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Racker’s Dan Brown appointed to national HCBS Technical Expert Panel

Congratulations to Racker CEO Dan Brown on being appointed to serve on the national Home and Community Based Services Technical Expert Panel.

An initiative of the Centers for Medicare and Medicaid Services (CMS), the HCBS Technical Expert Panel is a group of 15 thought-leaders from across the country who have been invited to help shape the direction of a set of HCBS quality measures.

For years, Dan has been a leader within our vibrant provider community. He currently co-chairs American Network of Community Options and Resources’ Board of Representatives, on which he has represented New York since 2018.

Dan is also a member of ANCOR’s Government Relations Committee. As ANCOR COO Gabrielle Sedor put it upon learning the news of Dan’s appointment, “I appreciate that Dan always brings multiple perspectives to the table, as well as a vested interest in helping to develop and identify measures that directly relate to quality supports that impact people’s lives in meaningful ways.”

“ANCOR is deeply appreciative of CMS’ efforts to convene the TEP, and we are immensely grateful for the work Dan  will do drive our field closer to meaningful quality measures,” said Barbara Merrill, ANCOR Chief Executive Officer.

“Dan is a leader and great advocate for our field, and I speak for everyone at CP state that I say his appointment is well-deserved,” said CP State Executive Director Mike Alvaro.

How is the workforce crisis affecting your agency?

The American Network of Community Options and Resources (ANCOR) is asking that we share and that everyone complete this survey about the impact of the workforce crisis on your agency.

From ANCOR:

We need your help – please. As I hope you have seen, recently, we’ve been successfully pitching more coverage in the press about the direct support workforce crisis as validated by the NCI staff stability report. We have been successful in connecting members to reporters to discuss specific agency/corporation experience, but to keep this momentum going, we need more information. 

For that reason, I write to ask that you tell us: What does the direct support workforce crisis mean for your organization and the people you support? Are you turning away new referrals because of inadequate staffing? Are you shuttering existing programs or delaying the launch of new ones because you don’t have enough staff to make those programs successful? How else might this issue be hindering your ability to support people in community? 

To answer this question, please take four minutes as soon as you’re able to complete this short questionnaire about the impact of the DSP workforce crisis on your organization. Any information you share will be kept confidential, and no identifying information will be preserved if and when we disseminate the results of this survey. That said, we will certainly put these insights to good use as we work to even further raise the visibility of the issue and make the case for solutions that work in the long-term. 

I know you’re busy, and I know you have survey fatigue, so I am immensely grateful for the time you take to complete the survey. Please try to coordinate to ensure only one person per organization responds – but also please do not let the perfect get in the way of getting this done. 

 

Medicaid Redesign Team II to hold Public Comment Forum in Albany on February 21  

The New York State Medicaid Redesign Team (MRT) II will hold the third of a series of public comment forums on February 21st in Albany, NY. The first public comment forum took place in New York City on February 14th, followed by a second in Rochester on February 18th. The purpose of these events is to give members of the community an opportunity to speak about changes to the State’s Medicaid program within the upcoming FY 2021 State Budget.

When: Friday, February 21, 2020, 10:00 a.m.- 1:00 p.m. Registration begins at 9:00 a.m.

Where: Albany Capital Center, 55 Eagle St, Albany, NY 12207

*A live webcast of the public comment forum will be available on the MRT II website: https://health.ny.gov/health_care/medicaid/redesign/mrt2/

The MRT webpage also offers more detail on the specific responsibilities and charges tasked to the MRT II, a complete list of MRT II members, recorded webcasts of past meetings and public forums, and a link to the MRT II Public Proposal Form.

Contact: New York State Department of Health
518-474-7354, Ext. 1
press@health.ny.gov

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Save the date: Quality and Compliance Conference on May 5!

The 13th Annual Quality & Compliance Challenges Conference for Providers Serving People with Disabilities will be held on Tuesday, May 5, 8:30 am  to 4 pm, at the Saratoga Hilton at 534 Broadway, Saratoga Springs, NY 12866.

Each year, this conference provides valuable information and insights for Corporate Compliance Officers, Quality Improvement Staff, Executive Leadership and other attendees to help ensure disability service providers are running effective, efficient, high quality programs.

