Types Of Home and Community-Based Services in New York

When you are a caregiver or parent to a child with special needs, it can be daunting to sort through the various home and community-based services (HCBS) that are available. These services, which provide aid and support to children and families in need, can make a meaningful difference in their daily lives.

Let's delve into the diverse types of HCBS that are accessible through programs like Health Home, the Children's Waiver HCBS program, and the Early Intervention Program, and explore how they can impact your family positively.

Eligibility Criteria for HCBS Programs

One of the most important factors to consider when seeking HCBS programs is eligibility. Each program has its own specific criteria that must be met in order to qualify for services.

For example, the Children's Waiver HCBS program requires that a child be under 21 years old and have a qualifying medical condition or disability. Health Home, on the other hand, is available for individuals with complex medical needs who require care coordination.

It's essential to research each program's eligibility requirements beforehand to determine which options are available and suitable for your family's situation. Many programs also have income limits and residency requirements, so be sure to review all qualifications carefully.

Children’s Waiver HCBS Program Services

The Children’s Waiver HCBS program is designed for children under the age of 21 who have a developmental disability or chronic medical condition. The program provides a range of services aimed at keeping children in their homes and communities, rather than in hospitals or institutions.

Community Habilitation

This service helps individuals acquire, maintain, and enhance skills necessary to perform daily living activities, health-related tasks, communication skills, community integration, and other skills related to independent living.

Day Habilitation

This service is designed to help individuals improve self-help, socialization, and adaptive skills in a non-residential setting. Activities are geared towards fostering greater independence, community inclusion, relationship building, self-advocacy, and informed choice.

Prevocational Services

This service prepares youth with disabilities (age 14 or older) for paid or volunteer work by providing them with the necessary skills to succeed in any work environment.

Supported Employment

This service helps youth with disabilities (age 14 or older) engage in paid work by providing assistance as they perform in a work setting.

Respite

This service provides short-term assistance to children/youth with disabilities due to the absence of or need for relief of the child or the child's family caregiver.

Adaptive and Assistive Equipment

This service provides technological aids and devices identified in the Plan of Care that enable individuals to accomplish daily living tasks necessary for their health, welfare, and safety.

Environmental Modifications

This service involves making physical adaptations to the home or other eligible residences of the enrolled child, as identified in the Plan of Care, to support the child's health, welfare, and safety. These adaptations may also help the child function more independently at home.

Vehicle Modifications

This service involves making physical adaptations to the primary vehicle of the enrolled child, as identified in the Plan of Care, to support the child's health, welfare, and safety. These adaptations may also help the child function more independently when traveling.

Caregiver/Family Supports and Services

This service enhances the ability of the child/youth, regardless of disability, to function as part of a caregiver/family unit. It also enhances the ability of the caregiver/family to care for the child/youth in their home or community. The term "family" includes families created through birth, foster care, adoption, or a self-created unit.

Community Self-Advocacy Training and Supports

Community self-advocacy training and support is a service that provides children, youth, their families, caregivers, and other relevant individuals with information and techniques to better respond to the participant's needs. The training is intended to help these individuals understand and address the needs of the participant related to their disability.

Non-Medical Transportation

Non-medical transportation services are available to help children and youth reach authorized HCBS and destinations that are related to a goal included on their Plan of Care. These services are separate from the medical transportation provided by the State Plan.

Palliative care

Palliative care is a specialized form of medical care that targets the relief of symptoms and stress that arise from chronic conditions or life-threatening illnesses. Its aim is to improve the quality of life for both the child and their family. Palliative care is provided by a team of medical professionals, including doctors, nurses, social workers, and other specialists that work together with a child's primary physicians to provide an additional layer of support. It is suitable at any stage of a chronic condition or life-threatening illness and can be offered in conjunction with curative treatment.

