CANS-NY

• Coding Definitions for the Ratings
  (Coding 542 KB)
• Effective Communication with Families Using the CANS
  (Effective 36 KB)
• Manual and Supporting Documentation
  (Manual 260 KB)
• Rating Sheet
  (Rating 294 KB)

B2H Forms

• OCFS-8000 Referral Form
  (OCFS-8000 58 KB) (OCFS-8000 PDF 16 KB)
• OCFS-8001 Authorization for Release of Health Information
  (OCFS-8001 70 KB) (OCFS-8001 PDF 16 KB)
• OCFS-8002 Understanding the Bridges to Health Medicaid Waiver Program
  (OCFS-8002 43 KB) (OCFS-8002 PDF 20 KB)
• OCFS-8003 Freedom of Choice Form
  (OCFS-8003 37 KB) (OCFS-8003 PDF 8 KB)
• OCFS-8004 Application Form for Enrollment
  (OCFS-8004 72 KB) (OCFS-8004 PDF 22 KB)
• OCFS-8005A Level of Care for Children with Serious Emotional Disturbances - SED
  (OCFS-8005A 74 KB) (OCFS-8005A PDF 24 KB)
• OCFS-8005B ICF-MR Level of Care Eligibility Determination-LCED Form
  (OCFS-8005B 1060 KB) (OCFS-8005B PDF 45 KB)
• OCFS-8005C Level of Care for Children with Medical Fragility (MedF) Pediatric Patient Review Instrument
  (OCFS-8005C 214 KB) (OCFS-8005C PDF 24 KB)
• OCFS-8006 Change of Provider Form
  (OCFS-8006 64 KB) (OCFS-8006 PDF 12 KB)
• OCFS-8007 Health Care Integrator Selection Form
  (OCFS-8007 44 KB) (OCFS-8007 PDF 11 KB)
• OCFS-8008 Waiver Participants Rights Form
  (OCFS-8008 49 KB) (OCFS-8008 PDF 19 KB)
• OCFS-8009 Notice of Decision- Authorization
  (OCFS-8009 64 KB) (OCFS-8009 PDF 20 KB)
• OCFS-8010A Notice of Decision - Denial of Enrollment
  (OCFS-8010A 70 KB) (OCFS-8010A PDF 20 KB)
• OCFS-8010B Notice of Decision - Denial of Waiver Services
  (OCFS-8010B 76 KB) (OCFS-8010B PDF 21 KB)
• OCFS-8011A Notice of Decision - Discontinuance from Waiver Program
  (OCFS-8011A 79 KB) (OCFS-8011A PDF 23 KB)
• OCFS-8011B notice of Decision Discontinuance of Waiver Services - Service Providers and or Reduction of Services
  (OCFS-8011B 91 KB) (OCFS-8011B PDF 24 KB)
• OCFS-8012 Wait List Notification Form
  (OCFS-8012 50 KB) (OCFS-8012 PDF 11 KB)
• OCFS-8014 Reauthorization Form
  (OCFS-8014 58 KB) (OCFS-8014 PDF 36 KB)
• OCFS-8015A Health Care Integration Agency Quarterly-Annual Report
  (OCFS-8015A 176 KB) (OCFS-8015A PDF 21 KB)
• OCFS-8015B Serious Incident Review Committee Quarterly Report
  (OCFS-8015B 74 KB) (OCFS-8015B PDF 18 KB)
• OCFS-8017 Individualized Health Plan-IHP
  (OCFS-8017 178 KB) (OCFS-8017 PDF 51 KB)(OCFS-8017 Excel 34 KB)
• OCFS-8018 Service Summary Form
  (OCFS-8018 85 KB) (OCFS-8018 PDF 226 KB)
• OCFS-8019 Progress Notes
  (OCFS-8019 38 KB) (OCFS-8019 PDF 9 KB)
• OCFS-8020 Detailed Service Plan
  (OCFS-8020 84 KB) (OCFS-8020 PDF 34 KB)
• OCFS-8021 Serious Reportable Incident Form
  (OCFS-8021 100 KB) (OCFS-8021 PDF 16 KB)
• OCFS-8022 Status Progress Report
  (OCFS-8022 58 KB)
• OCFS-8023 Serious Reportable Incident Response Form
  (OCFS-8023 60 KB) (OCFS-8023 PDF 14 KB)
• OCFS-8024 Grievance - Complaint Packet
  (OCFS-8024 110 KB) (OCFS-8024 PDF 22 KB)
• OCFS-8025 Certificate of Attendance
  (OCFS-8025 32 KB) (OCFS-8025 PDF 7 KB)
• OCFS-8026 Loss of Eligibility Recommendation Form
  (OCFS-8026 76 KB) (OCFS-8026 PDF 15 KB)
• OCFS-8027 Contact Information List
  (OCFS-8027 105 KB) (OCFS-8027 PDF 16 KB)
• OCFS-8028 Accessibility Modifications and or Adaptive and Assistive Equipment Discription Cost Projection and Final Cost
  (OCFS-8028 78 KB) (OCFS-8028 PDF 17 KB)
• OCFS-8030 Transition Plan
  (OCFS-8030 86 KB) (OCFS-8030 PDF 15 KB)
• OCFS-8034 Qualification Form
  (OCFS-8034 59 KB) (OCFS-8034 PDF 14 KB)
• OCFS-8035 Schedule A - Waiver Service Provider Commitment form
  (OCFS-8035 106 KB) (OCFS-8035 PDF 34 KB)
• OCFS-8036 Medication Error Report
  (OCFS-8036 50 KB) (OCFS-8036 PDF 8 KB)