Children and Family Treatment and

Support Services (CFTSS) “101”

NYS Office of Mental Health

Division of Integrated Services for Children and Families

Presentation for OMH Licensed Clinics

February 12, 2019

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I. History & Background

II. Overview to CFTSS

III. Pathways to Care

IV. CFTS Service Descriptions

V. Opportunities for Coordinated Care

VI. Additional References & Resources

Agenda

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History &

Background

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• Initiated under the recommendations of the Governor

appointed Medicaid Redesign Team and the Children's

Subcommittee

• The Subcommittee, comprised of a wide variety of key

stakeholders, guided the redesign efforts of the child-serving

State Agency Partners

• Focus on not only transitioning system to managed care, but

making improvements to the system to address gaps and

enhance continuum of care

Children’s Medicaid Redesign

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The guiding ideal behind these efforts was to assure the right

services, at the right time, in the right amounts through:

• earlier identification of needs of children and families,

• intervening earlier to prevent the onset or progression of

behavioral health needs,

• providing services in the most natural and least restrictive

setting, and

• maintaining children and youth in their homes and community

with adequate services and supports.

Children's Redesign Goals

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• Cross-agency effort to ensure equal access to services regardless

of “door” through which child enters (mental health, substance use,

children in foster care)

• Focused on making services, known to work well, more readily

available to a broader population of children with Medicaid

• Movement of historically “high need” services to EPSDT* for all

children who meet medical necessity criteria

• Expansion of age range to include children under 5 and young

adults over 18 years of age; to 0-21

(*Early Periodic Screening and Diagnostic Treatment)

Key Features of Design

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Children's Transition Timeline

Children and Family Treatment and Support Service

Implementation Date into the State Plan

Other Licensed Practitioners January 1, 2019

Community Psychiatric Supports and Treatment January 1, 2019

Psychosocial Rehabilitation January 1, 2019

Family Peer Support July 1, 2019

Youth Peer Support and Training January 1, 2020

Crisis Intervention January 1, 2020

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Overview of

CFTSS

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• Available to any Medicaid eligible child/youth with a mental

(behavioral) health need who meets medical necessity

• Enhances array of available treatment and rehabilitative supports

for children and youth

• Services can be accessed/provided individually or in a

coordinated comprehensive manner, depending upon the unique

needs of the child

• Intended to be delivered primarily in non-traditional settings, such

as in the home or community based locations

Overview of CFTSS

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• Services are flexible and may vary depending upon the child’s

age, developmental stage, needs of family/caregiver, and the

degree of clinical complexity

• Can be used as an initial intervention for newly identified mental

health needs/symptoms or for children with higher intensity

service needs to help prevent more restrictive levels of care

• All CFTSS are provided based on a determination of medical

necessity, recommendation by a licensed practitioner of the

healing arts (LPHA) and as part of a treatment plan

Overview of CFTSS (Continued)

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Pathways to

Care

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• There are a variety of ways in which children/youth can access

these services.

• A mental health need can be identified by multiple sources

including parents and caregivers, pediatricians, care managers,

school personnel, clinicians, or the young person themselves.

• Anyone can make a referral for services to a CFTSS designated

provider

• A recommendation for service provision must be made by a

licensed practitioner who can discern and document medical

necessity.

Pathways to Care

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• Referral: when an individual or service provider identifies a need

in a child/youth and/or their family and makes a linkage/connection

to a service provider for the provision of a service that can meet

that need. The family/caregiver and youth, themselves, may also

self-refer for services.

• Recommendation: when a treating or assessing Licensed

Practitioner of the Healing Arts (LPHA) identifies a need in a

child/youth based on a completed assessment and documents the

medical necessity for a specific service, & if applicable, may also

include the service on the child/youth’s treatment plan.

Pathways to Care

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The following practitioners, working within the scope of practice, are LPHAs:

– Registered Nurse Professional

– Nurse Practitioner

– Psychiatrist

– Licensed Psychologist

– Licensed Master Social Worker*

– Licensed Clinical Social Worker*

– Licensed Marriage and Family Therapist*

– Licensed Mental Health Counselor*

– Physician

– Licensed Creative Arts Therapist

– Licensed Psychoanalyst*

– Physician’s Assistant

*Note: These practitioners are also listed under OLP as NP-LBHPs, see OLP for additional information.

Licensed Practitioners of the Healing Arts (LPHA)

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• Recommendations must be in writing, signed and dated, include an

explanation of the need for the service(s) and have the LPHA NPI#.

• NYS has provided an example of how an LPHA may document

medical necessity and recommend one or more of the CFTSS. The

“Medical Necessity Form - LPHA Recommendation for CFTSS” is

not a required form, but a sample template to capture the

information necessary to demonstrate medical necessity.

• The form, along with the Medical Necessity Criteria Guidelines can

be found at the following link under Medical Necessity:

https://www.health.ny.gov/health_care/medicaid/redesign/behavioral_health/children/proposed_spa.htm

Making a Recommendation

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CFTSS Service

Descriptions

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• Prevent the progression of mental health needs through

early identification and intervention.

