1. Announcements: See Below
2. Newly Funded Family Support Services
OPWDD issued a 2011 request for family support proposals (RFP). The Manhattan allocation for this RFP was $463,500. We received a total of 28 proposals: 27 for Manhattan, 1 multiborough. All proposals were required to address one of the following Manhattan priorities:
• NEW AND EXPANDED RESPITE PROGRAMS – $375,000 total allocation
o After-program recreation for adults; transportation must be included
Proposal cap: $75,000
o Afterschool recreation for children; must be on-site at school; transportation home must be provided
Proposal cap: $75,000
o Weekend respite, day and overnight; may include programs without a site; transportation must be provided
Proposal cap: $75,000
o In-home respite for new families
Proposal cap: $56,500
o In-home respite for families already being served who need additional respite hours
Proposal cap: $56,500
o Overnight emergency respite programs
Proposal cap: $37,000
We did not receive any proposals for overnight emergency respite
• INNOVATIVE PROGRAMS – $88,500
Creative programming. Examples: unusual reimbursement, sports/athletic programs, inclusive programs, vacation/respite, sexuality training, skills training, etc. Transportation must be provided as appropriate.
Proposal cap: $50,000 for proposals with transportation
$38,500 for proposals without transportation
Funding was awarded to the following proposals, subject to approval by the NYS Office of the State Comptroller:
INNOVATIVE PROGRAMS:
For teens/young adults with ASD
Birch, new service: Fotography for Friendship, an interest-based social skills-building club.
For “high-functioning” adults with ASD/DD
YAI, new service: Hankering for More: social skills training.
NEW AND EXPANDED RESPITE PROGRAMS:
For people with DD
CARES, expansion: in-home respite for unserved families.
For some current recipients of CARES in-home respite who need additional hours
CARES, expansion: additional hours of in-home respite for some families already being served.
For people with DD
CRSC, expansion: in-home respite.
For adults with DD
CRSC, new service: after-program for adults in the agency’s day hab program.
For children with DD
Esperanza, expansion: in-home respite.
For people with DD
Mercy Drive, expansion: in-home respite.
For children with autism
QSAC expansion: afterschool on site at school.
For adults with DD
Sprout expansion: 3 weekend trips.
For people with ASD
QSAC expansion: in-home respite.
In addition, the NYS Office of the State Comptroller required that the boroughs re-bid their existing crisis intervention services. In Manhattan, YAI was awarded the contract.
3. Report on June Statewide Family Support Committee meeting
Margaret reported on the June meeting of the statewide Family Support Committee.
Commissioner Burke outlined reforms that OPWDD is undertaking to address the issues of abuse in state-operated developmental centers and group homes that was reported in the New York Times. The following reforms will be instituted in state-operated facilities:
• Raise the hiring qualifications for new direct support employees
• Provide trainings on abuse prevention, caregiver fatigue, and promoting positive relationships
• Require immediate reporting of abuse to law enforcement; collaborate with state police on how to work with law enforcement
• Institute an arms-length relationship in investigations – investigations of abuse won’t be conducted by DDSOs because of possible conflicts of interest but by regionalized investigators
• Establish centralized incident management – collect consistent information from all providers (non-profit as well as state-operated)
• Create a culture change to encourage staff to report abuse – staff now must sign on their time card that everyone is safe
• Attempt to make staff feel safe to report. Look at airlines as a model (must report pilots unfit for duty)
• Automate reporting, for non-profit agencies as well as state-operated facilities, which will enable OPWDD to track incidents and identify trends
• Maximize the amount of time a new employee remains on probation (during which the employee can be fired)
• Discontinue the practice on placing employees accused of abuse on administrative leave with pay; now accused staff will be placed on unpaid suspension.
• In cases of confirmed abuse, OPWDD will use arbitration and will not agree to settle
• Empower individuals – emphasize that no one has the right to abuse them
• Explore controlling the use of overtime
• Develop a metric to show measures of progress in these areas (e.g., incidents should decrease; incidents reported to police should increase)
This information will be available on the OPWDD website (www.opwdd.ny.gov). The Commissioner’s page will include action updates. You are invited to give your ideas, comments, concerns, and questions by e-mail regarding strengthening system oversight and accountability at people.first@opwdd.ny.gov.
The Commissioner also gave an update on implementation of budget cuts, which Wini Schiff will discuss following this report.
