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Office of Mental Health

New York State Consolidated Budget and Claiming Manual Subject: Appendix G – OMRDD Program Types, Definitions and Codes Section: 31
For the Periods:
January 1, 2009 to December 31, 2009
July 1, 2009 to June 30, 2010
Issued: September 9, 2009

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Below is an alphabetical listing of program types and the corresponding codes. Following this alphabetic list is a numeric list of program definitions and the corresponding codes.

Program Name Program Code
Care At Home - III 1220
Care at Home - IV & VI 2220
Case Management (Non-Medicaid) 0810
Certified Work Activity/Sheltered Workshop 0340
Classroom Education 0360
Community Residence, Part 671, Supervised Residential Habilitation 0053
Community Residence, Part 671, Supervised Room & Board 0054
Community Residence, Part 671, Supportive Residential Habilitation 1053
Community Residence, Part 671, Supportive Room & Board 1054
Consumer Transportation 0670
Crisis Intervention 0060
Day Program Services Included in the ICF/DD Reimbursement Rate (Off-Site) 6091
Day Program Services Included in the ICF/DD Reimbursement Rate (On-Site) 6090
Day Training 0330
Day Treatment – Free Standing 0200
Day Treatment – Partial 0202
Developmental Disabilities Program Council Grant 2190
Epilepsy Services 0414
Family Support Services 0150
HCBS Adaptive Technologies 0216
HCBS Assistive Supports 0221
HCBS Consolidated Supports and Services 0411
HCBS Environmental Modifications 0215
HCBS Family Education and Training 0413
HCBS Freestanding Respite 0233
HCBS Group Day Habilitation Service 0223
HCBS Individual Day Habilitation Service 0225
HCBS Live-in Caregiver 0415
HCBS Other Than Freestanding Respite 0235
HCBS Prevocational Services (Services on or after 1/1/06) 0227
HCBS Residential Habilitation, At Home 0219
HCBS Residential Habilitation Family Care 0220
HCBS Supervised IRA (Room and Board and Residential Habilitation Services) 0231
HCBS Supplemental Group Day Habilitation Service 0224
HCBS Supplemental Individual Day Habilitation Service 0226
HCBS Supported Employment 0214
HCBS Supportive IRA (Room and Board and Residential Habilitation Services) 0232
HCBS Waiver Plan of Care Support Services 0416
Homemaker Services 0630
ICF/DD (Over 30 Beds) 1090
ICF/DD (30 Beds or Less) 0090
Individualized Support Services 0410
Information & Referral 0750
Local Governmental Unit (LGU) Administration 0890
Medicaid Service Coordination 0229
NYC Housing Resource Consortium 0780
OMRDD Clinic Treatment Facility (Free-Standing Clinic) 0100
OMRDD Clinic Treatment Facility (Clinic Joint Venture) 0101
Options for People Through Services (NYS OPTS) 0234
Other Service Coordination (Non-Medicaid) 0222
Preschool Program 0370
Program Development Grant 0190
Recreation 0610
Residential School 0080
Shelter Plus Care Housing 3070
SOICF Sheltered Workshop/Day Training 4090
Special Legislative Grant 1190
Specialty Clinic 0120
Subcontract Services 0880
Summer Camp 0070
Supported Employment (Non-HCBS Waiver) 0390
Temporary Use Beds (TUBS) in an Intermediate Care Facility (30 Beds or Less) 0091
Temporary Use Beds (TUBS) in an Intermediate Care Facility (Over 30 Beds) 1091
Transitional Employment 0380
Traumatic Brain Injury (TBI) 1150
VOICF/DD , Day Services Contract 7090
VOICF/DD , Day Services (Not Operated by Service Provider) 7091
VOICF/DD , Day Training 5090
VOICF/DD , Day Training (Not Operated by Service Provider) 5091
VOICF/DD , School District Contract 3090
VOICF/DD , School District Contracts (Not Operated by Service Provider) 3091
VOICF/DD , Sheltered Workshop 2090
VOICF/DD , Sheltered Workshop (Not Operated by Service Provider) 2091
Voluntary Preservation Project – Formerly Known as Voluntary Operated Maintenance, Project 1850

0053 - Community Residence Part 671 Supervised - Residential Habilitation

A facility that provides 24 hour per day responsible supervision for the habilitation or rehabilitation of developmentally disabled persons as part of an overall service delivery system. Expenses for the following may be included:

Personal Services
Vacation Leave
Mandated Fringe
Non-mandated Fringe
Transportation Related
Staff Travel
Contracted Direct Care and Clinical Care
Other OTPS
Provider Paid Equipment

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the site’s Operating Certificate Number as the Program/Site Identification Number. For each Program Code 0053 column that is reported, there must be a corresponding Program Code 0054 column reported.

Note: Do not include Day Treatment/HCBS Day Habilitation To/From Transportation expense in this program. If a vehicle or staff person is assigned to this program, but is used for to/from transportation, the related expenses must be reported under Program Code 0670. See Program Code 0670 for instructions on reporting and allocating these expenses.

Units of Service: For each unit of service, count one participant day.

0054 - Community Residence Part 671 Supervised Room and Board

Room and Board. Report on a program/site specific basis.

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the site’s Operating Certificate Number as the Program/Site Identification Number. For each Program Code 0054 column that is reported, there must be a corresponding Program Code 0053 column reported.

Report only those costs normally occurring in a room and board situation. Additional costs because program participants may have special needs are Res. Hab. costs.

Note: Do not include Day Treatment/HCBS Day Habilitation To/From Transportation expense in this program. If a vehicle or staff person is assigned to this program, but is used for to/from transportation, the related expenses must be reported under Program Code 0670. See Program Code 0670 for instructions on reporting and allocating these expenses.

Units of Service: For each unit of service, count one participant day.

0060 - Crisis Intervention

Those activities that assist persons with developmental disabilities and their families in dealing with specific and time-limited problems which threaten to disrupt the individual’s residential situation and/or habilitation program. Such activities frequently include arranging for the provision of intensive behavioral services or other services such as respite care, health/medical services, nutrition services, counseling, legal services, and case management/service coordination.

Contract Budget consistent reporting is required for this program. The same number of columns use on the Consolidated Budget Report must be used on the CFR so that reporting is consistent.

The Program/Site Identification Number is created by using the first four digits of the Agency Code and the last three digits of the Program Code. Where more than one column will be created for this Program Code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: One hour equals one unit of service.

0070 - Summer Camp

A program certified by the Department of Health in accordance with sub-part 7-2 of Chapter 1 of the State Sanitary Code (Title X NYCRR) which provides overnight accommodations for periods of occupancy of more than 48 continuous hours. Such camps provide for the physical needs of campers and also implement a program of organized activities for the purpose of recreation and enhancement of the intellectual, sensorimotor and effective development of the participants.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent.

The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: For each unit of service, count one participant day.

For Budget Format: Count each participant day as one day.

0080 - Residential School

A non-publicly operated residential facility or institution providing a program of 24 hour professional care and treatment for developmentally disabled persons that is certified in accordance with Part 81 of Title 14 of NYCRR.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Units of Service: For each unit of service, count one participant day.

For Budget Format: Count each participant day as one day.

