- Introductions were completed.
- Minutes were approved; if you were unable to open them, they are available as always on the DD Council website (www.manhattanddcouncil.org).
III. Announcements:
Family Support Services Committee
Tuesday, January 13, 2015, 10:00 am – noon
YAI, 460 West 34th Street, 11th floor
Information: Amy Bittinger (718) 859-5420 x 234; Abittinger@ucpnyc.org
Transition Committee
Wednesday, January 14, 2015, 9:30 am – noon
AHRC, 83 Maiden Lane, 11th floor Board Room
Information: Kathy Kelly (212) 780-2724; Kathy.kelly@ahrcnyc.org
Legislative Committee – Save These Dates
- Manhattan Family Advocacy Day, Friday, February 27, 2015, 9:30 am – 2:00 pm
- Manhattan Legislative Breakfast, Friday, March 13, 2015, 8:00 – 10:00 am
Information: Jim Malley (212) 928-5810 x 101; Jmalley@esperanzacenter.net
Children’s Committee
Thursday, January 29, 2015, 9:30 am, 15 West 65th St.
Information: Christina Muccioli (212) 780-2532; Christina.muccioli@ahrcnyc.org
Service Coordination Committee
Topic: Kathleen Kingston, OPWDD, on Changes in the Front Door Protocol
Friday, January 16, 2015, 10:00 am – noon
UCP/NYC, 80 Maiden Lane, 2nd floor training room
Information: Carol Lincoln (718) 859-5420 x 225; Clincoln@ucpnyc.org
Outreach & Family Engagement
Immediately following the February 12, 2015, DD Council Meeting (see below)
Information: Lynn Decker (917) 575-5166; lynn_decker@me.com
DD Council
Thursday, February 12, 2015, 9:30 am- noon
IAC, 150 West 30th Street, 15th floor
Topic: Annual budget briefing by Peter Pierre, IAC
Information: Marco Damiani (212) 947-5770 x 456; manhattanddcouncilchair@ gmail.com
YAI
The Autism Family Support Series for caregivers is starting again in February; see attached for schedule and topics.
Free open workshops every Wednesday on navigating the system for people with developmental disabilities. Drop in at 460 West 34th Street, 11th floor. Call 212-273-6182, or link@yai.org for referrals and any other information.
UCP of New York City
Family Connect vacancy list is attached, as well as information for overnight respite and family reimbursement.
AHRC NYC
Program vacancy list is attached.
**As always – any agency announcements or non-fundraising events can be sent to manhattanddcouncil@yahoo.com to be included on the Council Facebook page (anyone) or Council website (dues paying members).
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Presentation: How Managed Care Will Affect Services for People with Developmental Disabilities, by Peter Pierri, Executive Director of IAC
Peter explained that the InterAgency Council (IAC) is a non-profit organization with 150 member agencies in New York City, Long Island, and Rockland. IAC advocates for funding, provides technical assistance, and serves as a communication vehicle between NYS and its members.
Peter described NYS’s plan to move to a managed care system under OPWDD. He pointed out that managed care may be familiar to us for how we access our healthcare. Managed care, in and of itself, is not bad or good. It is a vehicle to pay for services. Currently, for OPWDD services (such as residential, day, community habilitation, respite, etc.), agencies are paid by OPWDD for every separate service they provide. OPWDD pays about 5,000 different rates to about 350 agencies for these services, which is a very complex and expensive methodology. Under managed care, funding will flow from NYS OPWDD to managed care entities, which will then pay its providers. The managed care entities for OPWDD services will be called DISCOs (Developmental Disabilities Individual Supports and Care Coordination Organizations). DISCOs will have a network of providers. DISCOs will receive a lump sum payment per month per person. This will be a flat amount. DISCOs will use this money to purchase services from providers, who will get paid as currently. For people receiving residential services, DISCOs will be required to pay at least the rate that the providers are currently getting. For people receiving day services, DISCOs will have the same provision but only for 90 days, after which DISCOs can re-negotiate the day service rates. The service system must be revenue neutral: it cannot cost more than the current system.
OPWDD has been working on this plan for three years, but it has not yet been approved by the federal government (Centers for Medicare and Medicaid – CMS). It will not be implemented soon. The first stage in implementation will be voluntary enrollment, which will last at least two years. Eventually, enrollment will be mandatory.
Initially, managed care will cover only long-term services and those that are not basic health care, such as traditional OPWDD services, dentistry, durable medical equipment, hearing, nutrition, psychiatry, podiatry, and others. Eventually, DISCOs will also cover health care services.
Under managed care, individuals will still be able to self-direct their services, if they choose.
At first, there will be only a handful of DISCOs in NYS. Participating in a DISCO is a significant financial commitment: large cash reserves are required. Even banded together, the non-profit agencies won’t have these resources. Eventually, for-profit insurance companies may be invited to participate if there are not enough non-profit DISCOs. But this has not been approved or even requested yet.
Care coordination is a process, not a person. DISCOs will be required to coordinate all services—all of a person’s health care, residential, day, and other services. The responsibility is broader than under Medicaid Service Coordination. Care coordination is provided by a team, whose members vary according to the types of needs a person has. All services will be geared to individual outcomes.
