Tag Archives: opwdd

Deadline Extension for Submission of Comments on CCO Draft Application

Advocacy, CCO, opwdd, , , ,

PLEASE NOTE – The deadline for submission of comments on the Care Coordination Organization’s (CCO) Draft Application has been extended through Friday, August 11, 2017.  Details of this submission are included on the below email from Acting Commissioner Delaney which was originally sent on June 30, 2017.

 

Dear Friends and Colleagues:

New York State can take pride in its transformation of services for individuals with intellectual and developmental disabilities.  By building and supporting a community-based system of care over the past 40 years, New York is a great example of what a State can do in partnership with providers, families, advocates and communities.  Through this partnership, the Office for People With Developmental Disabilities (OPWDD) has been able to offer a wide range of residential and day supports.

However, as I travelled the State meeting with individuals, families and providers to assist in developing the recommendations of the Transformation Panel, it became clear that our system must evolve to meet the changing demands of today.  Individuals and families want more flexibility and participation in program design and services and there is growing recognition of the need to offer a more seamless transition of school age children into the adult service system.  In addition, as those we serve age, we must address their emerging needs. These challenges demand a more robust, integrated model of care; a model that not only includes the existing OPWDD services but brings together medical, behavioral health services and medication management in a single coordinated plan.  Our system needs a model of care that offers more flexibility in how services are designed and delivered and rewards providers for achieving good outcomes for you and your family members.

I am very pleased to tell you about the next major step in the evolution of the OPWDD system to meet this need.  We are prepared to begin a five-year effort that will start a new era of opportunity for people with intellectual and developmental disabilities.  This new initiative, called People First Care Coordination, will enhance and expand service coordination for people currently supported by a Medicaid Service Coordinator (MSC) in preparation for our system’s move to fully integrated services in managed care.

People First Care Coordination will add the coordination of people’s health and wellness services to their current developmental disabilities Individualized Service Plan (ISP), which will be known as a Life Plan.  Individuals currently enrolled in OPWDD services can have those services, plus those they receive from their dentists, physicians, behavioral health professionals and others, expertly combined into a single, integrated Life Plan which is overseen and monitored by their care manager.

The foundation of People First Care Coordination is Care Coordination Organizations (CCOs), authorized as Health Homes, which will be networks of existing OPWDD providers that will come together to provide integrated care coordination and work to transition MSCs into care manager roles.  CCOs will offer a professional Care Manager and a specialized care coordination team to work directly with each individual served and his or her family to address all of his or her needs.  The team and various service providers will be able to electronically share information and discuss an individual’s overall wellness and progress toward stated goals.  CCOs and providers will report to OPWDD on the outcomes they are helping individuals achieve.

People First Care Coordination is not managed care, but over the next few years, CCOs will become or begin working with managed care organizations to further our system’s move to managed care.  CCOs consisting of OPWDD providers will always be at the forefront in coordinating OPWDD services and supports.

In the coming weeks and months, we will be in further contact with you to explain People First Care Coordination, outline its timeline and respond to any of your questions.  I would encourage you to read and submit comments related to the draft Application for entities who may be interested in becoming CCO’s.  You can find a link to the Application on our website athttps://opwdd.ny.gov/opwdd_services_supports/care_coordination_organizations .

Thank you for your continued partnership as we transform our system of supports and services to enrich the lives of New Yorkers with developmental disabilities – today, tomorrow and well into the future.

Sincerely,

Kerry A. Delaney

Acting Commissioner

 

UPDATE People First Care Coordination Webinar for Individuals and Families

Advocacy, CCO, opwdd, , , , , ,

Last week, Acting Commissioner Delaney announced the availability of an online presentation on People First Care Coordination for individuals and families who receive services through the Office for People With Disabilities’ (OPWDD) service system. The presentation will describe plans for the move to enhanced care coordination, as well as provide the reasons for this shift and a timeline of anticipated next steps.

If you would like to attend this online presentation, please note that the online portion of the event which is viewable from your computer, is now full.  However, you can still connect with just a telephone and listen to the presentation by following the instructions below:

Date:  Monday, August 7

Time:   1:00pm – 2:00pm

To listen to the presentation by phone:

Call 1-844-633-8697

When asked for your Access Code or Meeting Number enter 647572988#

If you are unable to listen to the event at that time, it will be recorded and posted at this link  for viewing at any time.