• OLP services may be provided to children/youth who need

assessment and for whom mental health conditions have

not yet been diagnosed.

• May be more effective in engaging children, youth and

families/caregivers who may have difficulty participating in

traditional clinic based settings

Other Licensed Practitioner (OLP)

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• Provided by a Non-Physician Licensed Behavioral Health

Practitioner (NP-LBHP), which include:

• Licensed Psychoanalysts, Licensed Clinical Social Workers, Licensed

Marriage and Family Therapists, Licensed Mental Health Counselors,

Licensed Masters Social Workers (when under the supervision of licensed

clinical social workers (LCSWs), licensed psychologists, or psychiatrists)

• These practitioners must operate within a State designated agency

• Services include: Licensed Evaluation/Assessment, Treatment

Planning, Psychotherapy, Crisis Intervention Activities (Triage, Off-

site, and Complex Care)

OLP Services

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• CPST is intended to assist the child/youth and

family/caregivers to achieve stability and functional

improvement in daily living, personal recovery and/or

resilience, family and interpersonal relationships in school

and community integration. The family/caregiver(s) is

expected to have an integral role.

• Easily complimented by the integration of additional CFTSS

services, such as Psychosocial Rehabilitation.

Community Psychiatric Treatment and Support (CPST)

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• Can coordinate with clinical treatment services (e.g.

clinic, OLP, etc.) to address identified rehabilitative

needs within a comprehensive treatment plan.

• Service Components: Intensive Interventions; Crisis

Avoidance; Intermediate Term Crisis Management;

Rehabilitative Psychoeducation; Strengths Based

Service Planning and Rehabilitative Supports

CPST Services

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• Restore, rehabilitate and support a child’s developmentally

appropriate functioning for the integration of the child as an active

member of their family and community

• Services can assist the child/youth in developing and applying skills

in natural settings, to practice and operationalize skill that have

been identified as having a deficit on a treatment plan

• Activities can be provided in coordination with treatment

interventions by a licensed provider

• Service Components: Personal & Community Competence, Social

& Interpersonal Skills, Daily Living Skills, and Community

Integration

Psychosocial Rehabilitation (PSR)

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Opportunities

for Coordinated

Care

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• CFTSS can be provided to children who may not be

appropriate for clinic services, due to age of the child, early

demonstration of symptoms, inability to engage in office-

based interventions, etc.

• CFTSS can be provided in coordination with clinic services

for children who may benefit from additional rehabilitative

supports, such CPST or PSR, to address in-home familial

relationships or address practical skill restoration.

Enhanced Continuum of Care

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• CFTSS can be used in a comprehensive, coordinated

approach to wrap a variety of supports and services around

families who are struggling and at risk of their child being

placed outside of the home

• For OLP, if there’s a demonstrated need, that is different and

not duplicative of the treatment/services provided by the

clinic, both services can be provided*

*Guidance on the allowance for co-admission to clinic and OLP services can

be found at: https://omh.ny.gov/omhweb/bho/omh_clinic_and_olp.pdf

Enhanced Continuum of Care

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Additional

Resources

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FOR GUIDANCE DOCUMENTS AND PROVIDER RESOURCES:

• Children and Family Treatment and Support Services Provider Manual

for EPSDT Services (includes Medical Necessity Criteria)– https://www.health.ny.gov/health_care/medicaid/redesign/behavioral_health/children/

docs/updated_spa_manual.pdf

• Child/Youth and Family CTSS Education and Outreach Materials– https://www.omh.ny.gov/omhweb/bho/childrensmc.html

• Find an OMH CFTSS Designated Provider– https://my.omh.ny.gov/bi/pd/saw.dll?PortalPages&PortalPath=/shared/Mental%20He

alth%20Program%20Directory/_portal/Mental%20Health%20Program%20Directory

&page=Advanced%20Search&Action=Navigate

Additional Resources

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FOR MORE DETAIL ON CFTSS FROM MCTAC:

• CFTSS: OLP, CPST, and PSR Refresher

https://www.ctacny.org/training/cftss-olp-psr-cpst-refresher-webinar

• Children and Family Treatment and Support Services- Service Review

https://ctacny.org/training/children-and-family-treatment-and-support-

services-training

• CFTSS FAQ document from in-person training

https://ctacny.org/sites/default/files/Final%20FAQ%20for%20CFTSS%20T

rainings.pdf

Additional Resources

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RESOURCES TO STAY INFORMED:

• Subscribe to children’s managed care listserv

http://www.omh.ny.gov/omhweb/childservice/

• Subscribe to DOH Health Home listserv

http://www.health.ny.gov/health_care/medicaid/program/medicaid

_health_homes/listserv.htm

• Subscribe to the MCTAC website for ongoing training

announcements and previous trainings: https://www.ctacny.org/

Additional Resources

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For Program and Service related questions for OMH

affiliated (licensed or designated) providers, please feel free

to contact the Children and Families’ Division at OMH at:

DCFS@omh.ny.gov

For Managed Care related questions, please feel free to

contact the NYS OMH Managed Care Mailbox:

OMH-MC-Children@omh.ny.gov

More Questions?

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Thank you!

Questions and Discussion