I. Introductions were completed.
II. Minutes Attachments from the October minutes will be sent out shortly. There was a delay due to the recent storm.
III. Announcements (Flyers distributed available in .pdf format)
DD COUNCIL DUES ARE DUE! Please coordinate within your agency to have your dues paid. The Council sponsors many important events throughout the year, and this is made possible with the support of the member agencies. The invoice is attached.
JBFCS
Social skills group for children ages 6-10 years old who are on the autism spectrum. Contact Leslie Epstein Pearson for more details, 212-632-4513, or lpearson@jbfcs.org.
Archcare at Terence Cardinal Cooke Health Care Center
See attached for openings in the Developmental Disabilities Clinic.
UCP/NYC
Program vacancy list is attached.
YAI
The vacancy list is attached. The fall 2012-winter 2013 schedule of the Family Support Series for Caregivers of People with Autism Spectrum Disorders is also attached.
Call YAI LINK at 212-273-6182 for referrals and any other information.
There will be a one day conference about “Autism and Bullying” on November 28, see attached for details.
QSAC
There are openings in the Day Hab program in the Bronx, Queens and Nassau County; see attached for details.
AHRC NYC
Program vacancy list is attached.
IV. Guest Speaker, Gerry Huber, Acting Deputy Commissioner, OPWDD
Gerry came to update the Council on the People First Waiver. He led a similar effort in Wisconsin and is knowledgeable about the experiences in other states with these types of waivers. The initiative to bring the DD population into managed care comes from the Medicaid Redesign Team (MRT), not OPWDD. Because of budget concerns, the MRT is requiring mandatory Medicaid managed care for all long-term care populations. The goal of managed care is not to take away services, but to manage them in a fiscally responsible manner. OPWDD intends to redesign services so that they are no longer supply-driven but instead demand-driven. There are three reasons for utilizing managed care for DD services:
1. Sustainability: The amount of Medicaid money in New York State has always been among the highest in the country. It has kept our services robust, but it is now a liability. The amount of Medicaid money will be significantly reduced over the next five years (possibly by $2 billion).
2. Relevancy: New families entering the field are saying they do not want what is on the current menu of services. They want more choice in day and residential programs. OPWDD has recently introduced Individualized and Community Supports (ICS) to meet families’ desires. ICS offers people the opportunity to tailor services to meet their individual needs. ICS will incorporate the current individualized options: ISS, CSS, self-directed services, portal, Learning Institute. NYS OPWDD has a $10 billion budget, and 91% of that is devoted to residential and day programs. OPWDD is looking to create a new system based on what families want and need as well as what is affordable.
3. Compliance/Olmstead factor: It is possible that OPWDD could be viewed as noncompliant with the Olmstead law requiring people to be in the least restrictive environment because (a) 91% of resources go to residential and day programs and (b) only 9,000 people with DD are employed. The Commissioner wants to double that number.
Managed Care for our population will be different from the typical managed care programs that deal exclusively with health care. For our population, the hope is that the costs for those who need lighter-touch services will balance the costs for those with more intensive needs. Implementation of managed care will be in 2013-14. Three targeted work teams have developed recommendations with regard to access, enrollment, and advocacy; care coordination; and modernizing the fiscal platform. Their recommendations, along with a lot of other information about the waiver, are on the OPWDD People First website. The fiscal restructuring group has been working on standardization of the rates, in order to create stabilization of rates before the DISCOs are up and running. A draft of the Request for Applications for any agencies that want to become DISCOs is also online on the OPWDD website.
The largest challenges for the People First waiver are time and funding. Implementation is rapid: we have only 5 or 6 months until pilots are launched. The Article 44 process—the certification necessary for a managed care organization—is quite lengthy. Large non-DD health-care providers are interested in providing managed care because over 60% of our population is dually eligible for Medicaid and Medicare; while Medicaid is not attractive to these insurers because of low reimbursement rates, Medicare is quite attractive. If OPWDD does not have its DISCOs in place soon enough, the large insurers may be allowed to administer managed care for people with DD.
Gerry emphasized that one of the lessons learned from the Wisconsin experience is that it is essential to develop partnerships between DISCOs and for-profit entities. The for-profits are needed for their resources and their expertise: they can supply funds for the risk reserve pool and they have expertise is IT and managed care, which would be very useful to the DISCOs. For-profit partners would operate under a contract approved by NYS specifying what they can and cannot do, including limitations on the percent of profit they would be allowed to draw. OPWDD is making it very clear that there will be partnerships between the DISCOs and the for-profits going forward – the expertise is needed on both sides.