DISCOs will be judged on their effectiveness by utilizing the Personal Outcome Measures, a standardized national tool. The new system will include an independent advocacy entity. There will also be an enrollment broker to help people enroll in a DISCO.
OPWDD’s current plan is to implement the voluntary enrollment phase in October 2015. However, this appear unlikely.
IAC has two major concerns about managed care. (1) How will the managed care infrastructure be paid for? Estimated at $350 million/year, the ongoing infrastructure costs will be much higher than for the current system. It is not yet clear where that money will come from. IAC is strongly advocating that not one penny for infrastructure should be taken out of services. (2) The number of people waiting for needed services is very large. Funding is needed for new services—funding that should not be spent on infrastructure.
NYS hasn’t made the case for why they are switching to managed care. No other state with the size of NYS’s developmental disabilities population has converted to managed care. This will be new and untested. The federal government is not forcing states into managed care. The states themselves are looking to save money through managed care. However, no other state anticipates or has experienced managed care savings in long-term services, although managed care can result in savings and better quality health care. NYS believes that care coordination is better for people, but Peter questioned whether managed care is the best way to accomplish this. Under the new managed care system, NYS regulations will not change, and services will remain the same: we will not have any more flexibility in services. Additionally, there have already been changes to the current system: workshops are being phased out, services are becoming more integrated in community life, and the rate structure has been changed, demonstrating that much change can occur without managed care. On the other hand, managed care does offer the potential for improvement in care coordination and for accessing other types of care (for example, from the mental health system), which is hard to achieve now. Some outcomes of managed care could be very beneficial. NYS is now taking IAC’s concerns seriously.
State News:
Liz Cambra announced that for the Front Door, there is a new Service Amendment form in effect as of 12/15/14 which service coordinators or PCSSs must complete for people who currently receive a waiver service but are seeking a change or an additional service. The form should be submitted to the appropriate borough’s e-mail box:
- Manhattan: serviceamendment@opwdd.ny.gov.
- Bernard Fineson: serviceamendment@opwdd.ny.gov
- Brooklyn: serviceamendment@opwdd.ny.gov
- Staten Island: serviceamendment@opwdd.ny.gov
- Bronx: serviceamendment@opwdd.ny.gov
Liz also announced that NY Foundling has received a grant to provide crisis intervention/crisis prevention services to 100 NYC families with children ages 5-17. This is a time-limited service that utilizes a team approach. For information, contact Karmia Berry: 212-660-1386.
City News
Sandra Piggee announced that the first-round awardees of city RFP funds are starting up now. The city will proceed to Phase II of the RFP process. If there is money remaining after Phase II, first-round providers who have requested additional funding may be able to access it.
VII IAC/Federation
IAC: See above for report on Peter Pierri’s presentation.
Federation: The next meeting date has not yet been announced.
VIII. Committee Reports
Family Support Services: The December 18 Fair was a great success. 728 people attended, including 361 family members. Marco Damiani thanked Amy Bittinger and Jennifer Shaoul for all their extraordinary efforts. Amy thanked Margaret Puddington, Trish Chapmen, Rachel Wolfe (CGS), and Katie Brisley. The next meeting will be Tuesday, January 13, 2015, 10:00 am – noon, YAI, 460 West 34th Street, 11th floor. For more information, contact Amy Bittinger (718) 859-5420 x 234; abittinger@ucpnyc.org.
Legislative: The committee will meet in January to plan the following events. Please save the dates:
- Manhattan Family Advocacy Day, Friday, February 27, 2015, 9:30 am – 2:00 pm
- Manhattan Legislative Breakfast, Friday, March 13, 2015, 8:00-10:00 am
For more information, contact Jim Malley (212) 928-5810; jmalley@esperanzacenter.net.
Transition: The next meeting will be Wednesday, January 14, 2015, 9:30 am – noon, AHRC, 83 Maiden Lane, 11th floor Board Room. For more information, contact Kathy Kelly (212) 780-2724; Kathy.kelly@ahrcnyc.org.
Manhattan Family Support Services Advisory Council: Families and self-advocates are encouraged to attend Manhattan’s Family Advocacy Day and Legislative Breakfast (see above, under Legislative Committee). Therefore, no Council meetings will be held during that period. For more information, contact Margaret Puddington (212) 799-2042; margaret.puddington@gmail.com.
Service Coordination: The next meeting will be Friday, January 16, 2015, 10:00 am – noon, UCP/NYC, 80 Maiden Lane, 2nd floor training room. Kathleen Kingston, OPWDD, will speak on changes in the Front Door protocol. For more information, contact Carol Lincoln (718) 859-5420 x 225; clincoln@ucpnyc.org.
Outreach & Family Engagement: The committee met following the previous DD Council meeting and discussed outreach alternatives. Today’s jointly sponsored DD Council/FSS Advisory Council meeting is an outcome of that discussion. The next meeting will immediately follow the February 12, 2015, DD Council meeting at IAC, 150 West 30th Street, 15th floor. For more information, contact Lynn Decker (917) 575-5166; lynn_decker@me.com.