0090 - Intermediate Care Facility for the Developmentally Disabled (30 beds or less)

A facility operated by or subject to certification by the Office of Mental Retardation and Developmental Disabilities with a capacity of up to 30 in accordance with the requirements of Part 681 of Title 14 NYCRR and 42 CFR 442. Such facilities provide active programming, room and board, and continuous 24 hour per day supervision. They are located within the population areas of non-developmentally disabled persons. They are not of the facility type known as developmental center or school as defined by Section 13. 17 of the Mental Hygiene Law.

If this Program Code is reported, a corresponding OMRDD-1, ICF/DD Schedule of Service, must be completed.

Note: When the ICF/DD rate includes an add-on component for an ICF/DD School contract, report all expense and revenue in a discreet column as program code 3090 OR 3091 as appropriate. Add-on for ICF/DD Sheltered Workshop - use program code 2090 or 2091 as appropriate. Add-on for ICF/DD Day Training - use program code 5090 or 5091 as appropriate. When the ICF/DD rate includes funding for day program services, report all expense in a discreet column as Program Code 6090, Day Program Services Included in the ICF/DD Reimbursement Rate (On-Site) or Program Code 6091, Day Program Services Included in the ICF/DD Reimbursement Rate (Off-Site). Add-on for VOICF/DD , Day Services Contract – use program code 7090 or 7091 as appropriate.

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the site’s Operating Certificate Number as the Program/Site Identification Number.

Note: Do not include Day Treatment/HCBS Day Habilitation To/From Transportation expense in this program. If a vehicle or staff person is assigned to this program, but is used for to/from transportation, the related expenses must be reported under Program Code 0670. See Program Code 0670 for instructions on reporting and allocating these expenses.

Units of Service: For each unit of service, count one participant day.

For Budget Format: Count each participant day as one day.

0091 – Temporary Use Beds (TUBS) in an Intermediate Care Facility (30 Beds or Less)

When a bed (certified or uncertified) in an ICF/DD (30 beds or less) is used as a temporary use bed, the associated revenues and expenses should be reported under this program code. (Do not report the same revenue and expense under program code 0090 – Intermediate Care Facility (30 beds or less).) Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the site’s Operating Certificate Number as the Program/Site Identification Number.

Units of Service: One hour of service equals one unit of service.

0100 – OMRDD Clinic Treatment Facility (Free-Standing Clinic)

A certified physical space or setting and/or its services, including any certified satellite location(s) providing clinical services pursuant to Part 679, principally to persons with developmental disabilities, where such services are provided on an outpatient (i. e., non-residential) basis. The term "facility" also includes the headquarters for administration, management (including clinical records management), and clinician office (but not treatment) space for a provider authorized to provide exclusively off-site services, which holds an appropriate certificate of occupancy in accordance with the requirements of locality having jurisdiction.

Note: Off-site Services are services delivered at any location(s) other than the clinic’s main site or a certified satellite site.

For this program type, reporting is required based on operating certificate number, which should be used as the Program/Site Identification Number. All costs and services associated with an operating certificate number, including satellite(s) and off-site services, should be included in one column.

Units of Service: Units of Service as defined (Part 679. 5) is an allowable clinic service delivered at the main certified site, or at a certified satellite site or as an Off-site service. There is only one (1) billable visit per day per person regardless of the number of services provided during a given visit.

0101 – OMRDD Clinic Treatment Facility (Clinic Joint Venture)

A Clinic Joint Venture is defined as a Voluntary operated Clinic Treatment Facility certified as a State clinic satellite on the local DDSO state-operated clinic operating certificate. There is a formal contractual arrangement between a DDSO and a Voluntary Provider to operate a Clinic Treatment Facility as a Clinic Satellite of the DDSO.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the Program Code.

All costs and services associated with this satellite and any other additional certified satellites under this affiliation should be included in this cost center. Reimbursement received should be reported as Net Deficit Funding.

Units of Service: Units of Service as defined (Part 679. 5) is an allowable clinic service delivered at the main certified site, or at a certified satellite site or as an Off-site service. There is only one (1) billable visit per day per person regardless of the number of services provided during a given visit.

0120 - Specialty Clinic

Intensive diagnosis and/or medically prescribed treatment services provided during day and/or evening hours to mentally retarded and developmentally disabled persons who are served as needed for short periods of actual service involvement. Such programs are affiliated with a hospital or facility which holds, in addition to OMRDD certification, certification in accordance with Article 28 of the Public Health Law. The rates for payment and duration of visit are cost-related and determined in accordance with procedures established by the Office of Health Systems Management for the specific facility and the particular service being offered.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent.

The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: Count each billable visit as one unit of service.

0150 - Family Support Services

Those services other than basic residential and habilitative services needed by people with developmental disabilities to sustain themselves in appropriate community settings. They also include those services that families with disabled members need to provide environmental supports and maintenance of family stability and integrity. Family Support Services typically include information and referral, parent training, family counseling, recreation, home-based care, adaptive equipment and home modification, and legal services.

List free standing respite programs separately under 0650.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: As per contract.

For Budget Format: As per contract.

0190 - Program Development Grants

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. Include the name and address of the site that is being developed. Include the operating certificate, if known, as the Program/Site Identification Number. It the operating certificate number is not known, create a Program/Site Identification Number by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: Not applicable.

0200 - Day Treatment Free Standing

A planned combination of diagnostic, treatment, and rehabilitative services provided to mentally retarded and developmentally disabled individuals in need of a broader range of services than those provided in clinic treatment programs. Persons provided day treatment will attend regularly for periods in excess of three hours. Day Treatment Programs may vary widely in the services offered, the level of disability of participants, the staffing plan, the program goals and the types and numbers of cooperative agency relationships.

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the site’s Operating Certificate Number as the Program/Site Identification Number.

Revenue for transportation to and from Day Treatment should be reported as "Transportation, Medicaid" (CFR-1, Line 76) for Medicaid eligible consumers and/or "Transportation, Other" (CFR- 1, Line 77) for non-Medicaid eligible consumers.

See Program Codes 0670 and 0880 for specifics on reporting expenses regarding transportation to and from Day Treatment.

Note: Do not include Day Treatment/HCBS Day Habilitation To/From Transportation expense in this program. If a vehicle or staff person is assigned to this program, but is used for to/from transportation, the related expenses must be reported under Program Code 0670. See Program Code 0670 for instructions on reporting and allocating these expenses.

Units of Service:

Half-day visit: 3 but less than 5 hours.

Full-day visit: 5 hours or more.

0202 - Day Treatment Partial

Same as 0200 preceding, except available only in co-located setting with an emphasis on some subcontract work being performed.

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the site’s Operating Certificate Number as the Program/Site Identification Number.

Units of Service: One unit = 1. 5 hours but less than 3 hours

0214 - HCBS Supported Employment

Supported Employment services assist people in finding and keeping employment that the person finds meaningful. It provides appropriate staff and/or supports to help individuals obtain and maintain paid employment. The service takes place in integrated work settings in the community, which provide opportunities for regular interactions with individuals who do not have disabilities and who are not paid to provide services to people with a developmental disability.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Units of Service: One month of service equals one unit of service.

