Office of Children and Family Services

Bureau of Children’s Medicaid Management

The end of the Bridges to Health program means changes are coming to this site; the OCFS Bureau of Children’s Medicaid Management is working on updates!

Bureau of Children’s Medicaid Management

The Bridges to Health (B2H) Home and Community-based Medicaid services waiver program is designed to provide children in foster care who have significant mental health or developmental disabilities, or health care needs, with services to help them live in a home or community-based setting.

B2H helps improve the health and well-being of these children and avoid, delay, or prevent medical institutional care.

B2H consists of three waivers—B2H for Children with Serious Emotional Disturbances (SED), B2H for children with Developmental Disabilities (B2H DD), and B2H for Medically Fragile (B2H MedF) children.

B2H Eligibility

A child can qualify for waiver entry only while in foster care. However, once in the waiver, they can generally retain the services until age 21, as long as they meet waiver eligibility. To enhance their opportunities for successful reunifications and placements, the services can follow the participant home, into adoption, to lower levels of foster care and to adulthood.

  • The child must be Medicaid eligible.
  • The child must have a qualifying diagnosis.
  • The child must be able to benefit from the services.

The number of B2H waiver "slots" statewide is limited. Applications are accepted on a first come, first served basis, and a child may be placed on a waiting list for waivers.

B2H Services

The B2H program provides family and community support services that supplement primary foster care and Medicaid state plan programs. B2H offers the following services:

  • Health care integration
  • Family and caregiver supports and services
  • Skill building
  • Day habilitation
  • Special needs community advocacy and support
  • Pre-vocational services
  • Supported employment
  • Planned respite
  • Crisis avoidance, management, and training
  • Immediate crisis response services
  • Intensive in-home supports
  • Crisis respite
  • Adaptive and assistive equipment
  • Accessibility modifications

B2H Service Providers

Child care agencies with demonstrated experience in provided supplemental services for children in out-of-home care, known as Health Care Integration Agencies (HCIAs), provide B2H services. HCIAs must have experience in serving people with disabilities. Local Departments of Social Services (LDSSs) make the eligibility determinations, enrollment decisions and referrals to HCIAs. HCIAs employ Health Care Integrators (HCIs) and Waiver Service Providers (WSPs) who are responsible for coordinating and administering the services.

B2H Program Elements

B2H enables the family network to be served along with the child and can involve multiple families simultaneously, e.g., foster parents, biological parents, and pre-adoptive parents.

Many foster children have multiple disabilities which no single system serves well. The waivers serve three eligibility groups of children in foster care, so that cross-systems issues can be better integrated.

Individualized Health Plans (IHPs) are designed to specify a child's goals and the services necessary to maintain him or her in the home community. IHPs are paramount in order to address singular traumatic events a child in care can experience, such as identifying, intervening and following through a crisis situation.

B2H Rates

Approved rates for the Bridges to Health (B2H) Medicaid Home and Community-Based Services Waiver Program: