Power Point Template 2

OPWDD’s Transformation Update
NYSACRA Leadership Conference
December 4, 2014
Kate Bishop
Director, Health and Community Support,
Division of Person Centered Supports at the
NYS Office for People With Developmental
OPWDD’s Transformation Agenda Aims
to Provide Supports That:
 Are fully integrated into the individual’s
community of choice
 Focus on the person’s needs and wants
 Result in outcomes that can be
Why Managed Care?
 Each year, approximately 8,000 people
with a variety of needs come to OPWDD
seeking services.
 We need to create new and innovative
ways to deliver and fund supports
consistent with our vision in a changing
Where Are We Now:
 Awaiting approval of the 1915 b/c (People
First) waiver.
 Anticipate DISCOs to begin coordinating care
October 2015.
 We released the Certificate of Authority for
DISCOs/Start-up Grant Application.
Applications are under review, with
announcement on funding expected in
OPWDD’s Big Picture Initiatives
Three big initiatives are designed to
improve the system and ensure individuals
and their families get the services they
• 1. The Transformation Agenda
• 2. The Front Door
• 3. The HCBS Waiver Renewal
Transformation Agenda
Shared goals agreed upon by New York
State and the federal Centers for Medicare
and Medicaid Services (CMS) to:
Close institutions and support individuals
living in the community
Support individuals to be competitively
Provide opportunities for individuals to selfdirect their own services
Community Living
OPWDD Activities to Support
Community Living
• Enhancing system capacity through
• System education on broader array of living
• Reduce reliance on institutional supports
– Developmental Center closure and reduction
– Community ICF transition plan
Institutional Decline: 1975 -2014
OPWDD Activities to Increase
Employment Outcomes
• New service initiated in July 2014—Pathways to
Employment—to provide greater assessment and
skill building to facilitate improved job matches
• Changing supported employment model and
reimbursement to incentivize job retention; January
2015 implementation
OPWDD Competitive Employment Goal
• 700 new people engaged in competitive employment
(net increase)
• Employed in an integrated community setting
(general workforce)
• Earning at or above minimum wage
OPWDD Competitive Employment
As of April 1, 2013
As of March 31, 2014
*Employed in integrated setting at or above minimum wage.
Self Direction
Provide education to at least 1,500 beneficiaries
(with designated representatives as needed) per
quarter beginning on April 1, 2013.
Increase # of individuals self directing by 1,245 by
March 31, 2014.
Submit OPWDD self-direction policies for CMS
approval, January 2014
Education on Self Direction
Year One -Total Growth of People who
Self Direct
Transformation Progress
Year Two Update
Transformation Agenda
Connection to Federal Initiatives
 Several federal initiatives have been made available to
assist us in the transformation, including the Money
Follows the Person (MFP) program and Balancing
Incentives Program (BIP) (total $250m)
 MFP and BIP help OPWDD maximize resources by
adding specialized funding focused on accomplishing
transformational goals
The HCBS Waiver Renewal & Managed
• Managed care supports our mission and
helps OPWDD meet its goals by:
– Providing better and more seamless access to
– Removing “silos” that create barriers to services
across systems
– Emphasizing outcome-based supports
– Incentivizing providers who achieve quality
outcomes while using funds efficiently
• The HCBS waiver renewal will include two new
models for self-direction, allowing individuals to
select from an array of services and supports that
will allow them to live as independently as possible
• The new HCBS settings regulations will see
OPWDD and its providers offer services to
individuals emphasizing choice and autonomy
• New funding models for supported employment are
currently being developed
The Front Door
• Educate individuals and families about
service options that can help meet their
• Assist individuals in seamlessly and quickly
accessing services
• Emphasize integrated supports and how
people can gain more control over their
services and life plan.
The most significant changes are:
• Expedited processes for some individuals seeking non-waiver
services, including FSS and ISS; also for individuals who are
seeking only Supported Employment and/or Pathways to
• At initial contact, expedite work on determining eligibility,
accessing Medicaid if needed, and securing a referral to service
coordination services.
• Decrease the time needed for the development of a service plan
through the Preliminary Individualized Service Plan (PISP)
Implementing a streamlined process for individuals who are
already receiving services but are seeking changes or additions.
The Coordinated Assessment System (CAS)
• Validity Study is underway with stratified sample of
individuals receiving support
• Upon completion of study, validity of CAS will be
determined and any needed adjustments undertaken
• The data from the study will be used to develop acuity
scoring of need levels for people receiving supports
• OPWDD is working with DOH to determine how the
information will inform reimbursement in both FFS and
Managed Care environment
• It is expected that the CAS will be implemented by late
summer 2015
Systemic Therapeutic Assessment
Resources and Treatment (START)
• Launched in Western New York and Finger
Lakes. Next roll-out is for Capital District,
Hudson Valley, and Taconic.
• The program’s goal is to provide response and
prevention services to individuals with
intellectual or developmental disabilities and
behavioral health needs, as well as their
families and those who provide support within
the community.
NY START is not a separate system and does not
replace existing services.
The NY START program will provide training,
consultation, therapeutic services and technical
assistance to enhance the ability of the community to
support individuals with intellectual and
developmental disabilities and complex behavioral
health needs, and focuses on establishing integrated
services with agency providers.
Providing supports that help individuals to remain in
their home or community placement is NY START’s
first priority.
What Comes Next?
• Continuing process improvements to the Front Door,
including an informational video for individuals, are in
• Building upon our excellent success with the
transformation agenda - OPWDD will continue to set
and meet goals in its key focus areas
• Now that our rate issues have largely been resolved,
OPWDD has proposed a timeline to CMS that will allow
for managed care start-up on a voluntary basis

similar documents