0215 - HCBS Environmental Modifications

Selected internal and external changes to the person's physical home environment, required by the person's individualized service plan, which are necessary to ensure the health, welfare and safety of the person of which enable him or her to function with greater independence in the home and without which the person would require institutionalization. Environmental modifications will be provided on a limited one-time only basis to the extent necessary to enable people with physical infirmities and disabilities to live safely in community homes outside the institutional setting. Report all similar services as one program/site. The revenue is reported as Medicaid.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

100% of Environmental Modification cost is to be reported as Equipment or Property-Other as appropriate. If property or equipment belongs to the service provider, the cost will be depreciated on the service provider’s books and will be a reconciling item since 100% of the cost is reported in the first year.

Units of Service: Not applicable.

0216 - HCBS Adaptive Technologies

The provision of devices, aids, controls, appliances or supplies of either a communication or adaptive type determined necessary to enable the person to increase his or her ability to function in a home and community based setting with independence and safety. The aid, whether of a communication or adaptive type, must be documented in the person's individualized service plan as being essential to the person's habilitation, ability to function or safety, and essential to avoid or delay more costly institutional placement. Report all similar services as one program/site. The revenue is reported as Medicaid.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Units of Service: Not applicable.

0219 - HCBS Residential Habilitation Service (At Home)

Residential habilitation services are provided in the person's place of residence. This includes assistance with acquisition, retention or improvements of self-help skills related to activities of daily living, such as personal grooming and cleanliness, bed-making and household chores, eating and the preparation of food, and the social and adaptive skills necessary to enable the individual to reside in a non-institutional setting. Do not include any expenses for programming provided as day habilitation.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Units of Service: Contact during one 24-hour period, regardless of duration, equals one unit of service.

0220 - HCBS Residential Habilitation Services (Family Care)

Residential habilitation services are provided in the person's place of residence. This includes assistance with acquisition, retention or improvements of self-help skills related to activities of daily living, such as personal grooming and cleanliness, bed-making and household chores, eating and the preparation of food, and the social and adaptive skills necessary to enable the individual to reside in a non-institutional setting. Do not include any expenses for programming provided as day habilitation. The Difficulty of Care (DOC) payment should be reported as a Contracted Direct Care Personal Services expense.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Units of Service: One participant day equals one unit of service.

0221 - HCBS Assistive Supports

Assistive supports includes support staff for an individual or family with assistance and/or training in order to enhance the independence of the individual. Assistive supports must be included in the individual's service plan. Report all similar services as one program/site.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Units of Service: Not applicable.

0222 - Other Service Coordination (Non-Medicaid)

A service which assists persons with developmental disabilities and mental retardation in gaining access to necessary services and supports appropriate to the needs of the individual. Other Service Coordination is provided by qualified service coordinators and uses a person centered planning process in developing, implementing, and maintaining an Individualized Service Plan (ISP) with and for a person with developmental disabilities or mental retardation. Other Service Coordination promotes the concepts of choice, individualized services and supports, and consumer satisfaction and is designed for individuals who are non-Medicaid eligible. The revenue is reported as "Other, Mirrored Services."

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Units of Service: One month of service equals one unit of service.

0223 - HCBS Group Day Habilitation Service

HCBS day habilitation provides assistance with acquisition, retention or improvement of self-help, socialization and adaptive skills. Group Day Habilitation services are typically provided to two or more enrolled consumers on weekdays and have a service start time prior to 3:00 p. m.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Revenue for transportation to and from HCBS Group Day Habilitation should be reported as "Transportation, Medicaid" (CFR-1, line 76) for Medicaid eligible consumers and/or "Transportation, Other" (CFR-1, line 77) for non-Medicaid eligible consumers. See Program Codes 0670 and 0880 for specifics on reporting expenses regarding transportation to and from HCBS Day Habilitation.

Note: Do not include Day Treatment/HCBS Day Habilitation To/From Transportation expense in this program. If a vehicle or staff person is assigned to this program, but is used for to/from transportation, the related expenses must be reported under Program Code 0670. See Program Code 0670 for instructions on reporting and allocating these expenses.

Units of Service:

Half Unit: 2 or more hours with at least one face-to-face service

Full Unit: 4 to 6 hours with at least two face-to-face services

0224 - HCBS Supplemental Group Day Habilitation Service

HCBS day habilitation provides assistance with acquisition, retention or improvement of self-help, socialization and adaptive skills. Supplemental Group Day Habilitation services are typically provided to two or more enrolled consumers on weekdays with a service start time at 3:00 p. m. or later or anytime on weekends.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Revenue for transportation to and from HCBS Group Day Habilitation should be reported as "Transportation, Medicaid" (CFR-1, line 76) for Medicaid eligible consumers and/or "Transportation, Other" (CFR-1, line 77) for non-Medicaid eligible consumers.

See Program Codes 0670 and 0880 for specifics on reporting expenses regarding transportation to and from HCBS Day Habilitation.

Note: Do not include Day Treatment/HCBS Day Habilitation To/From Transportation expense in this program. If a vehicle or staff person is assigned to this program, but is used for to/from transportation, the related expenses must be reported under Program Code 0670. See Program Code 0670 for instructions on reporting and allocating these expenses.

Units of Service:

Half Unit: 2 or more hours with at least one face-to-face service

Full Unit: 4 to 6 hours with at least two face-to-face services

0225 - HCBS Individual Day Habilitation Service

HCBS day habilitation provides assistance with acquisition, retention or improvement of self-help, socialization and adaptive skills. Individual Day Habilitation services are provided with a staff-to consumer ratio of no greater than one consumer per staff member and are delivered on weekdays and have a service start time prior to 3:00 p. m.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Revenue for transportation to and from HCBS Group Day Habilitation should be reported as "Transportation, Medicaid" (CFR-1, line 76) for Medicaid eligible consumers and/or "Transportation, Other" (CFR-1, line 77) for non-Medicaid eligible consumers.

See Program Codes 0670 and 0880 for specifics on reporting expenses regarding transportation to and from HCBS Day Habilitation.

Note: Do not include Day Treatment/HCBS Day Habilitation To/From Transportation expense in this program. If a vehicle or staff person is assigned to this program, but is used for to/from transportation, the related expenses must be reported under Program Code 0670. See Program Code 0670 for instructions on reporting and allocating these expenses.

Units of Service: Report using billable units. (i. e.: one quarter hour equals one unit of service.)

0226 - HCBS Supplemental Individual Day Habilitation Service

HCBS day habilitation provides assistance with acquisition, retention or improvement of self-help, socialization and adaptive skills. Supplemental Individual Day Habilitation services are provided with a staff-to-consumer ratio of no greater than one consumer per staff member and are delivered on weekdays with a service start time at 3:00 p. m. or later or anytime on weekends.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Revenue for transportation to and from HCBS Group Day Habilitation should be reported as "Transportation, Medicaid" (CFR-1, line 76) for Medicaid eligible consumers and/or "Transportation, Other" (CFR-1, line 77) for non-Medicaid eligible consumers.

See Program Codes 0670 and 0880 for specifics on reporting expenses regarding transportation to and from HCBS Day Habilitation.

Note: Do not include Day Treatment/HCBS Day Habilitation To/From Transportation expense in this program. If a vehicle or staff person is assigned to this program, but is used for to/from transportation, the related expenses must be reported under Program Code 0670. See Program Code 0670 for instructions on reporting and allocating these expenses.

Units of Service: Report using billable units. (i. e.: one quarter hour equals one unit of service.)

