- Announcements
DD Council
Thursday, October 13, 2016, 9:30 am- noon
CP of NYS, 330 West 34th Street, 15th floor
Information: Marco Damiani (212) 947-5770 x 456; manhattanddcouncilchair@gmail.com
Family Support Services Committee
Tuesday, October 11, 2016, 10:00 am-noon
UCP of NYC, 80 Maiden Lane, 2nd floor training room
Information: Yesenia Estrella (212) 643-2840 x 349; yestrella@sinergiany.org
Transition Committee
Wednesday, October 19, 2016, 9:30 am – noon
AHRC, 2080 Lexington Ave.
Information: Kathy Kelly (212) 780-2724;Kathy.kelly@ahrcnyc.org
Legislative Committee
Next meeting to be announced.
Information: Jim Malley (212) 928-5810 x 101;Jmalley@esperanzacenter.net
Children’s Committee
Next meeting to be announced.
Information: Christina Muccioli (212) 780-2532; Christina.muccioli@ahrcnyc.org
SAVE THE DATE: Manhattan Family & Professional Resource Fair
Tuesday, December 13, 2016, 10:00 am – 2:00 pm
NY Academy of Medicine
1216 Fifth Ave. at 103rd St.
Margaret announced that parent volunteers are needed to sit on parent review committees for two family reimbursement programs. Alice Shulman and Teresa Adames volunteered. If you are interested in helping, please contact Margaret.
Lori Podvesker announced a City Council Oversight Hearing on Autism Family Support and Cultural Competency on October 6, 2016, 10:00 am, at City Hall.
- MFSSAC Elections
The following slate was proposed at May meeting. Lori Podvesker made a motion to accept the slate. Trish Chapman seconded the motion. The motion passed with none opposed.
Chairperson: Margaret Puddington
Executive Committee: Kate Bini, Caroline Grant, Michael Haas, Linda Irby, Adriana Maya, Sunny ONeil, Elly Rufer, Ursula von Wartburg, Susan Williams
- Report on Statewide Family Support Committee
Margaret reported on the September statewide Family Support Committee meeting. She omitted some topics which Donna Limiti, our speaker, will cover.
Acting Commissioner Kerry Delaney reported on the following:
- OPWDD Leadership changes: Dr. Tamika Black is the new Deputy Commissioner of the Division of Quality Improvement. Dixie Yonkers is the new Director of Advocacy Services.
- Reports to the Legislature are due 10/1: OPWDD is required to submit reports to the Legislature on the status of the Residential Registration List and stakeholder group recommendations (see below under Donna Limiti’s remarks for more information). OPWDD is continuing outreach to families to keep abreast of residential needs. OPWDD is also required to submit a report to the Legislature regarding the status of the Transformation Panel’s recommendations (see below under Donna Limiti’s remarks for additional information). Most of the recommendations have detailed work plans; OPWDD will issue a report to the public as well as ongoing quarterly reports beginning in January.
- OPWDD’s 5 year plan will be released in November.
- HCBS Waiver amendment: OPWDD had published its amendment to its waiver renewal application and received comments from stakeholders. OPWDD is now seeking CMS approval.
Role of Family Support Services (FSS) Advisory Councils re evaluation of waiver respite services
Recently, the Division of Quality Improvement (DQI) has taken responsibility for oversight of all waiver programs, including waiver respite, such as afterschool, recreation, and overnight respite programs. The FSS Advisory Councils want to continue to monitor these programs, as we have always done. In fact, there is an OPWDD Memorandum of Understanding specifying that Councils continue to have oversight of waiver respite programs as well as non-waiver programs. At present Councils in different regions throughout NYS handle this differently: some do visits, some don’t. FSS Coordinators in some regions no longer have time for this. OPWDD is continuing to explore with our committee how the Councils can continue to have a hand in monitoring waiver respite. Under consideration is that Councils could do joint visits with DQI. DQI is in the process of redesigning its survey tools. They are doing 3 types of review: site review; person-centered review of all of the individual’s services, including respite; agency review of procedures and policies. For joint visits, we will need to clarify FSS/DQI roles, how to handle FSS/DQI activities at the same visit, scheduling visits, using the same checklist, and a mechanism to share findings. Providers need to be informed of the change.
Eligibility of People Who Self-Direct to Purchase Family Support Services
People who use Self-Direction and have their own budgets are permitted to purchase existing services, including FSS. If FSS is purchased, the cost is deducted from the individuals’ budgets, but is not given to the FSS agency. That money goes into the General Fund. The issue raised by FSS Committee members is that people in Self-Direction may be using up available FSS opportunities, thereby depriving others who don’t have other options through their budgets, as Self-Directing individuals do. Discussion at the meeting did not resolve the problem.
Family Support Services Booklet
The Committee agree to revise and update an old FSS booklet from the 1990s.