The following are some of the services that are typically offered as part of palliative care:

• Expressive Therapy: This type of therapy incorporates art, music, and play to help children better comprehend and express their feelings through creative and kinesthetic treatment.
• Pain and Symptom Management: The goal of this service is to relieve or control the child's suffering related to their illness or condition.
• Bereavement Service: This service provides assistance for participants and their families to cope with grief related to end-of-life experiences. The bereavement counseling services are inclusive for those who receive hospice care through a hospice provider.
• Massage Therapy: This service aims to improve muscle tone, circulation, range of motion, and address physical symptoms related to the illness.

Health Home Serving Children Program Services

The Health Home program is designed to provide comprehensive care management to children with complex medical needs. The program is designed to coordinate care across different providers and settings, and to ensure that children receive the services they need to stay healthy and well.

Comprehensive Care Management

Care management provides assistance in coordinating medical and non-medical services for children with complex medical needs. This service can include coordination of primary care, specialty care, behavioral health services, and social services.

Care Coordination and Health Promotion

Care Coordination and Health Promotion is a service that works with children and their families to identify their needs, coordinate their care, and link them to appropriate providers. This service helps ensure that the child receives the necessary medical attention, therapy, and other services needed to promote their health and well-being.

The goal of this service is to help families navigate the complex healthcare system by providing them with support, information, and resources. By coordinating care across different providers and settings, this service helps improve overall health outcomes for children and youth.

Comprehensive Transitional Care

Transitional care provides support to children and families during transitions between different healthcare settings, such as from hospital to home. This service can include coordination of medical and non-medical services, education about medications and treatments, and assistance with follow-up appointments.

Patient and Family Support

Patient and Family Support is a service that provides assistance to patients and their families with appointments and meetings. This service helps ensure that patients are able to attend all necessary appointments, follow-up visits, and meetings related to their health care.

Assistance can include scheduling appointments, arranging transportation, providing reminders, and helping patients and families prepare for appointments or meetings. By providing this support, patients and their families are better able to manage their health care needs and improve their overall health outcomes.

Referrals to Community and Social Supports

Referrals to Community and Social Supports is a service that provides links to services and resources in the community. This service helps individuals and families connect with programs and resources that can support their needs, such as housing assistance, food banks, employment services, and other community-based programs.

By providing these referrals, individuals and families are better able to access the resources they need to improve their health and well-being. The goal of this service is to help individuals and families navigate the complex social service system by providing them with support, information, and resources.

Early Intervention Program Services

The Early Intervention Program is designed to provide support and services to infants and toddlers with developmental delays or disabilities, and their families. The program is designed to promote development and learning, and to support families in their role as primary caregivers.

Assistive Technology/Devices

Assistive Technology/Devices are items, equipment, or product systems that can be used to improve the functional capabilities of children with disabilities. This includes things like hearing aids, wheelchairs, and communication devices. Assistive technology services help children with disabilities select, acquire, or use these devices. This service includes evaluating the child's needs and environment, purchasing or providing the devices, coordinating with other therapies or programs, and providing training or technical assistance to both the child and their family, as well as professionals who work with children with disabilities. The goal of this service is to help children with disabilities better perform daily tasks and improve their overall quality of life.

Audiology

Audiology is a service that helps identify children who have hearing impairments. This service uses screening techniques to determine the range, nature, and degree of hearing loss and communication functions. If a child has a hearing impairment, they may be referred to medical or other services needed for their habilitation or rehabilitation.

The goal is to provide children with auditory training, speech reading and listening device orientation and training, and other services necessary for their communication needs. Additionally, this service includes prevention of hearing loss, family training and counseling, home visits, and parent support groups. Social workers, psychologists, and other qualified personnel may also provide services to help families understand the special needs of their child and enhance their development.

Family Training

Family Training is a service that provides support to families of children who are eligible for services under this program. This service includes counseling, home visits, and parent support groups, as well as the involvement of social workers, psychologists, and other qualified personnel.

The goal of this service is to help families better understand the special needs of their child and enhance their development. The service offers families resources and guidance to help them navigate the challenges of caring for a child with special needs.

