use the technology.
Maintenance and Repairs: Ensuring devices remain functional and up-to-date.
Environmental Modifications: Integrating technology into the home for accessibility (e.g., automated lighting and adaptive controls).
Communication Devices: Providing tools for speech generation and alternative communication methods.
Mobility Aids: Supplying powered wheelchairs, adaptive driving equipment, and more.
Sensory Aids: Delivering devices for visual or hearing impairments, including screen readers and hearing amplifiers.
Documentation: Keeping accurate records of assessments, device setups, and training sessions.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Assistive Technology provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for technology assessment, device management, and user training.
Ensure staff complete required background checks, health screenings, and technology training.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Assistive Technology Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, technology policies, and staff training documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including technology protocols, training plans, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Assistive Technology Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Assistive Technology Policy & Procedure Manual including:
Technology assessment and device customization procedures
Device maintenance, repair, and user training protocols
Safety and usability evaluation guidelines
Staff credentialing, background checks, and ongoing training records
Documentation standards for device setup, training, and Medicaid billing
HIPAA compliance, participant rights, and grievance handling
Emergency response and device safety protocols
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Assistive Technology Program Director
Requirements: Bachelor’s or Master’s degree in rehabilitation technology, biomedical engineering, or healthcare administration; experience in assistive technology and program management.
Role: Assistive Technology Specialists
Requirements: Certification in assistive technology or related field; experience in device customization and training; background clearance.
Role: Technicians/Support Staff
Requirements: Experience with device installation, maintenance, and technical support; background clearance.
All staff must complete:
Training in assistive technology application, device management, and client interaction
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety, emergency response, and technical troubleshooting training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Assistive Technology Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Assistive Technology Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK ASSISTIVE TECHNOLOGY SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Assistive Technology Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for device management and user training
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and community outreach strategies
Quality assurance systems for assistive technology and compliance monitoring
Collaboration with healthcare providers, device manufacturers, and community organizations
Behavioral Health
BEHAVIORAL HEALTH SERVICES PROVIDER IN NEW YORK
SUPPORTING MENTAL WELL-BEING THROUGH THERAPEUTIC INTERVENTIONS AND HOLISTIC CARE
Behavioral Health Services in New York support individuals with mental health conditions, substance use disorders, or behavioral challenges by providing counseling, therapy, and support services. These services are designed to promote mental well-being, enhance coping skills, and support recovery. Behavioral Health Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Behavioral Health Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for behavioral health programs serving individuals with mental and behavioral health needs.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for behavioral health services targeting individuals with developmental disabilities.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Behavioral Health Services meet quality, safety, and person-centered care standards.
2. BEHAVIORAL HEALTH SERVICES OVERVIEW
Behavioral Health Services include therapeutic interventions, mental health counseling, and behavioral support aimed at promoting emotional well-being and managing mental health challenges.
Approved providers may deliver:
Individual Counseling: One-on-one therapy sessions addressing mental health challenges.
Group Therapy: Facilitated group sessions for peer support and skill-building.
Substance Use Counseling: Support for individuals dealing with addiction and recovery.
Crisis Intervention: Immediate support during mental health emergencies.
Case Management: Coordinating care among healthcare providers and community resources.
Behavioral Interventions: Implementing strategies to address disruptive or harmful behaviors.
Psychoeducation: Educating individuals and families about mental health conditions and coping strategies.
Medication Management: Monitoring the effectiveness and side effects of psychiatric medications.
Social Skills Training: Building interpersonal skills for community and social interactions.
Trauma-Informed Care: Providing therapeutic approaches sensitive to past trauma.
Documentation: Maintaining accurate records of assessments, therapy sessions, and treatment outcomes.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Behavioral Health provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for therapy practices, crisis intervention, and mental health support.
Ensure staff complete required background checks, health screenings, and licensure verifications.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Behavioral Health Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, behavioral health policies, and staff licensure documentation.
Program Readiness Review:
NYSDOH, OMH, and OPWDD evaluate provider readiness, including clinical protocols, safety measures, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Behavioral Health Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Behavioral Health Policy & Procedure Manual including:
Counseling, therapy, and crisis intervention protocols
Safety protocols and emergency response guidelines
Staff credentialing, background checks, and ongoing training records
Documentation standards for therapy tracking and Medicaid billing
HIPAA compliance, participant rights, and grievance handling
Quality assurance and compliance monitoring
Client consent, confidentiality, and safety practices
6. STAFFING REQUIREMENTS
Role: Behavioral Health Program Director
Requirements: Licensed Clinical Social Worker (LCSW), Licensed Mental Health Counselor (LMHC), or Licensed Psychologist; Master’s or Doctorate in psychology, social work, or counseling.