This year’s sessions feature:

  • Rachel Dunn, Special Prosecutor & Inspector General, NYS Justice Center for the Protection of People with Special Needs
  • HIPAA Compliance Presentation by the U.S. Department of Health & Human Services Office for Civil Rights
  • The Relationship Between Human Resource Employment Concerns & Corporate Compliance
  • Managed Care and Creating a Culture of Quality

This is a great opportunity for Corporate Compliance Officers, Corporate Compliance Committee Members, Quality Assurance Officers, Board Members, and Executive Leadership.

REGISTRATION INFORMATION WILL BE AVAILABLE SHORTLY

For further information, contactThe Arc New York at (518) 439-8311 ~ www.TheArcNY.org.

 

NYC Ballet to host 3rd annual workshop in July for kids with I/DD

CP of NYS is pleased to announce that we will again partner with the New York City Ballet for the third annual dance workshop for children with disabilities at the Gideon Putnam Hotel in Saratoga Springs on Saturday, July 18.

Accompanied by a NYCB musician, two NYCB dancers will lead children in ballet-based warm-up and movement combinations inspired by a ballet from NYCB’s repertory, concluding in a performance for family and friends in attendance. Following the event, families can enjoy some light refreshments and a photo and autograph opportunity with the NYCB artists.

Dr. Joseph Dutkowsky, a member of the CP of NYS Board of Directors has created a relationship with the New York City Ballet that has given hundreds of children the opportunity to experience the joy of dance.

At the Saratoga Springs workshop we pair each young participant with a volunteer “buddy” to assist during the workshop and performance. The “buddies” can be a family member, friend or other individual who will work directly with the young dancers to help them with the movements. If you, or anyone you know, would like to volunteer to be a buddy, please have them contact CP of NYS staff listed below.

If you have questions or would like more information please contact Al Shibley at ashibley@cpstate.org or Deb Williams at dwilliams@cpstate.org or by phone at 518-436-0178.

April 21-22: Human Resources Professionals Conference For the Disability Provider Community

 

Make plans to attend the 4th Annual Human Resources Professionals Conference For the Disability Provider Community!

Previously brought to you by COPA, this two-day conference will feature HR subject matter experts who will discuss trending topics ranging from cultural diversity to recruiting in the current employment market.  Rich Landau, a principal with Jackson Lewis, will join us once again as the Opening Session Speaker.  A dynamic presenter, Rich has a wealth of practical knowledge about current labor and employment law practice. In addition to information-packed sessions, there will be informal time to catch up with peers and enjoy Saratoga Springs.

Click here to register!

Reserve your hotel room at Embassy Suites today!  There are a limited number of rooms available for this event – early registration is encouraged.

If you have any questions, please contact Tim Ferguson,  tferguson@cpstate.org

More information to come… We look forward to seeing you in April!!

OPWDD adopts emergency regs for extended treatment units

OPWDD has adopted new emergency regulations regarding extended treatment units.  This regulation is in effect and will appear in the State Register on February 12.  Comments will be received until April 12.  The regulation can be found on the OPWDD homepage under the regulations and guidance tab or by clicking the following link: https://opwdd.ny.gov/regulations_guidance/opwdd_regulations/emergency/intermediate_care

OPWDD has also released a new Administrative Directive Memorandum regarding “Revised Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) Level of Care Eligibility Determination (LCED) Form for Individuals Who Are Seeking To Access Or Maintain Home and Community Based Services (HCBS) Waiver, Comprehensive Care Coordination and other State Plan Services.”  The ADM can be found on OPWDD’s homepage under the regulations and guidance tab or by clicking on the following link https://opwdd.ny.gov/opwdd_regulations_guidance/adm_memoranda

CP of NYS will submit comments on the above emergency regulations on behalf of Affiliates – please email Executive Director Mike Alvaro any comments you are submitting on your own or would like CP to submit on behalf of all Affiliates by April 1.

New Funding Assistance Program for Equipment, Supplies, and other Supports

We are pleased to announce that CP of NYS has been awarded a one-year grant, effective January 1, 2020, to provide financial assistance for the purchase of equipment, services, supplies, and other supports needed by individuals with intellectual, developmental, and other significant disabilities when all other funding opportunities have been exhausted.

The Community Health Outreach Project seeks to assist people with disabilities of all ages by addressing the shortcomings in current supports and systems.  Funds through this project will provide access to supplies, equipment, and care for individuals in an effort to increase their health status and promote community participation. By removing barriers and offering assistance unavailable to them through other sources, CP of NYS can do its part to improve social and environmental living conditions while promoting quality of life.  CP of NYS will focus on health measures and outcomes as well as the social determinants of health to identify priorities for funding and enable people to remain independent and active within their homes and communities.