In the meantime, if you would like more information, please visit the People First Care Coordination section of the OPWDD website and feel free to submit any feedback you have about People First Care Coordination to care.coordination@opwdd.ny.gov.

 

CCO/HH – Memorandum of Concern by SWAN-NY

Advocacy, CCO, Managed Care, , , , ,

SWAN of New York State

Comments from the State-Wide Advocacy Network of New York State, a coalition of independent family groups focused on services for individuals with Intellectual and Developmental Disabilities.
DDAWNY Family Committee       ENYDDA                 GROW           NYC FAIR

CCO/HHs – MEMORANDUM OF CONCERN

Executive Summary

As parents, we are attracted by the vision of an integrated network that improves and coordinates the services that our children receive. We would like this network to be effective and responsive, and it is in this spirit that we lay out our concerns about the ambitious agenda for the creation of care management for the IDD population as set forth in the draft RFA. Our hope is to help New York State create and maintain a person-centered system that helps all individuals with IDD live better lives. We understand that for the system to survive in a world of competing budget priorities, it must be able to point to the data-driven evidence of those better lives. Our belief is that to be successful, the system must have these characteristics:

  • A fundamental focus on appropriate use of services and supports which result in personalized goals, in contrast to medical model focus on reductions in avoidable use.
  • Outcome measurements and Value Based Payments based on that fundamental focus, which therefore
    • recognize the wide range of support needs.
    • do not penalize individuals with high acuity and their service providers.
    • reward CCOs and MCOs for maximizing quality of life, rather than rewarding them for minimizing the overall cost.
  • Ongoing structured family involvement in every step of the governance process, from creation of outcome measurements to policy definition, and all the way through to operational oversight.

Concerns: Family Involvement in CCO/HH’s

We hope you share our belief that parent participation will help the transformation process achieve the best possible results. To begin with, the core principal of Comprehensive Care Management is to coordinate services by assembling an interdisciplinary team to develop an individualized plan of care. Other disciplines recognize family advocacy as part of that team. We encourage OWPDD and DOH to examine how a family advocacy role can be developed for the CCO/HH.

We would like to see a role for family advocacy in the governance of the CCOs and MCOs. We recommend a strong ombudsman role and an appeals panel of family advocates.

Concerns: Measures for Value Based Payments (VBP)

The suggested outcome measures do not sufficiently take into account the wide range of support needs. While we want to support and celebrate those individuals who are capable of independent living and competitive employment, we are deeply concerned about the possibility of neglecting the higher acuity portion of the IDD population. Measurements are based on CQL/POMs, or use an increase in the number of individuals employed, the number who have moved into self-direction or more integrated settings outcomes that do not recognize acuity. The recommendations of the DD Subcommittee of the Clinical Advisory Group recognized the limitations of these measures. Applying this paradigm across the wide spectrum of individuals that comprise the I/DD population is not only inappropriate, it encourages service providers to limit the number of higher need individuals that they serve.

Earlier this year SWAN met with Director Helgerson to introduce ourselves and to share our concerns about the system transition to managed care. At that meeting we discussed the need for the development of better outcome measures. We propose that DOH and OPWDD form a work group with SWAN to create a process for working with families to develop these measures. We think a combination of surveys and workshops could be conducted around the state to identify a more comprehensive way to measure the outcomes for our loved ones. This same effort will also serve to educate families about the system transformation.

Concerns: Healthcare Bias in the RFA

The RFA reflects a healthcare bias, the medical model emphasis on preventing avoidable utilization. We recognize the importance of coordination between healthcare services and long term services and supports, and support the goals of reducing hospitalizations, promoting wellness, communication between providers, etc. However, for individuals with IDD that is just the starting point. The big challenge in IDD is the Long Term Services and Supports (LTSS). It is not clear from this RFA how non-medical LTSS will be affected by CCO’s.

As the creation of the CCO/HH’s is intended to be the first step to transitioning I/DD services into Managed Care, we are concerned there will be an effort to reduce rates for all types of services. For example, the current difficulties CDPAS individuals have with maintaining staff are due to Managed Care imposed rate reductions. Individuals using Self Direction with employer authority may be especially affected, but the impact of rate reductions would be felt everywhere.

Concerns: CCO Requirements

As outlined the MSC workforce will require extensive training as a pre-requisite for the job of Care Manager and it is not clear if there is the time or the resources to make that happen. The qualifications of new Care Managers defines a workforce that is not only has more training, but is a much more costly workforce.