0227 - HCBS Prevocational Services (Services on or after 1/1/06)

Services that are aimed at preparing an individual for paid or unpaid employment, but which are not job task oriented. Services include teaching such concepts as compliance, attending, task completion, problem solving and safety. Prevocational services are provided to persons not expected to be able to join the general work force or participate satisfactory in a transitional sheltered workshop within one year (excluding supported employment programs). Report all similar services as one program/site.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code

Units of Service:

Half Unit: 2 or more hours with at least one face-to-face service

Full Unit: 4 or more hours with at least two face-to-face services

0229 - Medicaid Service Coordination (MSC)

A service which assists persons with developmental disabilities and mental retardation in gaining access to necessary services and supports appropriate to the needs of the individual. MSC is provided by qualified service coordinators and uses a person centered planning process in developing, implementing, and maintaining an Individualized Service Plan (ISP) with and for a person with developmental disabilities or mental retardation. MSC promotes the concepts of choice, individualized services and supports, and consumer satisfaction. The revenue is reported as Medicaid.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Units of Service: One month of service equals one unit of service.

0231 - HCBS Supervised IRA (Room and Board and Residential Habilitation Services)

A Supervised IRA has staff onsite or proximately available at all times when the individuals are present.

Report expenses for both Room and Board and Residential Habilitation Services. This includes assistance with acquisition, retention or improvements of self-help skills related to activities of daily living, such as personal grooming and cleanliness, bed-making and household chores, eating and the preparation of food, and the social and adaptive skills necessary to enable the individual to reside in a non-institutional setting.

Residential habilitation services are provided in the person’s place of residence. Do not include any expenses for programming provided as day habilitation. Do not include expenses for Residential Habilitation Services or Room and Board for HCBS Supportive IRAs or Part 671 Community Residences (Supervised or Supportive).

Program type reporting is required for this program. All program site expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the Agency Code and the last three digits of the Program Code.

Note: Do not include Day Treatment/HCBS Day Habilitation To/From Transportation expense in this program. If a vehicle is assigned to this program, but is used for to/from transportation, the related expenses must be reported under Program Code 0670. See Program Code 0670 for instructions on reporting and allocating these expenses.

Units of Service: One month of service equals one unit of service.

0232 - HCBS Supportive IRA (Room and Board and Residential Habilitation Services)

A Supportive IRA provides practice in independent living under variable amounts of oversight delivered in accordance with the individual’s needs for supervision. Staff typically are not onsite nor proximately available at all times when the individuals are present.

Report expenses for both Room and Board and Residential Habilitation Services. This includes assistance with acquisition, retention or improvements of self-help skills related to activities of daily living, such as personal grooming and cleanliness, bed-making and household chores, eating and the preparation of food, and the social and adaptive skills necessary to enable the individual to reside in a non-institutional setting.

Residential habilitation services are provided in the person’s place of residence. Do not include any expenses for programming provided as day habilitation. Do not include expenses for Residential Habilitation Services or Room and Board for HCBS Supervised IRAs or Part 671 Community Residences (Supervised or Supportive).

Program type reporting is required for this program. All program site expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the Agency Code and the last three digits of the Program Code.

Note: Do not include Day Treatment/HCBS Day Habilitation To/From Transportation expense in this program. If a vehicle is assigned to this program, but is used for to/from transportation, the related expenses must be reported under Program Code 0670. See Program Code 0670 for instructions on reporting and allocating these expenses.

Units of Service: One month of service equals one unit of service.

0233 - HCBS Freestanding Respite

Provision of temporary, short-term relief for families and care providers which enables them to arrange for their vacations, emergency coverage in the event of family or provider illness or death, or for a break from constant, intensive participant care and supervision. This applies only to respite provided in a freestanding center authorized or certified by OMRDD.

Site specific reporting is required for this program type. Each site is reported separately in its own column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this Program Code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: Report using billable units. (i. e.: one quarter hour equals one unit of service.)

0234 - Options for People Through Services (NYS OPTS)

Report all expenses and revenues related to an approved contract established under the NYS OPTS program. The revenue should be reported on Line 75 of CFR-1 ("OMRDD Residential Room and Board/NYS OPTS") and the expenses are reported using all applicable expense line items.

Service Type reporting is required for this program. For each Service Type included in the contract there must be a separate column on the CFR. Use the contract number as the Program/Site Identification Number (use "0" to replace the starting letter of the contract in order to create a seven digit number). Use the two digit Service Type indicator as the index code.

OPTS Service Types: 01 Supervised IRA with Res Hab; 02 Supportive IRA with Res Hab; 03 Comp Res Hab/Supervised IRA; 04 Comp Res Hab/Supportive IRA; 05 Group Day Habilitation; 06 Individual Day Habilitation; 07 Pre-Vocational; 08 Blended DP ; 09 At-Home Res Hab; 10 Hourly Respite; 11 Free Standing Respite; 12 Monthly Supported Employment (SEMP); 13 Family Care; 18 Supplemental Group Day Habilitation; 19 Blended DPS ; 20 Blended PS ; 22 General DD -Hourly; 23 General DD -Per Diem; 24 General DD -Monthly; 25 Supplemental Individual Day Habilitation; 26 General DD -Per Unit; 27 Blended DS; 99 Other.

Note: For NYS OPTS approved contracts for the Day Habilitation Service Type: revenue for transportation to and from Day Habilitation should be reported as "Transportation, Medicaid" (CFR-1, Line 76) for Medicaid eligible consumers and/or "Transportation, Other" (CFR-1, Line 77) for non-Medicaid eligible consumers.

Do not include Day Habilitation To/From Transportation expense in this program. If a vehicle or staff person is assigned to this program, but is used for to/from transportation, the related expenses must be reported under Program Code 0670.

See Program Codes 0670 and 0880 for specifics on reporting expenses regarding transportation to and from Day Habilitation.

Units of Service: Report units as per Service Type.

0235 - HCBS Other Than Freestanding Respite

Provision of temporary, short-term relief for families and care providers which enables them to arrange for their vacations, emergency coverage in the event of family or provider illness or death, or for a break from constant, intensive participant care and supervision. This applies only to respite provided in other than a freestanding respite center.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Units of Service: Report using billable units. (i. e.: one quarter hour equals one unit of service.)

0330 - Day Training

A program or planned combination of services provided to developmentally disabled persons whose level of disability is not so severe as to require day treatment services but whose functional behavior deficits limit their ability to function independently. The goal of day training programs is to provide program interventions that will assist developmentally disabled persons in the acquisitions of knowledge and skills that will enable them to improve their personal, social, and vocational skills and their ability to function independently. Day training also includes programs consisting of specialized developmental services that are operated with the goal of providing developmentally disabled persons with habilitation and social skills which will enable the individual to maintain gains made in other programs or to gain entry to a level of programming requiring more independent functioning. The program may operate as a complement to other day programs or on an intermittent basis to accommodate gaps in regular programs. Included here could be afternoon, evening or weekend programs operated by service providers who operate other day services. The emphasis of these programs is on the maintenance of existing skills and the development of social, recreational, and leisure activities which are intellectually and interpersonally stimulating and augment health maintenance. This may include recreational, music movement and art activities as indicated in the participant's program plan.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service:

Less than half-day visit: Less than 3 hours = .30

Half-day visit: 3 but less than 5 hours = .50

Full-day visit: 5 hours or more = 1. 00

For Budget Format: Count each visit as one visit.