Role: Therapists (LCSW, LMHC, Psychologists)
Requirements: State licensure; experience in individual, group, or family therapy.
Role: Substance Use Counselors
Requirements: Certified Alcohol and Substance Abuse Counselor (CASAC) or equivalent; experience in addiction recovery support.
Role: Behavioral Support Specialists
Requirements: Bachelor’s or Master’s in psychology, social work, or human services; experience with behavioral interventions.
All staff must complete:
Training in trauma-informed care, therapeutic interventions, and mental health support
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety, crisis management, and client interaction training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Behavioral Health Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Behavioral Health Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK BEHAVIORAL HEALTH SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Behavioral Health Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for therapy and mental health support
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and client outreach strategies
Quality assurance systems for therapeutic care and compliance monitoring
Collaboration with healthcare providers, mental health agencies, and community organizations
Home Modification
HOME MODIFICATION SERVICES PROVIDER IN NEW YORK
CREATING SAFE, ACCESSIBLE, AND FUNCTIONAL LIVING SPACES TO SUPPORT INDEPENDENCE IN HOME AND COMMUNITY SETTINGS
Home Modification Services in New York enhance accessibility and safety for individuals with disabilities, chronic conditions, or mobility challenges. These modifications allow individuals to live independently in their own homes by reducing physical barriers and creating adaptive environments. Home Modification Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Home Modification Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for home modification services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for home modification programs serving individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Home Modification Services meet quality, safety, and accessibility standards.
2. HOME MODIFICATION SERVICES OVERVIEW
Home Modification Services involve structural changes and adaptations to a residence to improve accessibility, safety, and independence for individuals with disabilities.
Approved providers may deliver:
Accessibility Enhancements: Installing ramps, stairlifts, and widened doorways.
Bathroom Modifications: Adding grab bars, roll-in showers, and accessible sinks.
Kitchen Modifications: Lowering countertops, installing adaptive fixtures, and optimizing layout for wheelchair use.
Safety Improvements: Installing non-slip flooring, handrails, and safety lighting.
Mobility Supports: Adding ceiling lifts, track systems, and transfer aids.
Environmental Controls: Integrating smart home systems for remote lighting, temperature, and door control.
Emergency Accessibility: Adding accessible exits and fire safety improvements.
Sensory Modifications: Creating environments suitable for individuals with sensory processing disorders.
Documentation: Maintaining records of assessments, installation, and compliance with safety standards.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Home Modification provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for accessibility assessments, project planning, and safety compliance.
Ensure staff complete required background checks, health screenings, and construction safety training.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Home Modification Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, modification policies, and staff training documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including safety protocols, modification standards, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Home Modification Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Home Modification Policy & Procedure Manual including:
Accessibility assessment and modification planning procedures
Construction safety protocols and compliance guidelines
Staff credentialing, background checks, and ongoing training records
Documentation standards for modification tracking and Medicaid billing
HIPAA compliance, participant rights, and grievance handling
Emergency response and safety verification protocols
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Home Modification Program Director
Requirements: Bachelor’s or Master’s degree in construction management, rehabilitation engineering, or healthcare administration; experience in project management and accessibility planning.
Role: Accessibility Consultants
Requirements: Certification in accessibility planning, architecture, or rehabilitation technology; experience in home modification assessments.
Role: Construction Technicians
Requirements: Experience in building modifications, safety compliance, and ADA standards; OSHA certification preferred.
All staff must complete:
Training in accessibility planning, construction safety, and client interaction
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety, emergency response, and construction compliance training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Home Modification Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Home Modification Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK HOME MODIFICATION SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Home Modification Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for accessibility assessments and safety compliance
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and community outreach strategies
Quality assurance systems for home modification and compliance monitoring
Collaboration with accessibility specialists and construction professionals
Therapy Services
THERAPY SERVICES PROVIDER IN NEW YORK
DELIVERING HOLISTIC AND PERSON-CENTERED THERAPEUTIC SUPPORT TO ENHANCE FUNCTIONAL ABILITIES AND WELL-BEING
Therapy Services in New York support individuals with physical, developmental, or mental health challenges through rehabilitative and therapeutic interventions. These services are delivered in home, community, or clinical settings to promote independence, mobility, and emotional well-being. Therapy Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Therapy Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for therapy services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for therapy programs serving individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Therapy Services meet quality, safety, and person-centered care standards.
2. THERAPY SERVICES OVERVIEW
Therapy Services are designed to support individuals in achieving functional improvement and maintaining well-being through physical, occupational, speech, and behavioral therapies.
Approved providers may deliver:
Physical Therapy (PT): Improving mobility, strength, and coordination through therapeutic exercises.
Occupational Therapy (OT): Enhancing daily living skills and fine motor functions for greater independence.
Speech and Language Therapy (SLT): Addressing communication disorders and swallowing difficulties.
Behavioral Therapy: Implementing strategies to manage challenging behaviors and improve social skills.
Mental Health Counseling: Supporting emotional well-being and coping mechanisms.
Rehabilitation Therapy: Assisting in recovery post-injury or illness.
Music and Art Therapy: Encouraging self-expression and emotional processing.
Sensory Integration Therapy: Addressing sensory processing issues to improve functioning.
Documentation: Maintaining accurate records of therapy sessions, progress tracking, and treatment outcomes.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Therapy Services provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for therapy planning, client safety, and professional practice standards.
Ensure therapists hold valid state licenses and complete required background checks.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Therapy Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, therapy policies, and staff licensure documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including therapy protocols, safety measures, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Therapy Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Therapy Services Policy & Procedure Manual including:
Therapy assessment, treatment planning, and intervention protocols
Documentation standards for progress tracking and Medicaid billing
Staff credentialing, background checks, and ongoing training records
HIPAA compliance, participant rights, and grievance handling
Safety protocols for in-home and community-based therapy
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Therapy Program Director
Requirements: Licensed therapist (PT, OT, SLP, or behavioral therapist) with a Master's or Doctorate in a relevant field; experience in program management and clinical supervision.
Role: Physical Therapists (PT)
Requirements: Doctorate in Physical Therapy (DPT); New York State license; CPR certification; experience in rehabilitative care.
Role: Occupational Therapists (OT)
Requirements: Master’s degree in Occupational Therapy; state licensure; experience in ADL training and rehabilitation.
Role: Speech-Language Pathologists (SLP)
Requirements: Master’s degree in Speech-Language Pathology; ASHA certification; state licensure.
Role: Behavioral Therapists
Requirements: Certification as a Board Certified Behavior Analyst (BCBA) or similar; experience in behavioral interventions.
All staff must complete:
Training in therapy techniques, safety protocols, and client interaction
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety, crisis management, and client care training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Therapy Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Therapy Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK THERAPY SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Therapy Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for therapy protocols and client safety
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and community outreach strategies
Quality assurance systems for therapeutic interventions and compliance monitoring
Collaboration with healthcare providers, therapy specialists, and community organizations
Home & Community Services
HOME AND COMMUNITY SUPPORT SERVICES PROVIDER IN NEW YORK
PROMOTING INDEPENDENCE AND COMMUNITY ENGAGEMENT THROUGH PERSONALIZED SUPPORT SERVICES
Home and Community Support Services in New York assist individuals with disabilities, chronic conditions, or age-related challenges by providing tailored support to enhance daily living, social interaction, and community integration. These services are designed to empower individuals to maintain independence while remaining actively involved in their communities. Home and Community Support Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Home and Community Support Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for community-based support services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for community support programs serving individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Home and Community Support Services meet quality, safety, and person-centered care standards.
2. HOME AND COMMUNITY SUPPORT SERVICES OVERVIEW
Home and Community Support Services focus on promoting independence and participation in community life through direct assistance, skill development, and support with daily living activities.
Approved providers may deliver:
Personal Assistance: Support with hygiene, grooming, mobility, and meal preparation.
Community Integration: Facilitating participation in social and recreational activities.
Life Skills Training: Teaching money management, communication, and problem-solving skills.
Companionship: Providing social interaction to reduce isolation and loneliness.
Health Monitoring: Assisting with medication reminders and basic health tracking.
Transportation Assistance: Helping individuals access community resources and appointments.
Safety and Supervision: Ensuring a safe environment during daily activities.
Respite Support: Offering short-term relief for primary caregivers.
Documentation: Maintaining records of care provided and progress tracking.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Home and Community Support provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for daily support, community engagement, and participant safety.
Ensure staff complete required background checks, health screenings, and training in community support.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Home and Community Support Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, support policies, and staff training documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including support protocols, safety standards, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Home and Community Support Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Home and Community Support Policy & Procedure Manual including:
Daily support and community integration procedures
Personal assistance and skill-building guidelines
Staff credentialing, background checks, and ongoing training records
Documentation standards for care tracking and Medicaid billing
HIPAA compliance, participant rights, and grievance handling
Safety, supervision, and emergency response protocols
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Program Director
Requirements: Bachelor’s or Master’s degree in social work, healthcare administration, or human services; experience in community support program management.
Role: Community Support Specialists
Requirements: High school diploma or GED; experience in direct care, community support, or habilitation; background clearance.
Role: Personal Care Aides (PCAs)
Requirements: Completion of an approved PCA training program; experience in personal care and community engagement; background clearance.
