Category Archives: Advocacy

Challenging “Denial of Services 
for People with Developmental Disabilities in Self Direction”

Advocacy, Self-Direction

Challenging “Denial of Services 
for People with Developmental Disabilities in Self Direction”

By Jim Karpe , March 2016

Highlights

  • Burden of proof is on OPWDD to prove that a setting is segregated.

Any denial of service can be appealed thru a fair hearing. Start your request at http://otda.ny.gov/hearings/request/

News from Fair Hearings

The Burden of Proof is on the Agency. A family on Long Island has successfully challenged the refusal by New York State to pay for a “community class” from a Self-Direction provider. They had a Medicaid Fair Hearing that established that the State had failed to provide credible proof of their claim that the services were provided in a segregated setting. “Accordingly the Agency’s action is not correct and is reversed.” http://otda.ny.gov/fair%20hearing%20images/2016-3/Redacted_7220725N.pdf

Fair Hearings for any refusal. That decision established that a Medicaid Fair Hearing DOES have jurisdiction over a refusal by the State to pay for services due to a claim that the setting is not integrated. In addition, it appears that the State has an obligation to inform families of their due process rights whenever there is a refusal. Over the past few years, the State has consistently failed in this “duty to inform”.

Challenge to the Settings rule.   Acting on behalf of my son, we have challenged the validity of the “community class” category and the other narrow categories for which OPWDD will approve funding. This case has not yet been decided. When it does, it should show up on the OTDA (Office of Temporary and Disability Assistance) site as:

http://otda.ny.gov/fair%20hearing%20images/2016-3/Redacted_7245277H.pdf

If that hearing does not result in eliminating the overly restrictive categories then the case will need to go to State or Federal court. This is only possible after the administrative appeals have been exhausted.

IF YOU HAVE BEEN REFUSED SERVICES

You can take action if you have been refused services—whether provided under
Self Direction or under the traditional service model, no matter how long ago that was. Call up your local DDRO and request the restoration of services based on hearing #7245277H, referenced above. Tell them that you will be requesting a Medicaid Fair Hearing if they do not provide the services. They may tell you that you are not entitled to a Medicaid Fair Hearing for this particular decision. If services were discontinued more than 30 days ago, then they may state that you are past the time limit to request a hearing. Ask them to put that in writing (they will not). Since they did not provide notification of your due process rights, the 30-day clock never started ticking. Go ahead and request the hearing no matter what—unless of course they restore your services based on your phone call.

How to request a Hearing. If you have been refused Medicaid Funded services, then you have a right to a Fair Hearing. This is true no matter the situation. Insist they fulfill their obligation to prove that their decision was appropriate. To file for a hearing, start here: http://otda.ny.gov/hearings/request/

Since the State did not inform you of your due process rights, select “My request is NOT about a notice.” You will get a letter within a few days acknowledging your request. The hearing will probably occur within three weeks of the request– and most likely a letter with the date of the hearing will come only a few days before the hearing.

 Challenging Denial of Services by Jim Karpe
for People with Developmental Disabilities

 

One House Bills

Action Alerts, Advocacy, NYS Legislative Information, opwdd

“Both the Senate and the Assembly printed their one-House bills on Saturday, March 12th. The one-House bills establish the opening positions of the two Houses and their Democratic and Republican majorities in the Assembly and Senate, respectively. The bills will not actually be passed by either House. Instead, each House passed a resolution proclaiming that the one-House bills represent its position on the state budget. Those positions must be negotiated into final budget by the three leaders: the Governor, the Assembly Speaker, and the Senate Majority leader.
Following are some highlights of what is in each of the one-House bills.”  from COPA

Click Here For Text: COPA – One-House Bill Highlights – march 19 2016
 Click Here For Text: NYSARC-Assembly and Senate print one house budget bills 3-14-16 FINAL

We have until April 1 to make a difference

Action Alerts, Advocacy, Bronx, Brooklyn, Events, Manhattan, Queens, Staten Island, , , , ,

We have until April 1 to make a difference

SAVE-THE DATE:

Michael Seereiter, Pres. & CEO of NYSRA and
Peter Pierri, Exec. Director of IAC

will meet with NYC FAIR on

Tuesday, March 22nd, 2016,
6 to 8pm, @ IAC, 

150 West 30th Street, 15th Floor

What the landscape is now and going forward
Actions we can take, things we can do 

Translation Available

Light Refreshments

Call-in

Register Here:

ALERT: MORE CALLS NEEDED!

