Frequently Asked Questions

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In April of 2016, there was a regulatory change that no longer allowed for an Article 16 Clinic to provide services at an off-site location. The regulation established a new way for these services to be funded called IPSIDD. If a service needs to be provided at a non-certified clinic site,  a  referral may be made to Presence.

Presence Services cannot be provided at the following locations:

• Educational Settings
• ICF’s/IID’s
• Day Treatment Facilities
• Clinic Treatment Facilities certified by OPWDD, DOH,OMH and OASAS
• Hospitals
• Any other licensed or certified residential or day healthcare programs that include clinical services as part of their service model/reimbursement rates.
• Presence cannot be provided to individuals receiving similar services from an Early Intervention Program.
• Presence services must not duplicate or replace Preschool Supportive Services or School Supportive Health Services that are authorized through an IEP. Presence may address needs that are not identified in the IEP and are not school related as determined by the child’s Committee on Special Education.
• Presence services cannot duplicate/replace services available through OPWDD certified day, residential, HCBS or clinic services/programs. It cannot duplicate services provided by a Certified Home Health Agency. Services can be provided however to address different clinical needs.
• Time spent receiving another Medicaid service cannot be counted toward Presence billable service time.

• In an individual‘s home. This may be an IRA, CR, Family Care home or personal residence
• Certified day hab, pre-vocational and day training programs as long as these are not also certified clinic sites
• Community settings deemed appropriate by the clinician