All staff must complete:
Training in community integration, personal care, and client interaction
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety, emergency response, and infection control training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Home and Community Support Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK HOME AND COMMUNITY SUPPORT SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Home and Community Support Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for daily living support and community integration
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and community outreach strategies
Quality assurance systems for community support and compliance monitoring
Collaboration with healthcare providers and community organizations
Supportive Housing
SUPPORTIVE HOUSING SERVICES PROVIDER IN NEW YORK
CREATING SAFE AND STABLE LIVING ENVIRONMENTS WITH WRAPAROUND SUPPORT SERVICES
Supportive Housing Services in New York assist individuals with disabilities, mental health conditions, or chronic challenges in maintaining stable housing. These services integrate housing assistance with personalized support to enhance independent living and community integration. Supportive Housing Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Supportive Housing Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for supportive housing services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for supportive housing programs serving individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Supportive Housing Services meet quality, safety, and person-centered care standards.
2. SUPPORTIVE HOUSING SERVICES OVERVIEW
Supportive Housing Services combine secure, affordable housing with comprehensive support services, promoting long-term stability and community integration.
Approved providers may deliver:
Housing Placement Assistance: Helping individuals secure affordable and accessible housing.
Case Management: Coordinating care and support services tailored to individual needs.
Life Skills Training: Teaching budgeting, cooking, personal care, and household management.
Behavioral Health Support: Addressing mental health needs through counseling and crisis intervention.
Health and Wellness Monitoring: Ensuring individuals maintain their physical and mental well-being.
Tenant Advocacy: Supporting tenants in understanding their rights and responsibilities.
Independent Living Skills: Enhancing skills needed for successful community living.
Substance Use Support: Connecting individuals to addiction treatment and recovery resources.
Community Engagement: Facilitating participation in local activities and social connections.
Documentation: Maintaining records of housing stability, support services, and outcomes.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Supportive Housing provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for housing stability, tenant support, and community integration.
Ensure staff complete required background checks, health screenings, and training in supportive housing practices.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Supportive Housing Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, housing policies, and staff training documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including housing support protocols, safety measures, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Supportive Housing Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Supportive Housing Policy & Procedure Manual including:
Housing placement and stabilization protocols
Tenant support and crisis intervention guidelines
Staff credentialing, background checks, and ongoing training records
Documentation standards for service tracking and Medicaid billing
HIPAA compliance, tenant rights, and grievance handling
Safety and emergency response protocols
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Supportive Housing Program Director
Requirements: Bachelor’s or Master’s degree in social work, human services, or healthcare administration; experience in housing stability and community support.
Role: Case Managers
Requirements: Bachelor’s degree in social work, psychology, or a related field; experience in client advocacy and housing support.
Role: Housing Support Coordinators
Requirements: Experience in property management, tenant support, and crisis intervention; background clearance.
All staff must complete:
Training in housing stabilization, tenant advocacy, and community integration
HIPAA compliance and tenant rights education
Annual competency evaluations and ongoing professional development
Safety, crisis management, and supportive interaction training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Supportive Housing Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Supportive Housing Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK SUPPORTIVE HOUSING SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Supportive Housing Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for housing stabilization and tenant support
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and community outreach strategies
Quality assurance systems for housing stability and compliance monitoring
Collaboration with housing agencies, healthcare providers, and community organizations
Case Management
CASE MANAGEMENT SERVICES PROVIDER IN NEW YORK
COORDINATING CARE AND SUPPORT FOR INDIVIDUALS IN HOME AND COMMUNITY SETTINGS
Case Management Services in New York assist individuals with disabilities, chronic conditions, or age-related challenges by coordinating care, advocating for services, and facilitating access to community resources. These services ensure comprehensive, person-centered care while promoting independence and well-being. Case Management Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Case Management Services and manages provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Monitors behavioral health and mental health services.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring Medicaid-funded Case Management Services meet HCBS quality, person-centered planning, and participant protection standards.
2. CASE MANAGEMENT SERVICES OVERVIEW
Case Management Services involve assessment, planning, coordination, and monitoring to ensure individuals receive appropriate care and support in their community.
Approved providers may deliver:
Comprehensive Assessment: Evaluating individual needs, preferences, and available supports.
Care Planning: Developing personalized service plans in collaboration with participants and families.
Resource Coordination: Connecting individuals with community services and supports.
Service Monitoring: Tracking the effectiveness of care plans and making adjustments as needed.
Crisis Intervention: Providing immediate support during emergencies or changes in health status.
Advocacy: Ensuring that individuals receive necessary services and support.
Referral Services: Linking to healthcare providers, behavioral health services, and community resources.
Documentation and Reporting: Maintaining accurate records of care coordination and outcomes.
Care Transitions Support: Facilitating smooth transitions from hospitals or other care settings back to the community.
All services are delivered according to the Individualized Service Plan (ISP) to meet the participant’s specific needs and support goals.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Case Management provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for case management, service coordination, and client advocacy.
Ensure staff meet background checks, health screenings, and case management training requirements.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application through the eMedNY Portal for Case Management Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, case management training documentation, and policy manuals.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including client assessment procedures, documentation standards, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Case Management Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Case Management Services Policy & Procedure Manual including:
Intake, assessment, and individualized care planning procedures
Service coordination, advocacy, and referral guidelines
Staff credentialing, background checks, and ongoing training records
Documentation standards for care tracking and Medicaid billing
HIPAA compliance, participant rights, and grievance handling
Emergency response, crisis management, and safety protocols
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Case Management Program Director
Requirements: Bachelor’s or Master’s degree in social work, human services, or healthcare administration; experience in case management and supervision.
Role: Case Managers
Requirements: Bachelor’s degree in social work, psychology, or a related field; case management certification preferred; experience with client advocacy; background clearance.
Role: Support Coordinators
Requirements: Experience in care coordination and client engagement; knowledge of community resources; background clearance.
All staff must complete:
Training in care coordination, person-centered planning, and advocacy
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety and emergency response training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Case Management Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Children’s Waiver
Traumatic Brain Injury (TBI) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Home and Community-Based Services (HCBS) Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Case Management Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK CASE MANAGEMENT SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Case Management Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for care coordination and client advocacy
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and client outreach strategies
Quality assurance systems for service coordination and compliance monitoring
Collaboration with healthcare providers and community organizations
Non-Medical Transportation
NON-MEDICAL TRANSPORTATION SERVICES PROVIDER IN NEW YORK
FACILITATING ACCESS TO COMMUNITY ACTIVITIES AND SERVICES THROUGH SAFE AND RELIABLE TRANSPORTATION
Non-Medical Transportation Services in New York help individuals with disabilities, chronic conditions, or age-related challenges access essential community services, social activities, and other non-medical destinations. These services are crucial for maintaining independence and participation in community life. Non-Medical Transportation Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Non-Medical Transportation Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for transportation services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for transportation programs serving individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Non-Medical Transportation Services meet quality, safety, and person-centered care standards.
2. NON-MEDICAL TRANSPORTATION SERVICES OVERVIEW
Non-Medical Transportation Services offer safe and reliable transportation to individuals who need assistance accessing community resources, employment, social activities, or other non-medical destinations.
Approved providers may deliver:
Community Access Transportation: Providing rides to community activities, social events, and recreational outings.
Employment Transportation: Facilitating transportation to and from workplaces and vocational programs.
Educational Access: Ensuring transportation to educational programs and training centers.
Social and Recreational Support: Enabling participation in community-based events and group activities.
Personal Errands: Transporting individuals for grocery shopping, banking, or other essential tasks.
Escort and Assistance: Providing help during transit, including mobility support and boarding assistance.
Trip Planning: Coordinating rides according to individual schedules and activity plans.
Safety Monitoring: Ensuring secure and supervised travel for all passengers.
Documentation: Maintaining accurate trip logs, mileage records, and service reports.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Non-Medical Transportation provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability, vehicle insurance, and professional liability insurance.
Develop policies for trip planning, passenger safety, and vehicle maintenance.
Ensure drivers complete required background checks, health screenings, and defensive driving training.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Non-Medical Transportation Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, transportation policies, and driver training documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including vehicle safety protocols, driver qualifications, and passenger assistance methods.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Non-Medical Transportation Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general, professional liability, and vehicle insurance
Non-Medical Transportation Policy & Procedure Manual including:
Trip planning and scheduling procedures
Safety protocols for passenger support and mobility assistance
Driver credentialing, background checks, and ongoing training records
Vehicle maintenance logs and safety inspection documentation
Documentation standards for trip tracking and Medicaid billing
HIPAA compliance, passenger rights, and grievance handling
Emergency response and accident reporting protocols
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Transportation Program Director
Requirements: Bachelor’s degree in business management, logistics, or a related field; experience in transportation coordination and compliance management.
Role: Drivers/Transportation Specialists
Requirements: Valid commercial driver’s license (CDL) with passenger endorsement; defensive driving certification; experience in transporting individuals with disabilities.
Role: Transportation Coordinators
Requirements: Experience in scheduling, logistics, and trip planning; background clearance.