0340 - Certified Work Activity/Sheltered Workshop

A program certified by the U.S. Department of Labor and OMRDD which provides services and experiences to participants with the goal of increasing their economic independence. Work activity programs would tend to emphasize prevocational skills with the objectives of task orientation, coordination skills, and the like with the goal of preparing the individual to function in a sheltered workshop program. Sheltered workshops are for developmentally disabled persons who have the prevocational skills necessary to perform occupational tasks with an acceptable level of output. The goals of such programs are to train individuals in the occupational tasks to be accomplished, provide necessary and appropriate adjustment training and to provide training and experience that will assist the individual in improving his/her performance. An example of this would be a sheltered employment program with the goal of assisting the handicapped person to progress toward competitive employment. The program objective is competitive employment if the potential exists, or long-term employment within a sheltered workshop if competitive employment is not feasible. Program elements would include:

  1. Diagnostic evaluation and testing;
  2. Controlled and supervised working experience for training, work adjustments, or employment in conjunction with other services, such as counseling and group therapy; and
  3. Assessment of progress, referral, and follow-up.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service:

Less than half-day visit: Less than 3 hours = .30

Half day visit: 3 but less than 5 hours = .50

Full-day visit: 5 hours or more = 1. 00

0360 - Classroom Education

A program of special education services provided on a consolidated basis with diagnosis and/or rehabilitative services for mentally retarded and developmentally disabled persons between the ages of 5 and 21. Examples of typical services include classroom education for school-aged children; diagnosis and evaluation; instruction in pre-academic skill areas; physical, recreational, and speech and hearing therapy; and counseling of families or other collaterals of participants.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: Each visit.

For Budget Format: Count each visit as one visit.

0370 - Preschool Program

Program which provides services to developmentally disabled individuals under the age of five. The goal of such services is to provide preventive and ameliorative services to children at risk of developmental disability diagnosis in order to prepare them for acceptance into a school program operated by the public schools. The activities of such programs would include but are not limited to pre-academic skills, social interaction skills, self care skills and infant stimulation.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: Each visit.

0380 - Transitional Employment

Short term intervention to lead to employment at or above minimum wage. Aimed at individuals who need assistance in learning marketable skills, good work habits and appropriate on-the-job socializing and who can become competitively employed within a time limited period. This takes place in integrated community work settings and emphasizes support provided at the worksite.

Contract Budget consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. The Program/Site Identification Number is created by using the first four digits of the Agency Code and the last three digits of the Program Code. Where more than one column will be created for this Program Code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: One hour of service provided to or on behalf of each participant equals one unit of service.

For Budget Format: Count the number of direct hours of service provided to individual participants.

0390 - Supported Employment (Non-HCBS Waiver)

Supported employment is designed for individuals who, because of the severe nature of their disabilities, require ongoing interventions and supports in order to obtain and maintain employment. It is not for those who would be better served in time limited preparations for competitive employment. The individuals must be engaged in meaningful work for wages on a full-time or part-time schedule. The employment must be in an integrated work setting providing frequent daily social interactions with people who are not disabled and who are not paid care givers. Federal guidelines suggest limiting the number of supported employees to eight per site. Supported employment exists only when there is on-going publicly financed support directly related to the maintenance of the supported employment.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: For Supported Employment programs that are funded via direct contract, report the direct care units of service. One hour of service provided to or on behalf of each consumer equals one unit of service. Direct care hours/units shall include: hours of pre-employment, hours of on-site intervention, and hours of off-site intervention, as reported on lines 17, 18 and 19 of the Individual’s Quarterly Report. For further clarifications, regarding these categories, refer to the "New York State Interagency Supported Employment Program Instructions for the Individual’s Quarterly Progress".

For Budget Format: Count the number of direct hours of service provided to individual participants.

0410 - Individualized Support Services

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: As per contract.

0411 - HCBS Consolidated Supports and Services

Only agencies that are designated as a Fiscal Employer/Agent should report under this Program Code.

Program type reporting is required for this program. All expenses paid and revenues claimed by the Fiscal Employer/Agent are to be aggregated and reported in one column. Expenses are reported using all applicable expense line items. Revenue is reported as Medicaid for Medicaid eligible individuals or as "Other Revenue" for non-Medicaid eligible individuals.

The Program/Site Identification Number is created using the first four digits of the agency code and the last three digits of the program code.

Units of Service: One unit of service equals one month.

0413 - HCBS Family Education and Training

HCBS Family Education and Training is training given to the families of consumers enrolled in the Home and Community Based waiver who are under 18 years of age. The purpose of family education and training is to enhance the decision making capacity of the family unit, provide orientation regarding the nature and impact of developmental disability upon the consumer and his or her family and teach them about service alternatives. Family education and training is distinct from service coordination in that the purpose is to support the family unit in understanding the coping with the developmental disability. The information and knowledge imparted in family education and training increases the chances of creating a support environment at a home and decreases the chances of a premature residential placement outside the home.

Family education and training is given in a two hour segment twice a year. Sessions may be private or in groups of families. Any personnel knowledgeable in the topics covered may conduct the sessions. Most frequently, this will be service coordinators, but it may also include other clinicians and experts in such fields as the law and finances pertaining to disabilities.

Program type reporting is required for this program. All expenses and revenues for all program sites are to be aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

If the individual receiving the services is HCBS waiver eligible, the funding source is Medicaid. If the individual is not HCBS waiver eligible, the funding is 100% OMRDD funded.

Units of Service: One unit of service equals a minimum of two hours. No more than 2 units of service per eligible person shall be provided on an annual basis to each family.

0414 - Epilepsy Services

Services needed by developmentally disabled individuals with epilepsy to sustain themselves in appropriate community settings. Epilepsy Services typically include, but are not limited to, information and referral, counseling, case management, education and support groups.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: As per contract.

0415 - HCBS Live-In Caregiver

When a live-in personal caregiver who is unrelated to the individual receiving care provides approved services, a portion of the rent and food that may be reasonably attributed to the caregiver who resides in the home or residence of the individual served may be reimbursed.

If the individual receiving the services is HCBS waiver eligible, the funding source is Medicaid. If the individual is not HCBS waiver eligible, the funding is 100% OMRDD funded.

Program type reporting is required for this program. All expenses and revenues for all program sites are to be aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Units of Service: One unit of service equals one month.

0416 - HCBS Waiver Plan of Care Support Services

HCBS Waiver Plan of Care Support Services are services needed to review and maintain a current Individualized Service Plan (ISP) for the consumer, and to maintain documentation of the consumer’s level of care eligibility.

If the individual receiving the services is HCBS waiver eligible, the funding source is Medicaid. If the individual is not HCBS waiver eligible, the funding is 100% OMRDD funded.

Program type reporting is required for this program. All expenses and revenues for all program sites are to be aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Units of Service: One unit of service equals six months.

0610 - Recreation

A program of social, recreational, and leisure activities which are intellectually and interpersonally stimulating but which are not necessarily part of a goal-based program plan. Agencies which provide no other types of programs should report this service in the recreation category. Recreation activities which are part of other programs should not be reported as part of recreation programs.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: Each visit.

For Budget Format: Count each visit as one visit.