Health Services

Health Services are services that help children with special health care needs to benefit from other early intervention services. This includes services such as clean intermittent catheterization, tracheostomy care, tube feeding, and changing dressings or colostomy collection bags. The goal of this service is to provide children with the necessary health care support they need while receiving other early intervention services. Physicians may also consult with other service providers to address any special health care needs of eligible children that may arise during the course of providing other early intervention services.

Medical Services

Medical Services are services provided by a licensed physician to determine the developmental status of a child and if they need early intervention services. These services are only for diagnostic or evaluation purposes. There may be prior approval requirements for exceptionally expensive services, as prescribed by the Commissioner. The goal of this service is to provide children with an accurate diagnosis and evaluate whether or not they require early intervention services.

Nursing Services

Nursing Care Assessment is an evaluation of a person's health status to provide the necessary nursing care. This includes identifying patterns of human response to actual or potential health problems, providing nursing care to prevent health problems, and restoring and improving functioning. Additionally, this service promotes optimal health and development. Nurses may also administer medications, treatments, and regimens prescribed by a licensed physician. The goal of this service is to help individuals maintain their health and prevent potential health problems from arising.

Nutrition Services

Nutrition Services are services that evaluate a child's nutritional needs. This includes conducting assessments on their nutritional history, dietary intake, feeding skills, and food habits. Based on these assessments, appropriate plans are developed and monitored to address the nutritional needs of eligible children. Additionally, referrals may be made to appropriate community resources to carry out nutrition goals. The goal of this service is to ensure that eligible children receive proper nutrition to support their growth and development.

Occupational Therapy

Includes services to address the functional needs of a child related toadaptive development, adaptive behavior and play, and sensory, motor, and posturaldevelopment. These services are designed to improve the child's functional ability to performtasks in home, school, and community settings, and include: identification, assessment, andintervention; adaptation of the environment, and selection, design and fabrication of assistiveand orthotic devices to facilitate development and promote the acquisition of functional skills;and prevention or minimization of the impact of initial or future impairment, delay indevelopment, or loss of functional ability.

Physical Therapy

Physical Therapy is a service that helps improve a child's sensorimotor function. This includes enhancing their musculoskeletal status, neurobehavioral organization, perceptual and motor development, cardiopulmonary status, and environmental adaptation. The service includes screening, evaluation, and assessment of infants and toddlers to identify movement dysfunction.

Additionally, it involves obtaining, interpreting, and integrating information to prevent, alleviate or compensate for movement dysfunction and related functional problems. Physical therapy provides individual and group services or treatment to prevent, alleviate or compensate for movement dysfunction and related functional problems. The goal of this service is to help children improve their movement abilities and related functional skills.

Psychological Services

Psychological Services involve administering psychological and developmental tests, as well as other assessment procedures. This service also includes interpreting the results of these assessments, obtaining and integrating information about child behavior, and conditions related to learning, mental health, and development.

Additionally, it involves planning and managing a program of psychological services, including psychological counseling for children and parents, family counseling, consultation on child development, parent training, and education programs. The goal of this service is to support the psychological well-being of children and their families through counseling, education, and other related services.

Respite Services

Respite Services are services provided to eligible children and their families based on their individual needs. The provision of these services takes into account several criteria, including the severity of the child's disability and needs, the potential risk of out-of-home placement if respite services are not provided, and the lack of access to informal support systems or other sources of respite.

Additionally, the presence of factors that increase family stress and the perceived need for respite services by the parent are considered. The goal of this service is to provide temporary relief to families caring for eligible children with disabilities, who may face challenges related to caregiving, and help them manage their daily responsibilities effectively.

Special Instruction

Special Instruction involves designing learning environments and activities that promote a child's development in various areas, such as cognitive processes and social interaction. This service includes curriculum planning that takes into account the child's individualized family service plan, as well as the interaction of personnel, materials, time, and space to achieve the desired outcomes.