For this initial project period, we will target those individuals/families with low income (200% of the 2019 federal poverty level) and no insurance other than Medicaid.  In addition, this project will be limited to servicing individuals living within the 14 counties of the Albany Diocese, which are Albany, Columbia, Delaware, Fulton, Greene, Herkimer, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, and Washington.  We hope to gain an additional year of funding to expand the project statewide.

In addition to individuals/caregivers applying for funding, CP Agencies have the opportunity to submit for reimbursement of expenses incurred during 2020 for any individual who meets the eligibility requirements.  Opportunities for funding include, but are not limited to:  Assistive Technology, Durable Medical Equipment (DME), Enhancements to DME, Environmental Modifications, Medical Supplies, Repair Services for Equipment and Vehicles, Specialty Care and Evaluations, and Vehicle Modifications.

Cindy Morris is the Project Director working at the CP of NYS offices.  Please contact her to learn more about the project or to obtain application forms.  She can be reached at (518) 436-0178 or via email at cmorris@cpstate.org.  Additionally, complete details can be found at www.cpofnys.org/CHOP.  There you’ll find an Application Form for Funding Assistance that can be completed by individuals/caregivers, and a separate form that Agencies can submit for reimbursement of expenses.

 

Proposed NYS budget restructures Medicaid to address $6.1 billion deficit

GOVERNOR CUOMO RELEASES HIS 2020-2021 STATE BUDGET PROPOSAL

Governor Andrew Cuomo unveiled his 2020-2021 $178 billion State Budget proposal on Tuesday, January 21, 2020.   The $178 billion executive budget outlines a plan to reduce the growth of government spending and restructure the state’s Medicaid program to combat a looming $6.1 billion deficit.

The Governor highlighted program initiatives that he would advance, including:

  • MRT II: Reconvenes the Medicaid Redesign Team (MRT II), that is charged with identifying cost-containment measures to provide approximately $2.5 billion in gap-closing savings in FY 2021 and ensure Medicaid spending in future years adheres to the Global Cap indexed rate
  • School Aid: A School Aid increase of $826 million, or 3 percent, with more than 80 percent of the increase targeted to high-need districts
  • Local Aid: Targeted savings in local aid programs
  • State Agencies: Continues to limit growth in agency operations to “investments that are expected to yield improved performance or reduced costs over time.”
  • Marijuana: Legalize Adult-Use Marijuana
  • Bail Law Reform: Proposes to update last year’s Bail Law reforms
  • Middle Class Tax Cuts: Continues middle class tax cuts for 4.7 million New Yorkers earning under $300,000 a year and recommends no new tax increases
  • Fighting Domestic Terrorism:  Enact the “New York Hate Crime Anti-Terrorism Act” which creates a domestic act of terrorism motivated by hate crime as a new A-1 class felony punishable by up to life in prison without parole

The Executive Budget proposal includes the following legislation:

  • Prevailing Wage: Requires that workers on projects, with a significant public subsidy, would be paid a prevailing wage.  This applies to projects valued at more than $5 million and exempts ESSHI funded projects.
  • Paid Sick Leave: Requires businesses with five to 99 employees to provide their employees at least five days of job-protected paid sick leave per year and businesses with more than 100 employees,to provide at least seven days of paid sick leave per year.
  • Continuing the Regional Economic Development Councils: $750 million to continue the regional economic development strategy.

The Budget proposes substantial capital investments, including:

  • $33 billion 5-year capital plan to tackle climate change
  • $275 billion infrastructure program
  • $133 million for homeless and affordable housing
  • $2.9 billion to combat childhood poverty
  • $12 million for emergency management equipment
  • $147 million for the Olympic Regional Development Authority capital improvements

Key elements of the FY 2021 gap-closing plan include:

