Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
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New York program

Medicaid that leaves out parents' income (Children's Waiver)

The Children’s Waiver is one New York route to Medicaid and home supports for a child with qualifying care needs. It can also add waiver services for a child who already has Medicaid.

What it is

The Children’s Waiver is one New York route to Medicaid and home supports for a child with qualifying care needs. It can also add waiver services for a child who already has Medicaid.

A child who needs hospital-level or similar care may qualify for Medicaid through the Children's Waiver. The financial review uses the child's own income and resources. A cancer diagnosis alone does not establish the care level.

Eligibility rules
  • The Children's Waiver serves eligible children ages 0–20 in its target groups.
  • The care test can be hospital, nursing-facility or ICF/IID level of care.
  • The local district reviews the child's finances as a household of one, without parental income.
What you get
  • Medicaid based on your child's finances, with parents' income disregarded.
  • Care coordination, respite and other approved home and community supports.
What the help includes
  • Services depend on the assessed needs and waiver plan. Transitional care coordination can help with a move home.
  • OPWDD has a separate waiver requiring a qualifying developmental disability. Leukemia alone does not establish that condition.
  • NHTD and TBI waivers have their own disability and nursing-facility tests for eligible 18–20-year-olds.
If you decide to apply
  1. Ask the oncology social worker to discuss a current C-YES referral with you.
  2. Describe a typical day and keep a two-week record of skilled care, frequency and safety needs.
  3. Ask the care team to explain what would happen without that daily support.

C-YES: 833-861-4467 or 518-408-5358; CYESConnect@health.ny.gov · Official page ↗

After you ask
  • C-YES or a Health Home assesses the care level, and the local district handles the financial review.
  • The state took over C-YES on January 1, 2026. Older referral forms are not accepted.
Good to know

The care assessment is separate from the income review. Chemotherapy alone does not automatically meet it.

Other details
  • The current waiver approval runs through March 31, 2027, following an amendment approved March 20, 2026.
  • A referral does not itself start coverage or promise a place.
  • A referral does not guarantee eligibility, an immediate place or a particular service. The social worker can ask C-YES or the Health Home to confirm the current assessment timetable, whether a discharge-priority process applies, and any wait for your child’s services. The district must identify the child’s financial category, current income and resource rules, and any amount the family would owe; a questionnaire cannot settle these points.

Federal background: Medicaid home-care programs (waivers).

Official sources
Ask your social worker

“Could the daily care our child needs meet the Children's Waiver test? What would it add, what would the assessment involve, and could you help with a referral if it makes sense?”

Why I’m asking: We want to know whether our child's care needs open a Medicaid route that does not depend on our income.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Sign the referral, keep a two-week log of daily tasks, and answer the evaluator's questions about a typical day.

Your social worker

The social worker sends the current C-YES referral and gathers the medical documentation.

The care team

Writes the description of daily skilled care (what, how often, what happens without it) that decides the level of care.

Who decides
C-YES or the Health Home decides whether the level of care is met. The local district budgets the child as a family of one. The state Department of Health runs the waiver.
Ask your social worker
“New York has no Katie Beckett: can you send the C-YES referral for the Children's Waiver this week, and who writes the level-of-care description?”

How to apply

First step: Ask the social worker to send the current C-YES referral this week, or call 833-861-4467 (518-408-5358; CYESConnect@health.ny.gov).

  1. Ask the social worker to send the C-YES referral this week, or call 833-861-4467.
  2. Ask the oncology team to describe every daily skilled task in writing (line care, tube feeds, IV nutrition, oxygen, monitoring).
  3. Once eligible, ask the care manager for the family-of-one Medicaid budget and the plan of care.

Official application / program page ↗

Where it starts: Ask the oncology social worker to send the current C-YES referral form (older versions are invalid), or call C-YES: 833-861-4467 (toll-free) or 518-408-5358; CYESConnect@health.ny.gov.

What to gather

  • Pathology report and oncologist's letter with the diagnosis and relapse dates
  • The doctor's and nurse's description of daily skilled care
  • A two-week log of what you do at home and how long it takes
  • The child's own accounts (the child's money is tested, not the parents')

How long: The evaluation timeline and the wait for a slot were not found. Ask C-YES when you send the referral.

What a yes looks like

A letter saying the waiver's level of care is met (the "HCBS eligibility determination"), a care manager's name, a plan of care listing the services, and a Medicaid card in the child's own name.

What a no looks like, and the next move

"Level of care not met": ask what was missing, add the daily-care log and appeal. If the child has Medicaid, ask the plan or Health Home meanwhile for home nursing and personal care under Medicaid's rule that a child under 21 gets what is medically needed (EPSDT).

Watch out

  • A questionnaire does not establish the clinical level of care. The care team can describe the daily tasks, risks and discharge needs for an assessment.
  • Use the current C-YES referral form: older versions are no longer accepted. The state took over C-YES on January 1, 2026.
  • Slots, waiting lists and the real wait were not found. Send the referral now and ask C-YES the current wait; do not drop the work plan while you wait.
  • The current waiting-list status, capacity and referral decision time remain unknown. An incomplete state-plan checkbox does not establish that every other disability coverage route is absent.

Dates that change this

2026-01-01: New York State assumed the C-YES role on January 1, 2026; use the referral form linked on the C-YES page, older versions are invalid. (not yet confirmed against the final rule)

2027-03-31: The Children's Waiver's current approval expires March 31, 2027; renewal terms were not found.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 10, 2026.

What it is worth

Medicaid on the child's own income (parents' income ignored), plus waiver services: care coordination, respite, transitional care coordination and other home and community supports. No premium was found.

Covers: Medicaid on the child's own income and resources (family of one) · Health Home or waiver care management · Transitional care coordination (hospital to home) · Respite, community habilitation, environmental and vehicle modifications and other HCBS as authorized

What it costs the family: No cost share was found. Ask C-YES or the Health Home what, if anything, the family pays.

The eligibility facts, as published

Age
ages 0 through 20 (medically fragile, technology dependent, physical disability and other target groups)
Age max exclusive
21
Level of care
hospital, nursing facility or ICF/IID level of care (any one suffices)
Financial
family of one: the child's own income and resources, disregarding parental income (NYSDOH children's system definitions)
No tefra
Unverified: the retrieved optional-group screen is incomplete; non-election is not established.
Waiver period
current approval expires 2027-03-31; latest amendment approved 2026-03-20 (CMS)
Waiting list
NOT FOUND (counts, dates, discharge priority, assessment deadline and practice wait all unknown on 2026-09-08)
Opwdd waiver
separate 1915(c) waiver requiring a qualifying developmental disability and ICF/IID level of care; leukemia alone does not establish it; parental deeming can be waived after a complete Application for Participation
Ages 18 20
NHTD and TBI waivers serve 18 to 20-year-olds who meet their own disability and nursing-facility tests

Decisions this site cannot make: Level-of-care determination · Family-of-one Medicaid budget by the local district · Waiver enrollment

Expect friction on: Referral form and evaluation · Slots and wait unknown · Care-plan authorization

The trap: The level-of-care review turns on daily care, not the diagnosis. Chemotherapy with ordinary care at home rarely passes. A central line, tube feeds, IV nutrition, oxygen or safety needs are what the review recognizes.

Where I read this

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