Similarly, the IT requirements are considerable. The RFA mentions start-up grants, but there is no mention of how large they will be. We are concerned about whether these IT expectations are truly achievable.

People First Care Coordination Webinar for Individuals and Families

Advocacy, CCO, Managed Care, , , , ,

Dear Friends and Colleagues,

As you may have heard, the New York State Office for People With Developmental Disabilities (OPWDD) is moving forward with a new initiative aimed at enhancing care coordination for people with developmental disabilities. Through this initiative, called People First Care Coordination, healthcare, behavioral health, and other community services will be coordinated—in addition to the OPWDD services a person receives—in a single “Life Plan”. People First Care Coordination builds on the current service coordination model to offer greater simplicity, improved follow-up, and a person-centered planning approach that considers the whole person.

As part of our continuing outreach and information-sharing regarding People First Care Coordination, we are pleased to announce a webinar on Monday, August 7 for individuals and families served through the OPWDD system. This online presentation will describe plans for the move to enhanced care coordination, as well as provide the reasons for this shift and a timeline of anticipated next steps.

If you would like to attend this webinar, please note that advance registration is required. You may register by clicking this link. To experience the full webinar, both an Internet-connected computer and telephone are required. If you do not have access to a computer, you can also connect with just a telephone and listen to the presentation. For those who are unable to attend, once the webinar is completed, a recording will be posted to the OPWDD website for viewing.

In the meantime, if you would like more information, please visit the People First Care Coordination section of the OPWDD website and feel free to submit any feedback you have about People First Care Coordination to care.coordination@opwdd.ny.gov. The website also includes links to the draft application that entities seeking designation as Care Coordination Organizations will be required to submit. The application lays out the standards and requirements for Care Coordination Organizations in the OPWDD system. Comments on the draft application can be submitted until August 4.

We are making strides toward enhancing person-centered planning and taking a more holistic approach in our system and your continued involvement assures your participation as we move into the future. I hope you will join us to learn more about the People First Care Coordination initiative by registering at this link.

Sincerely,

Kerry A. Delaney

Acting Commissioner

 

Message from Acting Commissioner Delaney Regarding People First Care Coordination and CCO Draft Application

Advocacy, opwdd, , , , ,

Draft Application Announcement

June 30, 2017

Dear Friends and Colleagues:

As you may know, the New York State Office for People With Developmental Disabilities (OPWDD) is embarking upon a new initiative aimed at enhancing care coordination for the people we serve. People First Care Coordination will retain the best of the current system of Medicaid Service Coordination, while building upon it to offer individuals and families a more comprehensive way of managing their services and supports.

Through People First Care Coordination, Care Coordination Organizations/Health Homes (CCOs/HHs) governed by OPWDD providers will oversee development of a Life Plan created for each individual. The Life Plan will include information not only about the services they receive from OPWDD, but also physical, behavioral health and other healthcare and wellness services. This initiative will be supported by improved information technology, allowing multiple providers to share important information related to a person’s Life Plan.

In partnership with the Department of Health, we are beginning the process of establishing the CCOs/HHs which will provide enhanced care coordination services. Organizations that are interested in operating as a CCO/HH will be required to complete an Application.  At this time, we are posting a draft Application for stakeholder review and comment.

Information regarding People First Care Coordination and the draft Application can be found at https://opwdd.ny.gov/opwdd_services_supports/care_coordination_organizations.  The draft Application and form for submitting your comments can be found at https://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/idd/.

The draft Application lays out the qualifications and requirements that CCO/HH applicants must meet, while also defining the expectations of New York State regarding the operation of the CCO/HH. Key requirements of the Application include identifying a transition plan for current Medicaid Service Coordinators to move into care manager roles and ensuring cultural competence for serving a diverse population.

The Application is currently in draft form, and applications are not being accepted at this time. After public comment has been received over the next month, the Application will be revised and is anticipated to be issued in September 2017 in final form, for completion by CCO/HH applicants by November 2017.

We look forward to our continued collaboration with you, and view this draft Application process as the first step in establishing a person-centered, specialized system of care coordination leading to managed care designed for people with intellectual and developmental disabilities. With your support and insight, we can move into the future under a framework that offers more flexibility and choice and preserves the great gains made for New Yorkers with developmental disabilities over the past forty years.

Sincerely,

Kerry A. Delaney
Acting Commissioner