Effective July 1, 2021, eligible children who are currently placed with a Voluntary Foster Care Agency (VFCA) may receive these services if the VFCA has an Article 29-I license to provide Core Limited Health-Related Services and has all required NYS certifications, designations, and/or licenses.
Core Limited Health-Related Services
These five Core Limited Health-Related Services play a vital role in assuring all necessary services are provided in the specified time frames; children, parents, and caregivers are involved in the planning and support of treatment, as applicable; information is shared appropriately among professionals involved in the child’s care; and all health-related information and documentation results in a comprehensive, person-centered treatment plan.
Service | Description |
Nursing Services | Nursing services provided utilizing one of the following: • Nurse’s office • Exam/Triage rooms (not to exceed three rooms) • Combination of nurse’s office and exam/triage rooms |
Skill Building | Counseling and intervention provided by licensed behavioral health practitioners (LBPHs) including: • Psychoanalyst • Clinical social worker • Marriage and family therapist • Mental health counselor • Master social worker Skill-building activities include: • Establishing treatment goals for children, utilizing historical and current available information in collaboration with the multi-disciplinary team • Assisting children and youth to develop skills as defined in treatment goals • Providing psychiatric supports and therapy • Providing individual counseling and treatment, substance abuse counseling and treatment, trauma-informed counseling and treatment, family and group counseling, transitional counseling • Promoting integration with community resources and skill-building • Providing psycho-education and wellness education • Communicating with family, case planning staff, and medical practitioners • Enhancing compliance with behavioral expectations • Utilizing interventions drawn from evidence-based psychotherapeutic methodology • Structuring interventions to decrease problem behavior and increase developmentally appropriate pro-social behavior |
Medicaid Treatment and Discharge Planning | Medicaid Treatment Planning and Discharge Planning for the exchange of health information, treatment planning, discharge planning, and documentation including medical escorts, transportation, and supervision to health care appointments in the community. The VFCA must develop a treatment plan for the Medicaid services provided to the child. |
Clinical Consultation/Program Supervision Services | Clinical Consultation/Program Supervision services may include: • Reviewing all health care information and medical records • Working with the direct treatment providers to establish treatment goals for children, utilizing historical and current available information • Prescription and non-prescription medication consultation according to the scope of practice of the practitioner • Medical eligibility recommendations for foster care rates pertaining to health care conditions • Advising the local department of social services (LDSS) commissioners and the VFCA executive directors regarding the medical needs of the children in their care and/or care and custody • Reviewing and approving required medical and behavioral health forms • Meeting and communicating with biological families, guardians, foster families, and caseworkers • Clinical supervision of medical and behavioral health staff according to the scope of practice of the practitioner in compliance with applicable laws, rules, and regulations to include NYSED requirements where applicable • Quality oversight and improvement services • Emergency medical and behavioral health consultation services |
VFCA Medicaid Managed Care Liaison Services/Administrator | VFCA and Medicaid Managed Care Liaisons ensure a coordinated approach for monitoring access to health care for children in foster care. In addition, the VFCA must have a program administrator that has oversight of functions related to Article 29-I VFCA Health Facilities License. |
Other Limited Health-Related Services
VFCA Health Facilities may provide Other Limited Health-Related services in addition to the Core Limited Health-Related services, including services consistent with treatment plans. The VFCA must be:
- Designated to provide CFTSS or HCBS services
- The child is Medicaid eligible and meets medical necessity for CFTSS or meets HCBS criteria
- Is contracted with EmblemHealth to deliver Core Limited Health-Related Services
The Other Limited Health-Related services may be provided to children in the care of a VFCA, as well as children in foster care placed with an LDSS-certified setting.
Visit the Special Services for Children webpage for more information on Other Limited Health-Related services.
For additional information:
- EmblemHealth – State-Sponsored Programs
- Voluntary Foster Care Agency (VFCA) Providers
- Voluntary Foster Care Agency (VFCA) Services
- 29-I Health Facility (VFCA transition)
- New York Medicaid Program Health Facility Billing Guidance
- Guide to Edits: New York Medicaid Program 29-I Health Facility Billing Guidance
- 29-I Health Facility Billing FAQ
- Article 29-I VFCA Health Facilities License Guidelines
- 29-I Transmittal Form