Overview
Programs certified under the Part 820 Residential Services Certification are approved to provide certain elements of care in a residential setting. A program may apply for any combination of Elements (Stabilization, Rehabilitation and/or Reintegration) and must complete an application identifying specific services and staffing for each proposed Element of Care.
Residential Redesign
Current residential treatment providers are encouraged to transition from Part 819 - Chemical Dependence Residential Services and/or Part 816.9 Medically-monitored Withdrawal and Stabilization certification to Part 820 - Residential Services. OASAS will provide a one-time payment of up to $205,000 to assist in program conversions. Providers should utilize the guidance documents on this page to formulate their transition and implementation plans. For technical assistance contact your Regional Office and [email protected].
Services
Residential redesign is intended to increase flexibility for programs to provide services within residential settings based on the needs of each resident. LOCADTR 3.0 is a tool that is used by substance use treatment providers, Medicaid Managed Care plans, and other referral sources to determine the most appropriate level of care for a resident with a substance use disorder, can be used to assist in the identification of the Element of care most appropriate to the needs of the individual prospective resident.
Residents should enter treatment at the Element that most meets their needs and may move through the Elements as their individual needs require. The Elements are not linear, and not all residents will need to move from one Element to another or require all Elements. Movement between Elements is based on the clinical needs of the resident and not time in treatment.
Application
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Residential Redesign Conversion Application
A program may apply for any combination of elements under the new 820 regulations (stabilization, rehabilitation and/or reintegration), and must complete the application and certification process for each element of care that is proposed. Updated 05/25/22.
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Conversion Funding
OASAS will provide a one-time payment of up to $205,000 to assist in program conversions.
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Clinical & Fiscal Guidance
Part 820 Fiscal & Programmatic Updates
OASAS hosted a webinar for Part 820 providers to address the availability of the Medicaid Tx per diem payment. This webinar includes programmatic guidance for the Reintegration element and time limited rate enhancements for all elements.
Residential Redesign Providers Meetings
February 27, 2024
Effective January 9, 2024, CMS has removed the IMD restrictions under a newly approved Federal waiver. All OASAS Part 820 residential programs are permitted to bill Fee-for-Service (FFS) Medicaid for Medicaid-enrolled program residents that are not members of a Medicaid Managed Care (MMC) plan. This webinar reviewed the related change and the impact on Part 820 programs.
Watch the February 27, 2024 Meeting
Download the Feb. 27, 2024 Meeting Slides
May 10, 2023
On May 10, 2023, OASAS facilitated a discussion about transition to Part 820 Elements of care and availability of the Medicaid Tx per diem payment. This webinar includes programmatic guidance for Residential providers and Part 820 designated providers.
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Clinical Pathways for Residential Redesign
Guidance for differentiating between the various types of issues addressed by Stabilization Programs and Rehabilitation Programs.
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Part 820 Residential Program Guidance
This guidance provides Residential Services programs with additional information related to certification, reimbursement, claim submission, funding streams, and Medicaid and managed care enrollment for service recipients.
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NYS Medicaid Managed Care Plan Resource Guide
Billing and contracting guidance for certified Part 820 Residential Services Programs from OASAS, NYS Department of Health, and the Office of Health Insurance Programs.
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Routine Medical Services in Part 820 Programs
Billing guidance for medical and clinical services at Part 820 Residential programs.
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Medicaid Managed Care Enrollment Guidance
OASAS guidance on the expedited Medicaid managed care selection and enrollment process for individuals receiving OASAS residential services (Title 14 Part 820).
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Maintaining Uninterrupted Managed Care Enrollments in Part 820 Elements of Care
Office of Temporary and Disability guidance on maintaining uninterrupted managed care enrollment for individuals receiving OASAS Certified Title 14 Part 820 Residential services when a case is transferred from New York State of Health (NYSoH) to the local department of social services (district). The documentation confirms that OASAS Certified Part 820 program may receive Congregate Care Level II funds.
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Appendix A
The Appendix A form together with the LOCADTR report, constitute notice to the insurer of an admission to a Part 820 specific element of service.
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Part 820 Revenue Streams
This table identifies the revenue streams available for each of the Part 820 elements of care: Stabilization, Rehabilitation and Reintegration.
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Part 820 Revenue Calculator
Providers can use this tool to project their Medicaid and Managed Care revenues for the Stabilization, Rehabilitation and Reintegration elements of Part 820 Certified Programs.
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Maintaining Uninterrupted Managed Care Enrollments in Part 820 Elements of Care
Office of Temporary and Disability guidance on maintaining uninterrupted managed care enrollment for individuals receiving OASAS Certified Title 14 Part 820 Residential services when a case is transferred from New York State of Health (NYSoH) to the local department of social services (district). The documentation confirms that OASAS Certified Part 820 program may receive Congregate Care Level II funds.
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Operational Guidance
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Policies and Procedures
A guidance document for addressing program operations that facilitate compliance with the Part 820 Residential Services regulations.
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Policies and Procedures Checklist
This checklist helps support the development of a Policy and Procedure Manual for OASAS-certified Part 820 residential programs. It should not be submitted with your application.
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Staffing Pattern Worksheet
Staffing schedule worksheet for employees working in a residential settings.
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Nurse Staffing
Frequently asked questions regarding nurse staffing in Part 820 Residential Programs.
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Guidance on Limitations on Participant Work Activities
Guidance addressing the appropriateness of OASAS program participants who become involved in work activities that are not directly related to their treatment and rehabilitation.
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Participant Screen and Search
Guidance on integrating person-centered, strength based, trauma-informed practices to ensure health and safety in residential settings. References to the prohibition on body cavity searches included in this guidance document will be effective upon adoption of pending amendments to Parts 815 and 836.
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