Additionally, it involves providing families and primary caregivers with information, skills, and support to enhance the child's skill development and working directly with the child to promote their development. The goal of this service is to help children acquire new skills and improve their overall development in a supportive learning environment.

Speech-Language Pathology

Speech-Language Pathology involves identifying children with communication or oropharyngeal disorders and delays in communication skill development. This service includes diagnosing and assessing specific disorders and delays in communication skills, as well as referring children for medical or other professional services needed for their habilitation or rehabilitation.

Supplemental Evaluations

Supplemental Evaluations are additional evaluations recommended by the multidisciplinary team conducting the core evaluation, with the agreement of the child's parent. These evaluations may be provided by a specialist trained in the area of the child's suspected delay or disability who conducts an in-depth assessment of the child's strengths and needs in that area.

If a Supplemental Evaluation is required after the child's Individualized Family Service Plan (IFSP) is created, it must be performed according to the IFSP. The goal of these evaluations is to provide a comprehensive assessment of the child's needs and abilities, which will inform the development of an appropriate service plan tailored to their individual requirements.

Social Work Services

Social Work Services involve a range of activities aimed at supporting the overall well-being of the child and their family. This service includes making home visits to assess the living conditions and patterns of parent-child interaction, as well as preparing a social/emotional developmental assessment of the child within the family context.

Transportation

Transportation is a service that covers the cost of travel and other expenses necessary to enable an eligible child and their family to receive early intervention services. This may include the cost of mileage or travel by taxi, common carrier, or other means, as well as tolls and parking expenses. The goal of this service is to ensure that eligible children and their families have access to early intervention services, regardless of their location or transportation needs.

Vision Services

Vision Services involve a range of activities aimed at evaluating and improving a child's visual functioning. This service includes assessing the child's visual abilities, as well as diagnosing and appraising specific visual disorders, delays, and abilities. Additionally, it involves referring the child for medical or other professional services needed for the habilitation or rehabilitation of visual functioning disorders.

Vision Services also provide communication skills training, orientation and mobility training for all environments, visual training, independent living skills training, and additional training necessary to activate visual motor abilities. The goal of this service is to help children with visual impairments to develop their visual abilities and motor skills, which will enable them to navigate their environment more effectively and improve their overall quality of life.

Finding and Choosing a Provider

Finding the right provider for early intervention services can be a challenging task. It is important to choose a provider that can meet your child's unique needs and provide high-quality care. To find a provider, you can start by contacting your state or local early intervention program.

Your state or local program can provide you with a list of qualified providers in your area. You can also ask your child's pediatrician for recommendations or search online for providers in your area.

When choosing a provider, it is important to consider their qualifications, experience, and reputation. You should also consider the location of their office, the availability of appointments, and whether they accept your insurance.

It is recommended that you schedule an initial consultation with the provider to discuss your child's needs and determine if they are the right fit for your family. During this meeting, you should ask questions about their approach to treatment, their experience working with children with similar needs to your child's, and any other concerns you may have.

By taking the time to find the right provider for your child's early intervention services, you can ensure that they receive the best possible care and support to help them reach their full potential.

Conclusion

In conclusion, early intervention services are vital in helping children with special needs to reach their full potential. These services cover a wide range of areas, including health care, education, and social and emotional support. By providing families with the necessary resources and guidance, early intervention services can help them navigate the challenges of caring for a child with special needs.

It is important to note that the availability and quality of early intervention services may vary depending on your location. However, there are resources available to help you find qualified providers in your area.

Sources

• U.S. Department of Education. (2017). Early Intervention Program for Infants and Toddlers With Disabilities.
• Centers for Disease Control and Prevention. (2020). Developmental Disabilities: Learn the Signs. Act Early.
• New York State Department of Health. “Children’s Waiver Home and Community Based Services (HCBS).” Accessed on June 24, 2021.
• New York State Department of Health. “Health Home.” Accessed on June 24, 2021.
• New York State Department of Health. “Early Intervention Program.” Accessed on June 24, 2021.