1. Announcements – Manhattan families are welcome to attend the DD Council as well as any or all of its committee meetings.
Family & Provider Information Committee
Tuesday, March 27, 2018, 10:00 am – noon
AHRC, 83 Maiden Lane, 11th floor
Information: Carol Lincoln (718) 859-5420 x 225; clincoln@adaptcommunitynetwork.org.
DD Council
NOTE NEW DATE & TIME
Thursday, April 19, 2018, 1:30-3:30 pm
Birch Family Services, 104 West 29th Street, 2nd floor
Information: Marco Damiani (212) 780-2661; manhattanddcouncilchair@gmail.com
Legislative Committee
Next meeting to be announced
Information: Jim Malley (212) 928-5810 x 101; jmalley@esperanzacenter.net
2. OPWDD and Legislative Updates – Margaret Puddington
OPWDD’s “Join the Conversation”: All families are invited to sign up to receive information and updates from OPWDD’s Acting Commissioner at https://opwdd.ny.gov/jointheconversation.
OPWDD Holding Informational Forums on Care Coordination Organizations. Information about the Care Coordination Organizations (CCOs) that will replace MSC as of July, 2018. Registration required.
NEW YORK CITY
April 12th – 6 p.m. to 8 p.m.
Heartshare
177 Livingston Street
Brooklyn, NY
April 19th – 6 p.m. to 8 p.m.
Staten Island Developmental Disabilities Services Office (SIDDSO)
930 Willowbrook Road – (In the Bubble, near 12G) located at
The Elizabeth Connelly Center – Building 40-41)
Staten Island, NY
April 24th – 6 p.m. to 8 p.m.
Bronx Developmental Disabilities Services Office (BXDDSO)
2400 Halsey Street
Bronx, NY
REGISTRATION CONTACT PERSON:
SELENA PRUDEN – selena.j.pruden@opwdd.ny.gov – 646-766-3655
Mary McGuire-Weafer shared this link to more information on the CCOs: https://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/idd/letters_of_interest.htm
Legislative Update
Over the last couple of months, there has been much legislative advocacy targeting the NYS budget: lobbying in Albany, meeting legislators locally, rallies, Legislative Breakfasts in all NYC boroughs. The main issue is workforce: the importance of raising the salaries of direct support professionals (DSPs) in OPWDD services and also of teachers in 853 and 4410 special education schools.
The state budget process begins with the Governor’s executive budget proposals, submitted in January. Next the state Assembly and Senate issue their own one-house budgets. That has just occurred. The final step is for the two houses and the Governor to reconcile and produce a budget by April 1.
Regarding DSPs, last year the bFair2DirectCare campaign requested increases over 6 years to achieve a living wage for DSPs: $17.72 downstate, and $15.54 in the rest of the state. DSP turnover and vacancy rates are still escalating: turnover is 26.7% this year, up 7.5% from 2016, and vacancy is now 14.4%, up 30% from 2016. Because of this escalation, this year we requested a speed-up of the salary increases over 4 years instead of 6, as originally requested. The Governor included a 4/1/18 increase of 3.25% in his proposals, as promised last year. Both one-house budgets include that. But none of the parties included a speed-up of the wage increases. The Senate budget included funding for future payments of 3.25% for 2019-2022, but that money would need to be allocated in future budgets for those years.
Regarding teachers in the 4410 preschool and 853 school-age special education schools, turnover and vacancy are at crisis levels. These schools are part of the public school system: the public school system refers children to these schools after a determination that the public schools are unable to serve these students because of the severity of their disabilities. Yet tuition rates for our schools are far below those in the public schools. Therefore, our teachers earn about $40,000 less than public school teachers, and the public schools easily recruit our most experienced teachers. Thus there is a severe shortage of teachers in these schools serving very vulnerable children. We requested $14.7 million to reduce the teacher pay gap, but that was not included in any of the proposals. We also support tuition increases for these schools, but tuition increases are not part of the legislative budget process, so we requested legislative support for increases, which we did not receive. Margaret distributed a two-day action alert, asking families to call their legislators to request that they add the $14.7 million for teacher recruitment and retention.
Further advocacy is being planned on these issues. If you get an action alert, please respond right away. Our voices can make the difference.
3. Election of Chairperson
As announced previously, Margaret is retiring as chairperson, and the Executive Committee and Margaret recommend Jackie Goldberg and Mary McGuire-Weafer as co-chairs. Jackie and Mary introduced themselves with brief bios. Margaret asked if there were other nominations from the floor. There were none. A vote was taken, and Jackie and Mary were unanimously elected.
Margaret emphasized that change can be good: both co-chairs have younger children at home and bring a different perspective to their role. We anticipate many positive developments for the MFSSAC.
The term of the present Executive Committee of the MFSSAC ends in June, at which time there will be elections for a new Executive Committee.