0630 - Homemaker Services

Services provided in the client's home by a trained person, who is not a member of the household. Services include, but are not limited to, assisting and training the client in home management skills, household tasks, and hygiene skills; and, the training and/or assistance to parents/collaterals in the provision of such services to the developmentally disabled family member.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: Each staff hour.

For Budget Format: Count the total number of homemaker services staff hours.

0670 - Consumer Transportation

The provision of transportation for persons, as specified in the individual service plan, including all necessary supportive services for full and effective integration of the person into community life. The vehicles utilized can be either centrally located, not assigned to a particular program or used exclusively for To/From Day Habilitation.

Service providers who operate their own transportation cost center should report under this program code, as follows:

Revenue: Revenues reported under program code 0670 are to be aggregated and reported in one column.

The only revenues that should be reported under program code 0670 are those revenues received by the reporting agency from billing another agency for the transportation of the other agency’s consumers. Transportation revenue included in a rate, fee or price should not be reported under program code 0670. Transportation revenue included in a rate, fee or price should be reported in the appropriate program/site.

Expense: Expenses reported under program code 0670 are to be aggregated and reported in one column on the appropriate expense lines (Depreciation – Equipment, Interest – Vehicle, etc.) of Schedule CFR-1.

The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

For each program/site operated by your agency for which other than to and from Day Treatment or HCBS Day Habilitation transportation expenses are included in 0670, please report the appropriate allocation of those expenses to that program/site on line 68a of CFR-1. The basis for this allocation must be reasonable and documented. Such allocation methods may include the number of trips or the number of individuals.

For each program/site operated by your agency for which transportation to and from Day Treatment or HCBS Day Habilitation expenses are included in 0670, please report the appropriate allocation of those expenses to that program/site on line 68b of CFR-1. The basis for this allocation must be reasonable and documented. Such allocation methods may include the number of trips or the number of individuals.

Units of Service: One unit of service equals one round trip per person. Note: For one way trips, count two one way trips as one unit of service.

0750 - Information and Referral

The initial process of contacting, interviewing and evaluating persons for the expressed purpose of preliminary determination of the appropriateness of such persons for the receipt of particular services and/or programs including the need for further assessment. Such activities also include the requested imparting of factual knowledge about the availability of particular services, answers to administrative questions, or statements and interpretation of specified clinical data. Included in this category also is the completion and forwarding of written materials that will allow the individual to access or will facilitate access to the appropriate program or service.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: Each staff hour.

For Budget Format: Count the total number of information and referral service staff hours.

0780 - NYC Housing Resource Consortium

A program that provides guidance to consumers, families of advocates, agencies and BDSO’s on the development and implementation of small, individualized living environments in New York City.

0810 - Case Management (Non-Medicaid)

Case management - Activities aimed at linking the patient to the service system and at coordinating the various services in order to achieve a successful outcome. The objective of case management in a mental health system is continuity of care and service. Services may include linking, monitoring and case-specific advocacy.

Linking - The process of referring or transferring a patient to all required internal and external services that include the identification and acquisition of appropriate service resources.

Monitoring - Observation to assure the continuity of service in accordance with the patient's treatment plan.

Case-Specific Advocacy - Interceding on behalf of a patient to assure to services required in the individual service plan. Case management activities are expediting and coordinative in nature rather than the primary treatment services ordinarily provided by the therapist.

Case management services are provided to enrolled patients for whom staff are assigned a continuing case management responsibility. Thus, routine referrals would not be included unless the staff member making the referral retains a continuing active responsibility for the patient throughout the system of service.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service:

Direct staff hours - The number of staff hours spent by staff in providing case management services face-to-face or by telephone directly to patients or collaterals.

Indirect staff hours - The number of staff hours spent by staff in providing case management services on behalf of patients other than face-to-face or by telephone directly with patients or collaterals.

For Budget Format: Count the total number of staff hours (combine direct and indirect).

0880 - Subcontract Services

This program code is used to report all expenses associated with sub-contract provider agencies for program delivery, and for all revenues received by the reporting agency on behalf of subcontracted provider agencies.

The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Transportation Subcontracts:

For service providers that subcontract for any transportation other than to and from Day Treatment or HCBS Day Habilitation, please report the appropriate allocation of those expenses to that program/site on line 68a of CFR-1. The basis for this allocation must be reasonable and documented. Such allocation methods may include the number of trips or the number of individuals.

For service providers that subcontract for transportation to and from Day Treatment or HCBS Day Habilitation, please report the appropriate allocation of those expenses to that program/site on line 68b of CFR-1. The basis for this allocation must be reasonable and documented. Such allocation methods may include the number of trips or the number of individuals.

Transportation revenue included in a rate, fee or price should not be reported under Program Code 0880. Transportation revenue included in a rate, fee, or price should be reported in the appropriate program/site.

Units of Service:

For transportation, one unit of service equals one round trip per person. Note: For one way trips, count two one way trips as one unit of service.

0890 - Local Governmental Unit (LGU) Administration

The Local Governmental Unit is defined in Article 41 of the Mental Hygiene Law. This program category includes all local government costs related to administering mental hygiene services that are provided by a local government or by a voluntary agency pursuant to a contract with a local governmental unit. LGU Administration is funded cooperatively by OASAS, OMH and/or OMRDD. As such, this program is reported as a shared program on the core schedules (CFR-1 through CFR-6) of the CFR. LGU Administration expenses and revenues related to each State Agency are reported on State Agency specific claiming schedules (DMH-2 and DMH-3). Note: This program type is exempt from the Ratio Value allocation of agency administration.

Units of Service: Not applicable.

1053 - Community Residence Part 671 Supportive - Residential Habilitation

Report one aggregated column for all similar services.

Expenses for the following may be included:

Personal Services
Vacation Leave
Mandated Fringe
Non-mandated Fringe
Transportation Related
Staff Travel
Contracted Direct Care and Clinical Care
Other OTPS
Provider Paid Equipment

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the Agency Code and the last three digits of the Program Code. If Program Code 1053 is reported, there must also be one column of Program Code 1054 reported.

Note: Do not include Day Treatment/HCBS Day Habilitation To/From Transportation expense in this program. If a vehicle or staff person is assigned to this program, but is used for to/from transportation, the related expenses must be reported under Program Code 0670. See Program Code 0670 for instructions on reporting and allocating these expenses.

Units of Service: For each unit of service, count one participant day.

1054 - Community Residence Part 671 Supportive - Room and Board

Room and Board. Report one aggregated column for all supportive sites.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. If Program Code 1054 is reported, there must also be one column of Program Code 1053 is reported.

Report only those costs normally occurring in a room and board situation. Additional costs because program participants may have special needs are Res. Hab. costs.

Note: Do not include Day Treatment/HCBS Day Habilitation To/From Transportation expense in this program. If a vehicle or staff person is assigned to this program, but is used for to/from transportation, the related expenses must be reported under Program Code 0670. See Program Code 0670 for instructions on reporting and allocating these expenses.

Units of Service: For each unit of service, count one participant day.

1090 - Intermediate Care Facility for the Developmentally Disabled (Over 30 Beds)

A facility operated by or subject to certification by the Office of Mental Retardation and Developmental Disabilities with a capacity of over 30 in accordance with the requirements of Part 681 of Title 14 NYCRR and 42 CFR 442. Such facilities provide active programming, room and board, and continuous 24-hour per day supervision. They are located within the population areas of non-developmentally disabled persons. They are not of the facility type known as developmental center or school as defined by Section 13. 17 of the Mental Hygiene Law.