- Speaker: Donna Limiti, NYC Director, OPWDD, on OPWDD Updates
Donna began by cautioning that with all the new initiatives she will discuss, there is constant tweaking and improving, so that what she tells us now could change tomorrow.
Residential Services
Donna recalled that the current budget includes $120 million for new services. Of that, $10 million has been set aside for residential services for people living at home. This happened because of families’ advocacy around the lack of residential development for people living at home, instead favoring people aging out of residential schools, people in developmental centers, and people in nursing homes. The Centers for Medicare and Medicaid (CMS), which controls the funding for residences, wants to decrease institutional services, which it defines as ICFs, developmental centers, and nursing homes, which have bundled services (a sort of package deal of services where you must take the entire package) and which offer little access to the community. Some of these services can be converted to IRAs (less institutional) or downsized or people can move to other types of residences.
Donna stated we need to be efficient about how we spend our OPWDD money. We need to develop services differently, which could be good for us. We did develop all the current waiver services, and tweaked them. Now we have an opportunity to develop another set of waiver services. For example, some people getting 24/7 residential services are very independent and could possibly move into a non-24/7 residential setting or live more independently in an apartment with services brought in.
To address family advocacy arguing that people at home should have equal access to residential services as people aging out of residential schools or needing to leave developmental centers or nursing homes, OPWDD changed the residential priorities, now called “priority categories.” Category 1 is emergency: people with true emergencies, such as homeless or without a safe place to live. Previously those in developmental centers and nursing homes and those aging out of residential schools were in the top priority. This has changed. They are now in Category 2, which is for those with substantial need, including individuals at home whose caregivers can no longer continue to provide care. Category 3 is for people with a current, but not urgent, need for residential placement.
The process for obtaining residential services has also changed. OPWDD maintains two lists. The Residential Registration List was cleaned up recently. It contains the names of people interested in residential opportunities now and into the future. OPWDD made calls to families on that waiting list to verify whether they still wanted a residence and to see if they had enough services at home while waiting. The other list is the Certified Residential Opportunities (CRO) list—except it is for uncertified as well as certified opportunities. This list is only for people who have a current need for residential services. People wanting residential placement soon must have their MSCs put their name on the CRO list. Once a person is on the CRO list, OPWDD assesses which priority category the individual falls into (see preceding paragraph). The CRO list contains information about the person, not just name and date of birth. OPWDD sends the CRO list to agencies every month, and agencies select people from that list to fill vacancies. OPWDD controls all referrals to these vacancies, but does not force an agency to take emergency people if they are not a good match with the vacancy (e.g., if the person uses a wheelchair and the vacancy is in a site with steps).
The different DDRO regions do not get allocations to develop new residences. Instead, the regions may submit proposals to the central OPWDD office, which manages the funding: the $120 million in the budget for new services. Thus it is important to have a consistent process across all the regions of the state for determining eligibility, assessing need, and authorizing services. The Front Door is supposed to accomplish this.
OPWDD established regional stakeholder groups to decide how to spend the $10 million set aside for individuals living at home for new residential development. New York City’s share of the $10 million is $2.8 million, which is not very much. NYC’s stakeholder group included parents, self-advocates, OPWDD staff, local government staff, and a housing navigator. The group received information from OPWDD on the needs of the people on the CRO list, and according to that information, made the following recommendations for dividing the $2.8 million: 50% would go toward uncertified options such as rent subsidies; 40% would go to certified options; 10% would go to a transition home where people could be assessed over 6 months to determine their support needs and could then remain in the transition home for another 6 months while the residence is being developed. OPWDD will issue requests for a Letter of Interest (a proposal) from agencies. All this information will eventually be posted on the OPWDD website.
Transformation Panel Recommendations
A group of stakeholders—providers, families, OPWDD representatives—have reviewed services and made 61 recommendations. These recommendations fall into 3 categories: those easily accomplished, those that are harder but do-able, and those that can’t be addressed until OPWDD services are in a managed care system. There are work plans for implementing all but the most difficult recommendations. Information will be made public about the recommendations, and updates will be provided.
People Embracing People
This is a certified family care program where a person takes an individual with DD into his/her home. The provider receives comprehensive training and works to achieve outcomes for the service. Oversight of the program is provided, just as for all certified programs. People Embracing People is being piloted in NYC and Long Island. It has an advertising campaign to recruit providers and families and to change the perception of the program—it is not intended to replace families but to serve as a complement.
Supportive Housing
$15 million was included in the budget for capital costs for supportive housing for people with DD. A request for proposals has been issued for developers, covering 50% of capital costs of a project. This would serve people who are able to live more independently but in close proximity to others, thereby benefitting from shared staffing. Council members recommended adding people with DD as a NYC priority for affordable housing.