All staff must complete:
Training in passenger safety, mobility support, and defensive driving
HIPAA compliance and passenger rights education
Annual competency evaluations and ongoing professional development
Safety, emergency response, and incident management training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Non-Medical Transportation Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK NON-MEDICAL TRANSPORTATION SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Non-Medical Transportation Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for transportation safety and trip planning
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and community outreach strategies
Quality assurance systems for transportation safety and compliance monitoring
Collaboration with healthcare providers and community organizations
Home Health
HOME HEALTH SERVICES PROVIDER IN NEW YORK
PROVIDING COMPREHENSIVE MEDICAL AND PERSONAL CARE TO INDIVIDUALS IN THE COMFORT OF THEIR HOMES
Home Health Services in New York support individuals with medical, therapeutic, and personal care needs, allowing them to receive healthcare at home rather than in a hospital or care facility. These services are designed to promote independence, manage chronic conditions, and provide rehabilitative care. Home Health Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Home Health Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for home health services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for home health programs serving individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Home Health Services meet quality, safety, and person-centered care standards.
2. HOME HEALTH SERVICES OVERVIEW
Home Health Services involve medical care, personal care, and therapeutic support provided in the individual’s home environment.
Approved providers may deliver:
Skilled Nursing Care: Administering medication, wound care, and chronic disease management.
Physical Therapy: Improving mobility and strength through rehabilitative exercises.
Occupational Therapy: Enhancing daily living skills and promoting independence.
Speech Therapy: Assisting with communication and swallowing disorders.
Medical Social Services: Providing counseling and connecting individuals to community resources.
Home Health Aide Support: Assisting with personal care, hygiene, and daily activities.
Medication Management: Ensuring proper administration and monitoring of medications.
Chronic Condition Monitoring: Tracking vital signs and managing health changes.
Post-Hospitalization Care: Supporting recovery at home after hospital discharge.
Documentation: Maintaining detailed records of care plans, treatments, and patient progress.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Home Health provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for medical care, personal care, and patient safety.
Ensure staff complete required background checks, health screenings, and professional licensure verifications.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Home Health Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, home health policies, and staff licensure documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including clinical protocols, safety measures, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Home Health Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Home Health Policy & Procedure Manual including:
Clinical care protocols and medication management
Infection control measures and hygiene standards
Staff credentialing, background checks, and ongoing training records
Documentation standards for care tracking and Medicaid billing
HIPAA compliance, patient rights, and grievance handling
Emergency response and patient safety protocols
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Home Health Program Director
Requirements: Registered Nurse (RN) license, Bachelor’s or Master’s in Nursing or Healthcare Administration; experience in clinical supervision and home health care.
Role: Registered Nurses (RNs)
Requirements: Active RN license; experience in home health care; CPR and BLS certifications.
Role: Licensed Practical Nurses (LPNs)
Requirements: State licensure; experience in patient care and medication administration.
Role: Home Health Aides (HHAs)
Requirements: Certified HHA training program completion; experience in personal care assistance.
Role: Physical/Occupational/Speech Therapists
Requirements: Appropriate licensure and certification in therapy specialties.
All staff must complete:
Training in patient care, chronic disease management, and safety protocols
HIPAA compliance and patient rights education
Annual competency evaluations and ongoing professional development
Safety, infection control, and emergency response training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Home Health Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Home Health Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK HOME HEALTH SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Home Health Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for clinical care and patient safety
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and community outreach strategies
Quality assurance systems for home health and compliance monitoring
Collaboration with healthcare providers and community organizations
Meal & Nutrition
MEAL AND NUTRITION SERVICES PROVIDER IN NEW YORK
PROMOTING HEALTH AND WELL-BEING THROUGH PERSONALIZED MEAL PLANNING AND NUTRITION SUPPORT
Meal and Nutrition Services in New York assist individuals with disabilities, chronic conditions, or age-related challenges by providing access to nutritious meals, dietary planning, and nutritional education. These services help maintain health, manage chronic conditions, and support independence within home and community settings. Meal and Nutrition Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Meal and Nutrition Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for nutrition services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for nutrition programs serving individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Meal and Nutrition Services meet quality, safety, and person-centered care standards.
2. MEAL AND NUTRITION SERVICES OVERVIEW
Meal and Nutrition Services provide individuals with assistance in meal preparation, dietary planning, and nutrition education to maintain health and manage specific dietary needs.
Approved providers may deliver:
Meal Preparation: Cooking and preparing balanced meals that align with dietary restrictions.
Meal Delivery: Providing pre-cooked, nutritionally balanced meals to homes.
Dietary Assessment: Evaluating nutritional needs based on medical conditions or dietary goals.
Nutritional Counseling: Offering guidance on healthy eating and meal planning.
Special Diet Management: Preparing meals tailored for diabetes, hypertension, or other chronic conditions.
Food Safety Education: Teaching safe food handling and storage practices.
Shopping Assistance: Helping individuals purchase groceries and plan healthy meals.
Culinary Skill Training: Teaching basic cooking skills for increased independence.
Community Meal Programs: Organizing group dining events to enhance social interaction.
Documentation: Maintaining records of meal plans, dietary assessments, and nutritional education.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Meal and Nutrition provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for meal planning, dietary safety, and client nutrition education.