Action Alerts, Advocacy, Bronx, Brooklyn, Manhattan, Queens, Staten Island, , , , , ,

COALITION OF FAMILIES FOR DIRECT SUPPORT STAFF

IN SERVICES FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES
c/o Margaret Puddington, 562 West End Avenue, 2A, New York, N.Y. 10024,  (212) 799-2042

FAMILIES, DIRECT SUPPORT PROFESSIONALS, EDUCATION STAFF

CALL THE GOVERNOR

AND YOUR LEGISLATORS  

RIGHT AWAY!!!!!

 

Governor Cuomo did not include funding to implement a minimum wage increase for low wage workers in programs for people with developmental disabilities or in school programs in his 30 day amendments.

Therefore, we are launching a second round of calls and letters to legislators and the Governor imploring them to include such funding in the final budget agreement.  

 

Governor Cuomo MUST add funding for his proposed minimum wage increase in his budget amendments.

  • Governor Cuomo has proposed a $15 minimum wage for all. But he failed to include funding to raise the salaries for Direct Support Professionals, Special Education staff, and other low-wage workers in non-profit agencies.  
  • Non-profit providers cannot raise wages without additional funding from the state.  These providers rely exclusively on the state for funding; they have no other sources of revenue (unlike McDonald’s, which can raise its prices or cut profits).   

CALL the Governor, Your Senator and Assemblymember, and SAY:

Governor Cuomo and our legislators MUST PROVIDE FUNDING in the budget for the $15 minimum wage proposal!

 

Non-profit organizations funded by the state provide services to people with developmental disabilities.  But non-profit providers cannot raise wages for their staff without additional state funding. 

Direct support and special education staff are highly trained and bear tremendous responsibility.  They deserve more than the minimum wage.   The state must provide funding for appropriate increases for the staff who work tirelessly caring for people with developmental disabilities.

CONTACT Information: 

  1. Governor (518) 474 -1041 and press 3 to speak to an assistant
  2. Senate switchboard  (518) 455–2800 – and ask for your Senator.  You can find your Senator at http://www.nysenate.gov/   Urge your Senator to call the Governor and tell him to fund his $15 minimum wage.
  3. Assembly switchboard (518) 455-4100 – and ask for your Assemblymember.  You can find your Assemblymember athttp://assembly.state.ny.us/ Urge your Assemblymember to call the Governor and tell him to fund his $15 minimum wage.

 OR

  1. Go to IACNY.org to automatically send emails andfind your local legislators to tell the Governor to fund his minimum wage proposal.  Click Legislative Action, then click Get Involved.
  2. Or send your own letter to:

The Honorable Andrew M. Cuomo
Governor of New York State
NYS State Capitol Building
Albany, NY 12224

 THANK YOU!

 

ALERT: MORE CALLS NEEDED!

GET READY TO RAAALLLYYY!!!

Action Alerts, Advocacy, Bronx, Brooklyn, Events, Manhattan, Queens, Staten Island, , , ,

GET READY TO RAAALLLYYY!!!

We support the Governors proposal to raise minimum wage to $15 an hour in NYS –

But there is NO MONEY IN HIS PROPOSED BUDGET to pay for it!

We need additional funding to pay workers the increased wages and to raise lower paid staff salaries so they don’t lose ground when the minimum is raised.

Where: Gov. Cuomo’s NYC Office

633 3rd Ave, Manhattan, 40th-41st St.

When: Friday 3/11/16, 11am till 1pm

More details soon. Rallies are being planned all over New York State, this is the one in NYC – more details to come on other regions..

Wini

  • Winifred Schiff
  • Associate Executive Director for Legislative Affairs
  • InterAgency Council of Developmental Disabilities Agencies, Inc.
  • 150 West 30th Street 15th floor New York, NY 10001
o­ 212­645­6360
c­ 917­750­1497