What is self-direction of OPWDD services in NYS?

Self-Direction is the opportunity to have partial or complete management and/or budget authority of your OPWDD funded supports. As a Start-Up Broker I provide a consulting service (paid by the state of NY) to help you develop a proposal based on your assessments of need, and your interests and preferences, then present that to OPWDD for funding.

We'll engage in a person-centered planning process and identify a circle of support for you (related and unrelated, paid and unpaid people who care about you and have insight about your support needs, safeguards, and things you want to do in life). With your Circle and your MSC, I'll help you or your family to develop that proposal, find staff, and get them on payroll with the Fiscal Agency who will pay approved payroll and expenses.

It's not simple (hence my role as consultant) and it does require a fair amount of work from you or your family and circle. And it doesn't free you entirely from following regulations. But self-direction offers you an alternative to traditional agency services with greater control and complete focus on you instead of a larger organization providing a service to you.

Saturday, November 22, 2014

A Guide to Self-Direction from some folks who know

The New York Self-Determination Coalition has a Guide for Families that gives helpful scenarios of how folks are using self-direction with budget authority to direct their services with OPWDD funding.

Not too bound up in jargon, a true practical guide.  48 page PDF

Self-Direction in New York: A Practical Guide for Families

Governor to Legislature RE: ID/DD constituents and families -- "I'll tell you your opinion when I'm ready to hear it"

"From a NYSARC Memo”

A couple of weeks ago, in anticipation of the Governor’s actions on the bills below, we asked you urge him to sign the measures.  We were reasonably sure the Governor  would veto at least one of the bills, namely S6641 which reforms the Front Door process.  In fact he vetoed all four bills.
No doubt anticipating a negative reaction to such sweeping vetoes, the Governor waited until after elections to have the bills delivered to his desk. 

Prior to elections the Governor signed one key bill, S.7232 requiring the Justice Center to follow safety protocols when interviewing a consumer.

All the bills below represent important concerns for people with developmental disabilities and their families.  The sweeping nature of his vetoes is troubling especially given a continuing lack of engagement and transparency by the Administration with the entire field regarding these bills and other issues, an indifference which appears to extend beyond the field of developmental disabilities to other human services areas.

Here are the bills along with the veto messages (see links) released by the Governor:

1) The S.6641 by Carlucci reforming the Front Door process. The Governor’s veto message sites cost and duplication of reform efforts already underway as the reason for his veto.  Reports however indicate that the Front Door process is still broken and that the crisis of people in need of out of home care – an important part of this bill – is getting worse, not better.

2)  S.7400 by Carlucci requiring that providers of service contracting with Managed Care Organization’s continue to consist of the trusted system of nonprofit and public providers.  The Governor’s veto message claims that the bill violates the Commerce clause of the US Constitution by limiting entities that can provide services under managed care.  This was wasn’t mentioned in extensive negotiations during the Spring.  That the Commerce Clause came out of the blue makes us skeptical that it is a valid excuse.  Furthermore, this veto raises disturbing questions about what the Administration intends the managed care system for people with developmental disabilities to ultimately look like.  Does it intend to replace the current system, at least in part, by inviting out-of-state for-profit provider into New York State?  Does the Administration currently have no such plans but wants the flexibility that this bill would eliminate?  Or is the reason for this veto in fact legitimate?

We don’t know the answer but this particular veto greatly increases the existing uncertainty around managed care; further underscores concerns about a lack of transparency; and, adds even more confusion to the entire managed care initiative.

3) Task Force bill S.6659 establishes a Task Force to assess and plan for the needs of Adults with developmental disabilities.  The veto message states that this “legislation simply duplicates efforts the Administration has undertaken” as well as the efforts of the Governor’s Olmstead Cabinet.

4) People First bill S.1109 requires identification of gaps in the existing developmental disabilities service system.  The veto message states that this “legislation simply duplicates efforts the Administration has undertaken”

Summaries of vetoed bills:

1)      “Front Door” S6641-C (Carlucci)/A8846 C (Weisenberg)-This bill would amend the Mental Hygiene Law to require the Commissioner of the OPWDD to develop a plan to overhaul and improve the front door process. The Front Door is intended to allocate services to people with developmental disabilities efficiently, based on person-centered planning.  S. 6641 requires that the Plan provide for a clear, rational and transparent Front Door process.  It requires expedited care for persons in critical need and for OPWDD to regularly submit an updated waiting list of people in critical need of out-of-home care.  The current Front Door process is making the issue of sufficient development for people in out of home care worse, not better.  This bill would hopefully improve that.  The plan must be submitted to the Speaker of the Assembly and the Senate Majority Leader no later than January 1, 2015 with implementation beginning no later than April 1, 2015.

2)      OPWDD Services Under Managed Care –  S.7400-B (Carlucci)/A.9766-A (Gunther) -This bill clarifies that those entities that provide supports and services for individuals with developmental disabilities, such as residential, day and employment services, must be public or non-profit entities with experience providing those services under OPWDD regardless of the type of managed care entity: Developmental Disabilities Individual Support and Care Coordination Organization (DISCO); Managed Care Organization (MCO); or Managed Long Term Care (MLTC) program.

3)      Task Force on Adults with Developmental Disabilities S6659-A (Carlucci)/A.8835-A (Gunther)-  This bill would create a task force on adults with developmental disabilities to study, evaluate and develop recommendations relating to measures to support and meet the needs of adults with developmental disabilities, including their vocational, residential and social needs. The task force will also study the long-term needs of adults with developmental disabilities who reside with caregivers. The recommendations of the task force would lead to the creation of a comprehensive plan for meeting the needs of adults with developmental disabilities which is to be submitted to the Governor and the Legislature by January 1, 2016.

4)      People First Act of 2014 – S.1109-D (Maziarz)/A.8452 (Gunther) – This bill requires the Commissioner of OPWDD to conduct a geographic analysis of the supports and services available in a community setting to individuals with developmental disabilities and to identify gaps in supports and services by regions of the state. The Commissioner is also directed to develop a web-based data base which will permit the prioritization of urgency of needs for those facing emergency or immediate need, those facing critical need, defined as additional services and supports within one year and planned need for those who will need additional services and supports within five years or where the individual’s caregiver is over sixty years old. Annual reporting requirements will allow the Legislature and the Executive to make informed policy decisions in the delivery of services and supports to individuals with developmental disabilities.

Wednesday, November 19, 2014

PLAN Institute Releases 2014 Edition of Safe & Secure E-Book

Planned Lifetime Advocacy Network is a Canadian not-for-profit providing training and resources for families of persons requiring support. Accordingly, some of the regulatory and policy statements in their materials are Canada-specific, but in terms of thoughtfully addressing the emotional and social realities of caring and planning for the future of a person who will require care when a parent is gone. Safe & Secure helps you conceptualize a process for future planning that is not locked into administrative hurdles like an 18th birthday and considering guardianship, or transition to adult living at age 21, but in language that both respects the citizenship of folks who require care and the anxiety of those who provide it.