Ensure staff complete required background checks, health screenings, and nutrition training.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Meal and Nutrition Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, nutrition policies, and staff training documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including meal safety protocols, dietary planning standards, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Meal and Nutrition Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Meal and Nutrition Policy & Procedure Manual including:
Meal planning, preparation, and delivery protocols
Nutritional assessment and dietary planning guidelines
Staff credentialing, background checks, and ongoing training records
Documentation standards for meal tracking and Medicaid billing
HIPAA compliance, participant rights, and grievance handling
Safety, hygiene, and food handling protocols
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Nutrition Program Director
Requirements: Registered Dietitian (RD) license, Bachelor’s or Master’s in Nutrition or Dietetics; experience in meal planning and program management.
Role: Dietitians/Nutritionists
Requirements: State licensure and certification in dietetics or nutrition; experience in dietary planning and meal preparation.
Role: Meal Preparation Staff
Requirements: Experience in food service, meal preparation, and dietary compliance; food handler certification preferred.
Role: Delivery Drivers
Requirements: Valid driver’s license; experience in food delivery and customer service; background clearance.
All staff must complete:
Training in food safety, nutrition planning, and dietary management
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety, hygiene, and emergency response training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Meal and Nutrition Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK MEAL AND NUTRITION SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Meal and Nutrition Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for dietary planning and meal safety
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and client outreach strategies
Quality assurance systems for meal service and compliance monitoring
Collaboration with dietitians, healthcare providers, and community organizations
Service Coordination
SERVICE COORDINATION SERVICES PROVIDER IN NEW YORK
CONNECTING INDIVIDUALS WITH NEEDED SERVICES THROUGH COMPREHENSIVE COORDINATION AND SUPPORT
Service Coordination Services in New York assist individuals with disabilities, chronic conditions, or complex needs by managing and coordinating a range of services. The goal is to ensure that individuals receive holistic, person-centered care through integrated service planning and continuous support. Service Coordination Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Service Coordination Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for coordination services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for coordination programs serving individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Service Coordination Services meet quality, safety, and person-centered care standards.
2. SERVICE COORDINATION SERVICES OVERVIEW
Service Coordination involves assisting individuals and families in accessing a range of support services, advocating for client needs, and ensuring the effective implementation of care plans.
Approved providers may deliver:
Assessment and Planning: Identifying individual needs and developing comprehensive service plans.
Care Coordination: Managing access to healthcare, behavioral health, and community-based services.
Service Monitoring: Continuously evaluating the effectiveness of care plans and adjusting as necessary.
Crisis Intervention: Coordinating support during emergencies or health changes.
Resource Linkage: Connecting clients to community resources, healthcare providers, and social support networks.
Advocacy: Supporting client rights and promoting access to necessary services.
Transition Planning: Assisting with changes in living arrangements or care settings.
Documentation: Maintaining detailed records of assessments, service plans, and progress tracking.
Follow-Up and Evaluation: Regularly reviewing client progress and updating care plans.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Service Coordination provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for service planning, coordination, and client advocacy.
Ensure staff complete required background checks, health screenings, and training in care coordination.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Service Coordination Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, coordination policies, and staff training documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including client assessment procedures, service coordination protocols, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Service Coordination Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Service Coordination Policy & Procedure Manual including:
Intake, assessment, and service planning protocols
Care coordination, advocacy, and client support guidelines
Staff credentialing, background checks, and ongoing training records
Documentation standards for care tracking and Medicaid billing
HIPAA compliance, participant rights, and grievance handling
Crisis intervention and emergency response protocols
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Service Coordination Program Director
Requirements: Bachelor’s or Master’s degree in social work, human services, healthcare administration, or a related field; experience in program management and care coordination.
Role: Service Coordinators
Requirements: Bachelor’s degree in social work, psychology, or related field; certification in case management preferred; experience in client advocacy; background clearance.
Role: Support Coordinators
Requirements: Experience in community resource coordination and client engagement; background clearance.
All staff must complete:
Training in service coordination, person-centered planning, and advocacy
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety and crisis intervention training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Service Coordination Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Service Coordination Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK SERVICE COORDINATION SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Service Coordination Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for care coordination and client advocacy
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and client outreach strategies
Quality assurance systems for service coordination and compliance monitoring
Collaboration with healthcare providers and community organizations
Supported Employment
SUPPORTED EMPLOYMENT SERVICES PROVIDER IN NEW YORK
EMPOWERING INDIVIDUALS WITH DISABILITIES TO ACHIEVE AND MAINTAIN SUCCESSFUL EMPLOYMENT THROUGH PERSONALIZED SUPPORT
Supported Employment Services in New York assist individuals with disabilities or other challenges in obtaining and retaining competitive employment. These services offer individualized support to develop job skills, build workplace readiness, and maintain long-term employment success. Supported Employment Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.