V. State News
During Hurricane Sandy, the OPWDD emergency center was open, visits were made to state-operated homes 24/7, and the Brooklyn DDSO was able to fill voluntary agency vehicles with gasoline.
The November 15 teleconference regarding the Five Year Plan was postponed. A new date has not been announced.
VI. City News
Nothing to report.
VII. IAC/Federation Report
IAC: Working on issues regarding the establishment of the Justice Center and on proposed changes in the Scope of Practice; on the latter there have been some clarifications, but not yet any resolutions.
Monitoring OPWDD’s general rate revision, set to be completed by next summer.
Suzanne Timmerhans has been hired to help agencies work collaboratively to reduce costs in preparation for the People First Waiver. Also meeting with start up DISCOs in preparation for the Waiver.
IAC has reached a membership of 150.
Provided information and direction during Sandy. Collecting financial data as a result of the storm.
The State’s Budget is due to be released the week of January 21. The Commissioner will be a guest at the Membership meeting on January 31.
IAC’s Lobby Days are scheduled for February 26 and 27.
Federation: No meeting held, and no meeting scheduled.
VIII. Committee Reports
Family Support – The Family Support Fair will be held on Thursday, November 29, 2012, 10:00 a.m.-2:00 p.m. at Church of St. Paul the Apostle, 405 West 59th Street, at 9th Ave. The FSS Directory is being updated and brochures are available. Everyone is asked to take responsibility for outreach for the fair. Volunteers are needed for the registration table and to set up at 8:00 a.m.
Jennifer Shaoul explained that people who have a Medicaid “code 95” –people in the waiver or waiver look-alikes—are exempt. To secure a code 95 to be exempt from Medicaid Managed Care, you must be deemed OPWDD eligible; it is not necessary to be in the waiver in order to be exempt. Information about this issue will be distributed at the Fair, and there will also be a workshop on this subject.
The November meeting topic will be Medicaid managed care enrollment and problem solving and free psychological and psychosocial evals at AHRC. In January there will be a speaker about residential options outside of OPWDD and possibly a speaker from Adult Protective Services. The next meeting will be held on Tuesday, 11/13, at 10am at YAI, 460 West 34th Street, 11th floor. Call 718-859-5420, ext. 234 for more information.
Legislative – The date for the 2013 Manhattan Legislative Breakfast is Friday, March 15. The Committee will start meeting soon. If you are interested in being involved, please contact jmalley@esperanzacenter.net.
Transition – The next meeting will be on Wednesday 11/14 at 9:30 at Life Adjustment Center, 1430 Broadway (at 40th Street), suite 503. Call Kathy Kelly at 212-780-2724 for more information.
Manhattan Family Support Services Advisory Council – Joint FSSAC/DD Council meeting: presentation on Effective Legislative Advocacy, with Assembly Member Richard Gottfried and his Chief of Staff, Wendi Paster, had to be rescheduled due to Hurricane Sandy. The new date is: Wednesday, December 12 from 5:30 to 7:30 p.m., at YAI, 460 West 34th Street, 12th floor. Call Margaret Puddington for more information, 212-799-2042.
Service Coordination –The Committee welcomes Carol Lincoln from UCP/NYC as the new co-chair. The MSC Forum will have to move to a new venue as Morton Street will no longer be availableThe Committee will host a meeting about PCSS at the beginning of December. Agencies are urged to send MSC Directors as well as MSCs to the Committee meetings and to have them participate in planning the Forum. Please contact Carol to participate, clincoln@ucpnyc.org.
Children’s Committee – Members are being encouraged to attend the Family Support Fair. The next meeting will be announced. For information about the Committee, contact Christina Muccioli at Christina.Muccioli@ahrcnyc.org.
IX. New Business
There is a play at the Minetta Lane Theater, about a young adult on the autism spectrum. It was written by a mother of a young man with autism, and it is about him and his family. It was highly recommended by a few people at the Council meeting. www.fallingplay.com for more information.
Next meeting: FRIDAY, December 14 at YAI, 460 West 34th Street, 11th floor.