If this Program Code is reported, a corresponding OMRDD-1, ICF/DD Schedule of Service, must be completed.

Note: When the ICF/DD rate includes an add-on component for an ICF/DD School contract, report all expense and revenue in a discreet column as program code 3090 or 3091 as appropriate. Add-on for ICF/DD Sheltered Workshop - use program code 2090 or 2091 as appropriate. Add-on for ICF/DD Day Training - use program 5090 or 5091 as appropriate. When the ICF/DD rate includes funding for day program services, report all expense in a discreet column as Program Code 6090, Day Program Services Included in the ICF/DD Reimbursement Rate (On-Site) or Program Code 6091, Day Program Services Included in the ICF/DD Reimbursement Rate (Off-Site). Add-on for VOICF/DD , Day Services Contract – use program code 7090 or 7091 as appropriate.

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the site’s Operating Certificate Number as the Program/Site Identification Number.

Note: Do not include Day Treatment/HCBS Day Habilitation To/From Transportation expense in this program. If a vehicle or staff person is assigned to this program, but is used for to/from transportation, the related expenses must be reported under Program Code 0670. See Program Code 0670 for instructions on reporting and allocating these expenses.

Units of Service: For each unit of service, count one participant day.

For Budget Format: Count each participant day as one day.

1091 - Temporary Use Beds (TUBS) in an Intermediate Care Facility (Over 30 Beds)

When a bed (certified or uncertified) in an ICF/DD (over 30 beds) is used as a temporary use bed, the associated revenues and expenses should be reported under this program code. (Do not report the same revenue and expense under program code 1090 – Intermediate Care Facility (over 30 beds).)

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the site’s Operating Certificate Number as the Program/Site Identification Number.

Units of Service: One hour of service equals one unit of service.

1150 - Traumatic Brain Injury (TBI)

Those services which provide individuals with TBI and their families with information, referral, counseling, advocacy, training and emotional support. A professional approach includes intake, follow up documentation and confidentiality. In addition, outreach to schools, hospitals and other human service agencies, as well as, linkage to other professionals through client specific discussion is provided.

Program type reporting is required for this program. All program sites expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code.

Units of Service: As per contract.

For Budget Format: As per contract.

1190 - Special Legislative Grants

Specific grants funded as a result of legislative member support, targeted for a particular purpose.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent. The Program/Site Identification Number is created by using the first four digits of the Agency Code and the last three digits of the Program Code. Where more than one column will be created for this Program Code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: Not applicable.

1220 - Care at Home - III

A Medicaid Waiver service providing financial assistance to families with children living at home who have severe disabilities or medical conditions. Parental income and resources are not considered when determining the child’s eligibility for Medicaid. Medicaid services include Service Coordination, Respite Care and Assistive Technologies. For care at Home III only: the family must have applied for out-of-home residential placement for the child.

Program type reporting is required for this program. All expenses and revenues for all program sites are to be aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code

Units of Service: Not applicable.

1850 - Voluntary Preservation Project-Formerly Known as Voluntary Operated Maintenance Contract (Also Known as VAAM)

Program type reporting is required for this program. All Program/Site expenses and revenues are aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the Agency Code and the last three digits of the Program Code. Costs related to Voluntary Preservation Projects may not be included with any other program or site-specific reporting. 100% of Voluntary Preservation Project cost is to be reported as Equipment or Property, as appropriate. If the cost is depreciated on the service provider’s books, it will be a reconciling item since 100% of the cost is reported in the first year.

Units of Service: As per contract.

2090 - Voluntary Operated Intermediate Care Facility for the Developmentally Disabled,

Sheltered Workshop

Sheltered Workshop services defined as part of the VOICF/DD Active Treatment Plan that are provided to VOICF/DD consumers.

When the service provider operates both the VOICF/DD and the Sheltered Workshop program, the increased portion of the rate and the associated expense are to be reported in this discreet column using the operating certificate number of the VOICF/DD as the program/site identification number. The revenue is reported as Medicaid and the expense is reported using all applicable expense line items. Do not include this revenue and expense in the column used to report the workshop program.

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the ICF/DD’s Operating Certificate Number as the Program/Site Identification Number. For each Program Code 2090 column that is reported, there must be a corresponding Program Code 0090 or 1090 column reported

Units of Service: One day equals one unit of service.

2091 - Voluntary Operated Intermediate Care Facility for the Developmentally Disabled,

Sheltered Workshop (Not Operated by Service Provider)

When VOICF/DD consumers attend a Sheltered Workshop program that is not operated by the service provider, the increased portion of the rate and the associated expenses are to be reported in a discreet column under program code 2091 (VOICF/DD , Sheltered Workshop) using the operating certificate number of the ICF/DD as the program/site identification number. Report revenue as "Medicaid" and expense as "OTPS-Other".

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the ICF/DD’s Operating Certificate Number as the Program/Site Identification Number. For each Program Code 2091 column that is reported, there must be a corresponding Program Code 0090 or 1090 column reported.

Units of Service: One day equals one unit of service.

2190 - Developmental Disabilities Program Council Grants

Specific grants funded by the New York State Developmental Disabilities Program Council, targeted for a particular purpose.

Contract Budget Consistent reporting is required for this program. The same number of columns used on the Consolidated Budget Report must be used on the CFR so that reporting is consistent.

The Program/Site Identification Number is created by using the first four digits of the agency code and the last three digits of the program code. Where more than one column will be created for this program code, the last digit of the Program/Site Identification Number is increased by one.

Units of Service: Not applicable.

2220 - Care at Home – IV & VI

A Medicaid Waiver service providing financial assistance to families with children living at home who have severe disabilities or medical conditions. Parental income and resources are not considered when determining the child’s eligibility for Medicaid. Medicaid services include Service Coordination, Respite Care and Assistive Technologies.

Program type reporting is required for this program. All expenses and revenues for all program sites are to be aggregated and reported in one column. The Program/Site Identification Number is created by using the first four digits of the Agency Code and the last three digits of the Program Code.

Units of Service: Not applicable.

3070 - Shelter Plus Care Housing

A federally-funded program of housing assistance specifically targeted to homeless persons with disabilities and their families. Funds may be used for the payment of rent stipends up to the federally established Fair Market rent, and associated administrative expenses. OMRDD requires any not-for-profit agency in receipt of these funds to report the funds in a separate program column. Shelter Plus Care Grants are made for five or ten years at a time. This program code is used in cases where the federal funds flow through OMRDD.

Units of Service: Not applicable.

For Budget Format: Not applicable.

3090 - Voluntary Operated Intermediate Care Facility for the Developmentally Disabled, School District Contract

If a service provider operates both the School and VOICF/DD programs, VOICF/DD add-on components to the VOICF/DD rate are to be reported as a stand alone program using program code 3090. The educational expenses and revenues relating to the approved private school program should be allocated based on the number of FTE students of the school program. The allocated expenses and revenues should be reported using program code 3090. The revenue is reported as Medicaid and the expense is reported using all applicable expense line items. The expenses and revenues of students served in the approved school program not residing in the ICF will continue to be reported to SED using program code 9000. Refer to program code 3091, if the School and VOICF/DD programs are not operated by the same service provider.