4. Speakers: Organizations Providing Care Coordination to NYC Individuals with I/DD
Peter Pierri, Advance Care Alliance
James Moran, Anne Ogden, Care Design NY
Annrose Bacani, Partners Health Plan
David Mizrahi, Connie Twerski, and Bob Manley, Tri-County Care
Speakers discussed their own organizations and also answered general questions about Care Coordination Organizations (CCOs). For purposes of clarity, the general questions will precede the organization-specific discussion in these minutes. The general questions were addressed by all the speakers.
About CCOs – General Questions
MSCs are being phased out by July 1, 2018, because it is required that care management be conflict-free: care management may not be provided by the same agencies that provide services. To address this issue, the CCOs are independent networks of existing OPWDD providers that provide integrated care coordination. The CCOs will help individuals and families access not only on OPWDD services, as currently under MSC, but also behavioral health and medical services. OPWDD has approved 6 CCOs in NYS. Each CCO will have a robust network of providers. Providers will likely choose to be part of all the CCOs. When you enroll in a CCO, all that changes is your care management arrangements. Your services don’t change unless you want them to. You can continue to choose your providers. You can change CCOs or care managers at any time. Care managers will have more resources than MSCs because they will now be part of the larger network of care managers and can share information. The goal of CCOs is to enhance the quality of people’s lives. The focus will now be on outcomes and efficiencies. A person will have a Life Plan, similar to an ISP, that includes OPWDD services and wellness goals. Everyone will have an electronic health record; all CCOs will use the same technology.
MSCs are expected to inform families about the change to CCOs. If your MSC doesn’t inform you, or is unaware of what is happening, you should take your concerns to the MSC supervisor.
If you like your current MSC, you may want to stay with him/her and enroll in the same CCO as your MSC. If you prefer a change, you can choose from any of the CCOs in your region. You can also choose whether to enroll in a CCO or to stay with Basic HCBS service coordination, which provides only minimal care management. People who are not eligible for Medicaid will likely continue to have access to family support (non-Medicaid) service coordination, as currently.
Care Design NY – James Moran and Anne Ogden
Care Design has been collaborating with other CCOs on common issues such as training and financing. Care Design has 70 affiliated agencies and covers 31 counties. It will hire MSC staff and supervisors directly at the outset, rather than contracting with MSC affiliated providers. They have just sent out offering letters. The organization is holding meetings with staff. Staff will remain at their current locations for up to 2 years and then move to a new location. Care Design puts individuals and families first and will invest in the workforce. Has bilingual staff in various languages and pays more to bilingual staff. Case loads will average 1:35. Care Design is not a nonprofit: in order to maximize resources. its partners have invested in the organization but will not make a profit; instead, will reinvest any surpluses back into the CCO. Care manager salaries will be better, on average, than MSC salaries.
Advance Care Alliance – Peter Pierri
ACA covers 14 counties. Many of its affiliated agencies are mid-size to smaller size, serving diverse populations and subgroups. ACA has expertise in transition– especially into adulthood, but also with people who are aging, and people transitioning out of hospitals. Initially, ACA will contract with MSC agencies for a year, and will then employ its staff directly. Will have a rental agreement with agencies. ACA does webexes every 2 weeks to inform MSCs in affiliated agencies. ACA has bilingual affiliates who speak Spanish, Cantonese, and Mandarin. Case loads will be less than 40 per care manager. ACA is nonprofit. Care manager salaries will be better, on average, than MSC salaries.
Tri-County Care – Connie Twerski, David Mizrahi, and Bob Manley
This CCO covers 27 counties. They strive to help people have better quality lives and to help people make informed choices. They emphasize wellness services and preventive care, including exercise and healthy diet. Their maximum case load is 35. Their staff speak various languages and are culturally sensitive. Care manager salaries will be better, on average, than MSC salaries.
Partners Health Plan – Annrose Bacani
Not a CCO, Partners Health Plan is an option available today for adults over 21 who are OPWDD-eligible and have both Medicaid and Medicare. PHP is a non-profit managed care organization covering 9 counties. Managed care will become mandatory; CCOs are the first step toward managed care. PHP wants to set the standard for managed care for people with I/DD before the for-profit generic managed care insurance companies are permitted to do so. Enrollment in PHP is voluntary and you can disenroll at any time. PHP will help obtain Medicaid or Medicare for those who qualify. Their care management consists of a two-person team, unlike the CCOs. They have care managers, who are licensed clinical professionals (nurse or social worker) and care coordinators who are qualified I/DD professionals or who have a bachelor’s degree and two years of experience. PHP has the ability to authorize services themselves, without Front Door involvement. They cover all services—I/DD, medical, behavioral, social. When you enroll, you can keep all your I/DD services, but you must use network providers in the PHP network for your medical and other services. You can keep your medical and other non-I/DD services for 90 days, after which you must choose a provider in their extensive network. If you request it, PHP will invite your doctors to join the network or to make a single-patient agreement so that you can keep your doctors. Like the CCOs, PHP develops a Life Plan for each person. They pay their care coordinators $10,000-$15,000 more than MSCs earn. They have staff who are bilingual in Spanish, Cantonese, and Mandarin. Each care manager supervises 2 care coordinators. Care coordinators have a case load of 35.
Please see attachments for more information on the CCOs and PHP.