1. GOVERNING AGENCIES
Agency: New York State Department of Health (NYSDOH)
Role: Administers Medicaid waiver funding for Supported Employment Services and oversees provider enrollment, service authorization, and reimbursement.
Agency: Office for People With Developmental Disabilities (OPWDD)
Role: Provides oversight for employment services targeting individuals with developmental disabilities.
Agency: New York State Office of Mental Health (OMH)
Role: Ensures compliance for supported employment programs serving individuals with mental and behavioral health needs.
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure Medicaid-funded Supported Employment Services meet quality, safety, and person-centered care standards.
2. SUPPORTED EMPLOYMENT SERVICES OVERVIEW
Supported Employment Services are designed to help individuals with disabilities gain meaningful employment through tailored job support, training, and on-the-job assistance.
Approved providers may deliver:
Job Development: Identifying suitable job opportunities that match the individual’s skills and interests.
Employment Assessment: Evaluating strengths, job readiness, and vocational preferences.
Job Placement: Assisting with job applications, interviews, and hiring processes.
Job Coaching: Providing one-on-one training and support during the initial employment phase.
Skills Training: Teaching soft skills like communication, teamwork, and problem-solving.
Workplace Accommodation Support: Assisting employers in adapting workspaces for accessibility.
On-the-Job Support: Monitoring progress and addressing challenges at the workplace.
Career Advancement Planning: Supporting career growth and skill enhancement.
Follow-Along Services: Offering ongoing support to ensure job retention and satisfaction.
Documentation: Maintaining accurate records of employment plans, progress tracking, and follow-up support.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Supported Employment provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for job development, placement, and on-the-job support.
Ensure staff complete required background checks, health screenings, and training in supported employment practices.
4. NEW YORK PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Complete the Provider Enrollment Application via the eMedNY Portal for Supported Employment Services under HCBS waivers.
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, employment support policies, and staff training documentation.
Program Readiness Review:
NYSDOH, OPWDD, and OMH evaluate provider readiness, including job development protocols, support methods, and staff qualifications.
Approval & Medicaid Enrollment:
Upon approval, providers are authorized to bill Medicaid for Supported Employment Services using designated billing codes.
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Supported Employment Policy & Procedure Manual including:
Job development, placement, and coaching procedures
Skill assessment and vocational planning guidelines
Staff credentialing, background checks, and ongoing training records
Documentation standards for client support and Medicaid billing
HIPAA compliance, participant rights, and grievance handling
Safety protocols for workplace support and crisis intervention
Quality assurance and compliance monitoring
6. STAFFING REQUIREMENTS
Role: Supported Employment Program Director
Requirements: Bachelor’s or Master’s degree in vocational rehabilitation, social work, or human services; experience in workforce development and program management.
Role: Employment Specialists/Job Coaches
Requirements: Certification in job coaching or vocational training; experience in supported employment and client advocacy.
Role: Vocational Rehabilitation Counselors
Requirements: Master’s degree in rehabilitation counseling; state licensure and experience in employment readiness.
All staff must complete:
Training in job development, supported employment practices, and client interaction
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety, crisis management, and workplace adaptation training
Documentation and record-keeping best practices
7. MEDICAID WAIVER PROGRAMS
Supported Employment Services are available under the following New York Medicaid Waivers:
OPWDD Comprehensive Waiver
Home and Community-Based Services (HCBS) Waiver
Nursing Home Transition and Diversion (NHTD) Waiver
Traumatic Brain Injury (TBI) Waiver
Children’s Waiver
8. TIMELINE TO LAUNCH
Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months
Phase: New York Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Supported Employment Service Launch
Timeline: 30–45 days
9. CONTACT INFORMATION
New York State Department of Health (NYSDOH)
Website: https://www.health.ny.gov/
Office for People With Developmental Disabilities (OPWDD)
Website: https://opwdd.ny.gov/
New York State Office of Mental Health (OMH)
Website: https://omh.ny.gov/
eMedNY Provider Enrollment Portal
Website: https://www.emedny.org/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW YORK SUPPORTED EMPLOYMENT SERVICES PROVIDER
WCG supports agencies in launching Medicaid-compliant Supported Employment Services in New York, offering:
Scope of Work:
Business registration, Medicaid enrollment, and licensing assistance
Policy manual development for employment support and job coaching
Staff credentialing, training program templates, and compliance documentation
Medicaid billing setup and audit-prepared financial management
Branding, website development, and employer outreach strategies
Quality assurance systems for employment support and compliance monitoring
Collaboration with employers, vocational training centers, and community organizations
Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.