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the ICF/DD's Operating Certificate Number as the Program/Site Identification Number. For each Program Code 3090 column that is reported, there must be a corresponding Program Code 0090 or 1090 column reported.

Units of Service: One ICF residential day equals one unit of service.

3091 - Voluntary Operated Intermediate Care Facility for the Developmentally Disabled,

School District Contracts (Not Operated by Service Provider)

Educational services defined as part of the VOICF/DD Active Treatment that are provided to ICF consumers via a contract between the VOICF/DD provider and a local school district. The increase to the VOICF/DD rate that was added for this service and the associated expense is to be reported in this discreet column. Use the operating certificate number of the consumers' ICF as the program/site identification number. The revenue is reported as Medicaid and the expense is reported as "OTPS - Other". When this condition exists in more than one VOICF/DD , multiple columns for the VOICF/DD School District Contract will be required.

For each VOICF/DD School District Contract column, there must be a corresponding Program Code 0090 or 1090 column reported.

Units of Service: For VOICF/DD School District Contract, one ICF residential day equals one unit of service.

4090 - State Operated Intermediate Care Facility for the Developmentally Disabled, Sheltered Workshop/Day Training

Sheltered Workshop/Day training services defined as part of the SOICF/DD Active Treatment Plan that are provided to SOICF/DD consumers via a contract. The revenue and the associated expense is to be reported in this discreet column using the operating certificate number of the day training program as the program/site identification number. The revenue is reported as Medicaid and the expense is reported using all applicable expense line items. Do not include this revenue and expense in the column used to report the day training program.

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the Operating Certificate Number of the day training program as the Program/Site Identification Number.

Units of Service: One day equals one unit of service.

5090 - Voluntary Operated Intermediate Care Facility for the Developmentally Disabled, Day Training

Day training services defined as part of the VOICF/DD Active Treatment Plan that are provided to VOICF/DD consumers.

When the service provider operates both the VOICF/DD and the Day Training program, the increased portion of the rate and the associated expense is to be reported in this discreet column using the operating certificate number of the VOICF/DD as the program/site identification number. The revenue is reported as Medicaid and the expense is reported using all applicable expense line items. Do not include this revenue and expense in the column used to report the day training program.

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the ICF/DD’s Operating Certificate Number as the Program/Site Identification Number. For each Program Code 5090 column that is reported, there must be a corresponding Program Code 0090 or 1090 column reported.

Units of Service: One day equals one unit of service.

5091 - Voluntary Operated Intermediate Care Facility for the Developmentally Disabled,

Day Training (Not Operated by Service Provider)

When VOICF/DD consumers attend a Day Training program that is not operated by the service provider, the increased portion of the rate and the associated expenses are to be reported in a discreet column under program code 5091 (VOICF/DD , Day Training) using the operating certificate number of the ICF as the program/site identification number. Report revenue as "Medicaid" and expense as "OTPS-Other".

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the ICF/DD’s Operating Certificate Number as the Program/Site Identification Number. For each Program Code 5091 column that is reported, there must be a corresponding Program Code 0090 or 1090 column reported.

Units of Service: One day equals one unit of service.

6090 - Day Program Services Included in the ICF/DD Reimbursement Rate (On-Site)

Day program services for ICF/DD (Program Code 0090 and 1090) consumers whose comprehensive functional assessments require that such services be delivered by the ICF/DD and the funding for these services is included in the ICF/DD rate.

When an ICF/DD has reimbursement for Day Program Services provided by the ICF/DD included in its rate, the associated expenses of the day program are to be reported in a discreet column under Program Code 6090 using the operating certificate of the ICF/DD as the program/site identification number. The revenue is reported as Medicaid and the expense is reported using all applicable expense line items. Do not report Sheltered Workshop, School District Contract, or Day Training Expenses included in an ICF/DD rate under Program Code 6090. These should be reported using Program Codes 2090, 2091, 3090, 3091, 5090 or 5091.

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the ICF/DD’s Operating Certificate Number as the Program/Site Identification Number. For each Program Code 6090 column that is reported, there must be a corresponding Program Code 0090 or 1090 column reported.

Units of Service:

Half-day service: 3 but less than 5 hours.

Full-day service: 5 hours or more.

6091 - Day Program Services Included in the ICF/DD Reimbursement Rate (Off-Site)

Day program services for ICF/DD (Program Code 0090 and 1090) consumers whose comprehensive functional assessments require that such services be delivered by other than the ICF/DD and the funding for these services is included in the ICF/DD rate.

When an ICF/DD has reimbursement for Day Program Services provided by other than the ICF/DD included in its rate, the associated expenses of the day program are to be reported in a discreet column under Program Code 6091 using the operating certificate of the ICF/DD as the program/site identification number. Do not report Sheltered Workshop, School District Contract, or Day Training Expenses included in an ICF/DD rate under Program Code 6091. These should be reported using Program Codes 2090, 2091, 3090, 3091, 5090 or 5091. If the service provider operates both the ICF/DD and the day program service, the expense is reported using all expense lines. If the service provider does not operate the day program service, the expense should be reported as "OTPS-Other". The revenue is reported as Medicaid.

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the ICF/DD’s Operating Certificate Number as the Program/Site Identification Number. For each Program Code 6091 column that is reported, there must be a corresponding Program Code 0090 or 1090 column reported.

Units of Service:

Half-day service: 3 but less than 5 hours.

Full-day service: 5 hours or more.

7090 - Voluntary Operated Intermediate Care Facility for the Developmentally Disabled, Day Services Contract

This Program Code should be used when the ICF/DD rate includes an add-on for day programming services where the provider of day program service bills OMRDD directly.

When the service provider operates both the VOICF/DD and the Day Service program, the increased portion of the rate and the associated expense is to be reported in this discreet column using the operating certificate number of the VOICF/DD as the program/site identification number. The revenue is reported as Medicaid and the expense is reported using all applicable expense line items. Do not include this revenue and expense in the column used to report the day service program.

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the ICF/DD’s Operating Certificate Number as the Program/Site Identification Number. For each Program Code 7090 column that is reported, there must be a corresponding Program Code 0090 or 1090 column reported.

Units of Service: Contact during one 24-hour period, regardless of the length of service, equals one unit of service.

7091 - Voluntary Operated Intermediate Care Facility for the Developmentally Disabled, Day Services (Not Operated by Service Provider)

This Program Code should be used when the ICF/DD rate includes an add-on for day programming services where the provider of day program service bills OMRDD directly.

When VOICF/DD consumers attend a Day Service program that is not operated by the service provider, the increased portion of the rate and the associated expenses are to be reported in this discreet column using the operating certificate number of the ICF as the program/site identification number. Report revenue as "Medicaid" and expense as "OTPS-Other".

Site specific reporting is required for this program type. Each site is reported separately in its own column. Use the ICF/DD’s Operating Certificate Number as the Program/Site Identification Number. For each Program Code 7091 column that is reported, there must be a corresponding Program Code 0090 or 1090 column reported.

Units of Service: Contact during one 24-hour period, regardless of the length of service, equals one unit of service.

Comments or questions about the information on this page can be directed to the Community Budget & Financial Management (CBFM) Group.