Category Archives: Self-Direction

Services for People With Disabilities: Terrified about the future

Services for People With Disabilities: Terrified about the future
Report from the OPWDD Transformation Panel Forums              Sept 21, 2015

by Jim Karpe, NYC FAIR member            www.nycfair.org

As parents of adult children with disabilities, we hear beautiful words of a future with a wide range of individualized services. Meanwhile the actual system in place today continues to disintegrate before our eyes.  Programs and supports have been discontinued before alternatives have been developed.   The negative impacts we see are the result of poor planning or lack of planning. Or perhaps there is an evil plan, but most likely our adult children are the victims of incompetence.  The distinction does not matter to those individuals whose lives have been damaged by the gap between words and reality.

In Transformation Panel forums on Long Island and in Manhattan on September 17th, dozens of parents and self-advocates testified about the real obstacles to care they are facing.  Our population is so diverse, with a wide range of issues and challenges.  Yet over and over we heard the same thing from those different perspectives:  The system has stopped working, is un-raveling, has let us down, has abandoned us.  There is no monitoring, and there is no place to voice our dissatisfaction.

We also heard from OPWDD Acting Commissioner Kerry Delaney at the forums.  We heard Ms. Delaney acknowledge the need for transparency, but we continue to get very little data.  We heard acknowledgement that “one-size does not fit all”, but we continue to have policies which shut down the “fitting” options for the most fragile.  We heard that the transformation is “not about taking away services, instead about responding to actual needs and being sustainable.”  But meanwhile we watch the dismantling of the supports which were in place.  Individuals are getting pulled out of sheltered workshops where they feel valued and needed, and are instead “out in the community”—walking aimlessly around a mall, losing hope and regressing.  Other individuals are losing their homes of 20 or 30 years, since those homes are now alleged to be harmful “institutions”.  And those individuals capable of greater independence find that the Self-Directed programs of OPWDD have thickets of restrictions and forests of paper work.  The promise of Self-Direction was “you control your own budgets.”  The reality is that we can spend money only within narrow, non-overlapping categories.  It’s like the choice offered by the Model-T Ford: “You can have any color you want, as long as it’s black.”

People With Disabilities are getting forced out of options which were working—which did fit.  No one should be limited to sheltered workshops as their only option for activity.  But neither should anyone be forced out of a sheltered workshop that they treasure and which works for them.   Our actual needs are the same as every one else—housing, transportation, education, jobs, friends.  A full and meaningful life.

The fears, the concerns, and the stories were the same on Long Island and in New York City.  I’m confident they are the same in Upstate NY as well.  Ronnie, a plain-spoken self-advocate in Manhattan, captured the spirit of us all with his simple message to OPWDD: “You are not doing your job.”

This situation is not the fault of Olmstead.  That landmark Supreme Court decision has at its heart the right of the individual to choose the level of community integration they desire.  The fundamental issue instead is lack of courage.  For decades, New York State siphoned Medicaid funds to help balance the State budget.
(See www.nytimes.com/2012/10/24/nyregion/new-yorks-medicaid-program-is-at-the-mercy-of-washington.html )
That has ended, and in the aftermath:

  • Federal bureaucrats are punishing NYS for past fiscal sins, as the federal Centers for Medicare & Medicaid Services (CMS) puts in place regulations that restrict choice,
  • State officials have abandoned OPW, now that it is no longer a profit center,
  • With no political backing to fight for the individuals who need services, the Office for People With Developmental Disabilities (OPWDD) has become the Office for CMS Compliance.

Fundamentally, OPWDD needs to start advocating for People With Disabilities.  Has to stop falling over themselves in their rush to comply with every CMS edict.  Sadly, when they fall down, it is our kids who get bruised.  OPWDD needs to stop adhering to CMS regulations which damage fragile individuals.  And they need to stop going beyond those regulations!  New York State is putting in place policies and procedures which go far beyond what is required by CMS.

It comes down to us: Parents and self-advocates.  Our state officials must support our population, and must support OPWDD– and if needed, pressure OPWDD.  The appropriate response to many of the CMS regulations is not “Yes sir”, but “No way!”  Tell your legislator, tell the governor, and tell OPWDD itself, that we need to put People back into the center of the process.  Say no to serving CMS, and say yes to serving People.

Self-Direction Community of Practice meeting with Kerry Delaney, Acting Comm., OPWDD

By Lynn Decker

On March 30th, about 30 NY Metro families met by video-conference with Acting Commissioner Kerry Delaney and Kate Marlay, Deputy Director. Division of Person-Centered Supports, and Kate Bishop, Director of Health and Community Support, Division of Person Centered Supports.  This gathering was organized through NY Metro SD Community of Practice and we thank Mary Somoza for securing the meeting.

The agenda included the reduction in compensation to Fiscal Intermediary agencies that took effect on October 1, 2014, along with a variety of other elements of that “re-invention” of Self-Direction.  OPWDD staff recognized that the FI Compensation is an issue demanding attention, but stated they will be unable to re-open it for consideration with CMS until there is a year of experience data to present, and that can’t occur until July 2015 at the earliest.  They reviewed several measures they are offering to FI agencies in the meantime to provide financial assistance in the interim, including the Balancing Incentives Program grants that were announced in February.

Also discussed were the reductions in the available Personal Resource Allocation for some participants under the new formula, and the restrictions on rates and licensure for certain clinical consultants to Self-Direction plans.  OPWDD staff sought details from families to assess the impact of the first of these and possible alternatives or solutions to the other.

Exclusion of Individually Directed Good and Services (IDGS) funding for settings that are ‘specialized’ rather than integrated, which many families stated were the only suitable programs for their family member at this time, was also discussed.  Non-traditional but disability-focused programs that offer enhanced supports for behavior or physical mods that make it possible to develop skills needed for success in integrated settings are desired by many families, but excluded from Self-Direction funding.  OPWDD staff were less receptive to these concerns, saying that such settings needed to be made integrated in order to qualify for IDGS funds.

And finally, the inadequacy of the housing subsidy formula for any market priced housing in areas well served by transit was raised, along with inadequate support to access existing affordable housing offerings that may be appropriate.  The role of housing discrimination when approaching a potential landlord with documentation of housing subsidy on the basis of disability was also raised.

The commissioner expressed broad general recognition of family concerns and promised a face-to-face meeting with this group in the future.

If you or your family member are eligible for OPWDD funded services and wish to pursue Self-Direction with Budget Authority, you may request to join the google group for this parent effort at https://groups.google.com/forum/#!forum/ny-metro-self-direction-community-of-practice

Lynn Decker

Executive Board Member, NYC FAIR
lynn_decker@me.com