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As a reminder, New York State Department of Health guidance states Home and Community Based Services (HCBS) such as Community Habilitation and Respite cannot be duplicative or delivered at the same time as services otherwise available to the individual through a local educational agency for educational services in grades pre-K-12 under the Individuals with Disabilities Education Act (IDEA) or Vocational Rehabilitation under the Rehabilitation Act of 1973.
The schedule for HCBS delivery for children and young adults who attend school in- person must be outside of regular pre-K-12 school hours. For non-school aged children/youth, there is no prohibition on providing HCBS during regular “school hours”. For students who are home schooled or receiving virtual instruction, HCBS can be delivered during traditional school hours, but the services must be outside the scheduled time for educational instruction provided to the child.
Effective June 1, 2023, Fidelis Care will require school schedules and HCBS service schedules as components of clinical information for Utilization Review and must be submitted with other clinical documents at the time of request in order for requests to be processed. The schedules should be submitted in writing.
For more information related to HCBS School and Provider schedule services, please see the following guidance from New York State (NYS).
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