  • County management of the Medicaid program:   If counties stay within the 2% tax cap but exceed 3% Medicaid growth, they will pay for Medicaid expenditures above the 3% for that year. If they stay within the 2% tax cap and under a 3% Medicaid increase, they get 25% of the savings. If counties fail to stay within the 2% tax cap, they have to cover 100% of Medicaid growth.
  • DOB has revised the tax receipts forecast across all years in the Financial Plan based on stronger receipts to date and updated economic information. Through the first three quarters of FY 2020, General Fund receipts, including transfers from other funds, totaled $57.8 billion, $1.5 billion (2.7 percent) above the initial estimate of which PIT receipts were $1.3 billion higher.
  • The MRT II is charged with identifying cost-containment measures that will provide approximately $2.5 billion in gap-closing savings in FY 2021 and ensure Medicaid spending in future years adheres to the Global Cap indexed rate. The spending targets are incorporated into the Financial Plan projections. The Team’s recommendations are due prior to the Enacted Budget.
  • Another $1.8 billion in local assistance savings is expected from targeted actions and the continuation of prior-year cost containment.
  • Savings in agency operations, including fringe benefits, are expected to reduce spending by $359 million from the baseline forecast. The Executive Budget holds agency operations spending flat at $10.7 billion. In addition, sensible reforms are again advanced to achieve savings in health insurance and judgments against the State.

OPWDD held a call with the provider associations on January 22 to review the Governor’s 2020-2021 state budget proposal.  We were pleased that the 2% #bFair2DirectCare funding, effective 4-1-2020, was in the budget and not surprised that neither the COLA nor the 3 for 5 funding

were in the Governor’s budget proposal.  We met with the Health and Medicaid team from DOB and they provided clarification on Medicaid, MRT II, Early Intervention and telemedicine for dual eligible individuals. Any details or clarification from the OPWDD call and DOB meeting are contained below.

Below is an overview of the Governor’s budget proposal by section.  We will provide additional details as we get them.

OPWDD

  • #bFair2DirectCare Increases & Minimum Wage funding:  The budget contains $127 million (state & federal) in funding to cover the continuation of the 1/1/20 2% increase for 100 & 200 CFR Code positions and another 2% for the 4/1/20 increase for 100, 200 & 300 CFR Codes.  $44 million (state & federal) is included to continue the minimum wage increase.  As part of the “two-year agreement” to provide these two 2% increases, there is no COLA in this budget proposal.
  • Development:  Once again the budget includesadditional State resources “that can leverage up to $120 million” all shares fully annualized (state and Federal) in additional funding available for “Program Priorities,” including; certified housing supports in the community; more independent living; more day program and employment options and increased respite.
  • Housing:  $15 million in capital funds to develop affordable, independent living housing.
  • “Improve Accountability and Oversight”: Includes legislation that provides OPWDD with the authority to issue operating certificates to providers of certain Medicaid State Plan services.   “The purpose of this legislation is to create more direct authority for oversight and ensure quality of services by providers…and to eliminate duplication of efforts between multiple State agencies.” (See“CCO’s” below)
  • “Promote More Efficient Use of State Resources”: “OPWDD will leverage federal Medicaid funding, utilize other supplemental aid where available and take other actions to more cost-effectively support the provision of person-centered programs.”.  Recoupments of surpluses in supplemental room and board and other state fund payments should yield $10M, reduced State Operations overtime payments should produce $7M.
  • Managed Care:  Guidance on Specialized I/DD Plans – Provider Led (SIP-PL) “is expected to be released for public comment soon.”  Responses will inform OPWDD on the system’s fiscal and other readiness for Managed Care.  In July 2018, OPWDD developed regional Care Coordination Organizations (CCOs) as a first step.
  • Justice Center:  Discontinue the requirement that every Justice Center investigation of abuse and neglect must also include a Statewide Central Register of Child Abuse and Maltreatment (SCR) check except in cases where the check may aid the investigation.
  • CCO’s:  $30M in savings are expected to be realized from reductions in CCO rates.  Since the 90% enhanced federal support of CCO’s is now reduced to 50%, OPWDD will provide $178 million and will assume oversight of CCO’s from DOH.

SED

  • School Aid: The proposed school aid increase is $826 million or 3.0% for a total of $28.5 billion which is the largest line item in the budget. Therefore, we hope that our 853 schools will get 3% growth as they have received the same percentage increase as school aid in recent years.
  • 4410 & 853 Schools: We were extremely disappointed that there weren’t any funding or teacher retention proposals for our 4410 or 853 schools or any inclusion of the Regents proposals to add funding for teacher certification or loan forgiveness.
  • School Mental Health Resource and Training Center: $500,000 is provided for the Resource and Training Center.  The funding will be utilized to continue the work of educating teachers, administrators, students and other school personnel about the inclusion of mental health education in schools and to help promote school climates that are conducive to mental health and wellness.
  • Master Teacher Program:  $1.5 million for the Master Teacher Program to create a corps of outstanding teachers and counselors in order to improve the quality of instruction and counseling at public schools.

