1. Announcements: See Below for Meeting Details
View a video celebrating Linda and Todd Irby Ranniar’s Employment Accomplishments!
2. Report on OPWDD Commissioner’s One-Year Progress Report
Commissioner’s first anniversary accomplishments
- • reduction in direct support staff overtime, which can cause fatigue, by 43%
- • reduction in unnecessary administrative leave by 55%
- • percentage of allegations of sexual abuse reported to law enforcement rose from 76% to 100%
- • percentage of allegations of physical abuse reported to law enforcement rose from 16% to 98%
- • pilot program: video recorder in state vehicles transporting people with developmental disabilities
- • resources in state budget to improve fire safety in residences
- • certification of additional independent investigators
- • implementation of moving people out of institutions into community settings
Upcoming reforms:
- • System-wide adoption of standardized training on core competencies for state and voluntary direct support staff
- • Continued development of the people first waiver
- • New required trainings to reduce use of physical interventions and psychotropic drugs; instead promoting positive relationships and preventive actions
3. Report on the Justice Center for the Protection of People with Special Needs
Last week the Governor held a briefing and press conference for Clarence Sundram’s final report and accompanying legislation. The Legislation is 160 pages long.
Governor Cuomo, Speaker Silver and Majority Leader Skelos want the legislation to be passed by the end of this session.
The Governor’s intent is to provide consistency across 6 State agencies, OPWDD, Office of Mental Health, Office of Alcoholism and Substance Abuse Services, Office of Children and Family Services, Department of Health adult care facilities, and State Education Department residential programs. There will be a new agency, the Justice Center for the Protection of People with Special Needs and 4 new abuse classifications:
Category 1:
Serious physical and sexual abuse by employees which warrants criminal prosecution, and other serious offenses warranting termination of employment. Upon a determination that an employee has committed a category one offense, the employee would be placed on a permanent registry that would bar the hiring of persons with a record of similar offenses in any of the six agencies.
Category 2:
Lesser misconduct including abuse and neglect by employees, consultants and others who have regular and substantial contact with the residents of a facility. These would be subject to progressive discipline and, in the state system, addressed by the Table of Penalties developed pursuant to the collective bargaining agreement. The table of penalties would also serve as a guide to the application of fair and proportional consequences for employee misconduct in these settings operated by the voluntary non-profit providers, consistent with any existing collective bargaining agreements. Repeated misconduct in this category would elevate severity to category one for placement on the abuse registry and a ban on future employment.
The notion of “restorative justice” will also be employed where there is reason to believe in the potential for rehabilitation of the employee.
Category 3:
Conduct between service recipients that results in harm. These cases should be investigated as they may be indicators of staff neglect or systemic problems (see category 4 below). If it is determined by investigation to be neither, but the allegation is substantiated, service recipients would not be eligible for inclusion in the register but the incident may require plans of prevention and correction to avoid recurrence.
Category 4:
“Systemic problems” to deal with cases of harm to individuals where any staff culpability is substantially lessened by program deficiencies such as inadequate staff, training, supervision, etc. For such cases, the supervising state agency would have responsibility to ensure prompt remediating of the deficient condition. Providers should be held responsible for repeated systemic problems at their sites and subject to aggressive enforcement of standards, including termination of operating certificates for prolonged or repeated failures to correct identified problems. In some cases, systemic problems may also support a finding of neglect of duty by supervisors and managers.
The Justice Center will employ 400 people and will host a 24-hour hotline and the abuse registry. There will be an Executive Director, Special Prosecutor, and an
Inspector General. $15 million has been included in the budget to set up the hotline; it is assumed that many of these employees will come from existing state agencies. The Commission on Quality of Care will be dissolved. The Center will directly investigate all Category 1 cases of abuse. When an incident is called in to the hotline, a determination will be made as to which category applies.
A Training Academy will be established which will develop a common core
curriculum for direct support staff and supervisors with a system for credentialing. In addition, there will be a code of conduct applicable to all employees in human service agencies and a common clearinghouse for background checks.
Also, State agencies will require their private contractors to be subject to the same FOIL disclosure requirements as state providers regarding the reports and investigations of allegations of abuse and neglect.
Inforrmation: www.governor.ny.gov/Justice4SpecialNeeds/home
4. Nominations Committee, Linda Irby
Linda reported that elections for the Chairperson and the Executive Committee will be held at the June meeting. Officers serve for 2 years. To be eligible for office, a member must have attended 3 meetings within the last year. You may nominate yourself or another person for either office. To make a nomination, please call Linda Irby at 212-926-1615.