We also had a presentation on the new 1115 waiver, which Wini will also discuss. The Commissioner is holding listening tours and public forums about this. Summaries of those will also appear on the OPWDD 1115 waiver website at www.opwdd.ny.gov/2011_waiver.
Finally, the statewide committee began a discussion of the different regions’ processes for reviewing family support proposals to identify best practices. This discussion will be continued at the next committee meeting.
4. Speaker: Wini Schiff on Update on Budget and Related Issues
Budget Cuts: Cuts to services for people with developmental disabilities go into effect July 1, 2011. OPWDD has determined varying amounts of cuts for different providers, according to elaborate formulas. The cuts average from 2% to 6%, with some as high as 12%. Agencies are determining what reductions they can take without cutting services or staff. For instance, they would look to cut administrative office functions first. The agencies are looking for efficiencies and collaboration with other agencies. This will be a time of change for our services.
Pending Legislation: With one week left to this year’s legislative session in Albany, several important bills are being considered. If they are not passed now, the next opportunity in most cases is not until January. Among the new bills are:
• A bill to limit staff overtime to prevent staff becoming exhausted and unable to function effectively. The bill would impose a workweek limit of 60 hours, allowing no more than one consecutive double shift and no more than two double shifts per week. To this bill, an amendment should be added granting an exception for extreme emergencies (power outages, etc.).
• A bill to require the termination of staff who commit physical or sexual abuse: After an allegation of abuse, the staff would be placed on leave and if the allegation was substantiated the staff would be fired. This bill would supersede any future labor contract.
• A bill to require that anyone fired for abuse or neglect would be listed in a sort of registry; when prospective employers conducted their required background check, they would receive a report of that firing, along with any employee contestation.
• A bill to increase the number of surprise OPWDD inspections of DD facilities from twice annually to three times annually.
• A bill requiring OPWDD to report to the Legislature on the residential waiting list every six months.
1115 Waiver: A new Medicaid waiver to fund most DD services is being designed by OPWDD. Presently, our DD services are funded through the Home and Community Based Services Medicaid waiver (HCBS). The new 1115 Medicaid waiver is a research and demonstration waiver. It runs for 5 years but is renewable. OPWDD submitted a concept paper describing the goals and principles for this waiver, which was approved by the Centers for Medicare and Medicaid Services (CMS). The 1115 waiver will entail a complete change in the way our services are delivered and funded.
Under the current system, one of the issues being examined is the funding for institutions. As people move out of the institutions and into the community, the amount of funding is not reduced, so that for fewer people the amount remains constant and the per-person cost increases. The extra funding generated by this practice has always been used to fund services in the community (residential, day, etc.). This funding arrangement has come under scrutiny and will be discontinued under the new 1115 waiver.
Under the 1115 waiver, there will be a fixed pot of money for DD services, probably based on a per-person allocation. At this moment, it appears that the pot would include a yearly trend (cost of living increase) and a growth rate, since new people enter our system yearly.
The 1115 waiver will be based on care-coordination: all services, both acute medical and long-term, would be included, and people’s care would be managed by care-coordination providers, hopefully DD providers.
The guiding principles of the 1115 waiver are: people should have choice; services should be provided in the least restrictive environment; services should be person-centered; costs should be reduced; there should also be safety net services; there should be “no wrong door” for accessing services; and funding should be for people, not programs.
The Commissioner is requesting public input. Also the IAC will host a meeting over the summer for NYC parents to gather parent input. More information is available on the OPWDD website: www.opwdd.ny.gov/2011_waiver. There is a link on that website for giving input. Wini strongly encouraged parents to take this opportunity to give input. Members requested that we have a presentation at our next Council meeting on the 1115 waiver.
Announcements: From Above
Family Support Services Committee
Tuesday, June 14, 2011, 10:00 am – noon
UCP NYC, 120 East 23rd Street, 5th floor
Information: Amy Bittinger (212) 979-9700 x 708
DD Council
Thursday, September 19, 2011, 9:30 am
YAI, 460 West 34th Street, 11th floor
Information: Margaret Puddington (212) 799-2042
Transition Committee
Wednesday, September 14, 2011, 9:30am – noon
UCP of NYC, 122 East 23rd Street, 1st floor board room
Information: Kathy Kelly (212) 780-2724
Childrens Committee
To Be Announced
Information: Christina Muccioli (212) 780-2532
Legislative Committee
To be announced
Information: Judith DeIasi (212) 780-2667