The Nominations Committee is proposing the following slate:
Chairperson: Margaret Puddington
Executive Committee Members:
- Marie Christopher
- Gloria Gonsalves
- Caroline Grant
- Michael Haas
- Kennan Hourwich
- Linda Irby
- Joey Perez
- Lori Podvesker
- Julia Rogge
- Elly Rufer
- Susan Williams
- Yee Wah Yee
5. Speaker: Marco Damiani, Senior Director, YAI, on the People First Waiver
Marco explained the core concepts of the People First Waiver. He said that OPWDD’s stated goals are to increase personal choice, person-centeredness, and flexibility of services, and to maintain high-quality services. However, the compelling reason for the new waiver is fiscal. Last year New York State had a $12 billion deficit; at the same time, costs are growing. We need to contain costs while improving quality and accountability. New York has the best-developed system in the nation but also the most expensive. NY spends about $10 billion per year, which is more than the next highest 5 states combined.
The current payment system is fee-for-service, where a provider is paid only for physical visits. This type of system costs many millions of dollars just for overhead and for managing payments. And this type of system encourages more visits and treatments in order to increase provider revenue.
Additionally, OPWDD wants to retain $2 billion – $4 billion in Medicaid federal and state payments per year for “safety net services.” This money comes from a billing agreement for OPWDD’s developmental centers, which was approved by CMS (Centers for Medicare and Medicaid), but is now at risk.
Thus, we are in a situation where our costs are unsustainable going forward, and OWPDD is proposing a new mechanism to help contain costs. This new mechanism is—the People First Medicaid Waiver. This waiver is based on managed care and capitated payments instead of fee-for-service payments.
Capitation means that government would make one payment per month per person (pmpm) that would cover all the person’s services – both long-term services (residential, day, family support, etc.) and medical services, too.
To receive services, people with developmental disabilities would have to enroll in managed care organizations, called DISCOs. The DISCOs would develop a plan for each person’s total service needs. The DISCOs would be non-profit DD agencies, or groups of agencies, not for-profit managed-care organizations like Oxford. Each DISCO would have a network of service providers of all types of services, including DD services, medical, mental health, substance abuse, and other types of needed services.
Each person would have an assessment, using the InterRAI assessment tool, to understand what his/her support needs really are. The assessment would be used to determine the person’s capitated rate. There would be a number of capitated payment levels to accommodate low needs through high needs.
Government would make the capitated payments to the DISCOs. The DISCOs would develop individual service plans for all their enrollees and then arrange for the services. Using the total pool of capitated payments of all their enrolees, each DISCO would pay the service providers. The DISCO must see to it that all enrolees get what they need, no more and no less.
If the DISCO’s expenses exceed the amount of their capitated payments, they would ultimately bear full risk and be responsible for whatever money they need to spend beyond what government gives them. DISCOs would ultimately have to have an amount equal to 12% of their pool in a separate reserve account for this purpose.
Marco explained that in preparation for the waiver, providers need to collaborate to find ways to strength systems and to find greater operating efficiencies. If there are savings—for example, in finding alternatives to use of expensive emergency room services—those savings may be able to be reinvested into long-term savings.
Marco encouraged families to regularly check the OPWDD website for the People First Waiver: www.opwdd.ny.gov/2011_waiver/ and to attend DD Council meetings and forums about the waiver. He encouraged families to make their concerns, questions, and ideas known. Visit the People’s First Waiver Page
ANNOUNCEMENTS:
Family Support Services Committee
Tuesday, June 12, 2012, 10:00 am – noon
YAI, 460 West 34th Street, 11th floor
Information: Amy Bittinger (718) 859-5420 x 234
Transition Committee
Wednesday, June 13, 2012, 9:30 am – noon
Life Adjustment Center, 1430 Broadway (at 40th Street), Suite 503
Information: Kathy Kelly (212) 780-2724
DD Council
Thursday, June 14, 2012, 9:30 am
YAI, 460 West 34th Street, 11th floor
Information: Marco Damiani (212) 273-6188
Legislative Committee
To Be Announced
Information: Jim Malley (212) 928-5810 x 101
Childrens Committee
To Be Announced
Information: Christina Muccioli (212) 780-2532
Service Coordination Committee
Next Meeting: To Be Announced
Information: Irina Tuchina (212) 273-6100 x 2418
Self-Advocacy Assn NYC Annual Regional Conference
Friday, June 1, 2012, 9:00 am – 3:00 pm
Keynote speaker and workshops; fee: $20
Information: (212) 627-2104
Resources for Children with Special Needs
Symposiumm: Friendship, Dating, Sexuality, & Disability
Wednesday, May 23, 2012, 5:00-7:00 pm
Credit Suisse, One Madison Ave.
Free but registration required: 212-677-4650
What Special Ed Reform Means for You and Your Child
Downtown: Tuesday, May 22, 2012, 6:00-8:00 pm
1 Centre Street, Office of Manhattan Borough President Scott Stringer
Uptown: Friday, May 25, 2012, 9:30-11:30 am
PS 129, 500 West 138 Street