DOH

  • Medicaid Redesign Team (MRT) II: The Governor has proposed a reconstitution of the MRT to identify $2.5 billion in Medicaid savings.  If the MRT II doesn’t come up with $2.5 billion in savings, the Governor’s budget proposal provides the authority for the Division of Budget to implement up to $2.5 billion in across the board cuts. Although, the Mental Hygiene agencies, including OPWDD, are “excluded” from the MRT, OPWDD providers are the only ones that continue to have a 2011 MRT cut (#26) in place (Article 16s that provide more than the average number of therapies).  The first MRT was given almost a year to identify savings but the MRT II has just two months. The short time frame will make it difficult to involve stakeholders and devise thoughtful strategies.
  • Early Intervention: Although 42% of children who receive EI services have commercial insurance coverage, only 2% of EI services are paid for by commercial insurance.  The other 98% is paid for by the state and counties (including Medicaid).  The Governor’s budget proposes language to ensure that commercial insures pay for covered EI services.
  • Consumer Directed Personal Assistance Program (CDPAP): The Governor’s proposal names the CDPAP program for a large portion of the increase in Medicaid costs.  It says, [Managed Long Term Care] spending growth overall – and CDPAP within it – have been the biggest drivers of spending growth in New York’s Medicaid program” and notes that “Between 2017 and 2018 alone, spending for CDPAP grew by 85 percent from $1.5 billion to $2.4 billion.”   While DOH has put out the CDPAP RFO for Fiscal Intermediaries and the 12-12-19 proposed regulations on per member/per month payments, CDPAP is also included  in  MRT II which states that the cuts shall be uniform across all categories and geography, unless there are “sufficient grounds” for non-uniformity, such as the extent to which a specific category has contributed to the excess spending.   Therefore, while there are no specific cuts to CDPAP in the Governor’s budget proposal, there continues to be grave concern for the viability of the program and the potential impact of MRT II recommendations.

OMH

  • #BFair2DirectCare: The Budget includes the 2% increase effective 1-1-2020 for 100 & 200 codes and 2% increase effective 4-1-2020 for 100, 200 & 300 codes but delays the COLA.
  • Housing: $20 million for increased funding for community housing rates which doubles prior year funding.
  • School Mental Health Resource and Training Center: $500,000 in funding for the Resource and Training Center.  The funding will be utilized to continue the work to educate teachers, administrators, students and other school personnel about the inclusion of mental health education in schools and helping to promote school climates that are conducive to mental health and wellness.
  • Master Teacher Program:  $1.5 million for the Master Teachers Program to create a corps of outstanding teachers and counselors in order to improve the quality of instruction and counseling at public schools.
  • Behavioral Health Parity: Establishes the Behavioral Health Parity Compliance Fund for the collection of penalties imposed on insurance
  • Homeless Veterans: $5 million for projects for homeless veterans.
  • Adult Home residents: $12.5 million to support the transition of adult home residents to the community.
  • Community Reinvestment: there is no mention of Community Reinvestment funding that has long been derived from state hospital beds closing or facility consolidation.
  • Kingsboro Psychiatric Center: Includes a plan to develop a voluntary-operated, step-down transition to community residence program on the Kingsboro PC campus and transform the campus into a “Recovery Hub Facility.”
  • Substance Use Disorder and Mental Health Ombudsman Program: Continues $1.5 million in funding to support the behavioral health ombudsman program, which helps individuals and their families navigate the behavioral health care system.

 Budget Documents can be found at https://www.budget.ny.gov/

OPWDD clarifies responsibilities during Life Plan meetings

OPWDD recently sent out an Informational letter clarifying the responsibilities for information sharing during a Life Plan meeting, as well as the need to ensure timely sharing of information and/or documentation as established by the care planning team during the Life Plan meeting.

The memo, reproduced below, is immediately effective.

Also, as we enter 2020, please remember to write out the full year on documentation, rather than just the last two digits.  A date with the last two digits could be altered. For example, writing 1/22/20 could allow someone to change the date to 1/22/2017.  Keep this in mind for all documentation or any place you include the date.

As always, if you have any questions or concerns, feel free to reach out to Debra A. Williams at DWilliams@cpstate.org or 518-436-0178, ext. 108.

OPWDD  INFORMATIONAL LETTER
Transmittal: 20-INF-01

Background: 

A Life Plan meeting is a time to develop a new Life Plan or to review and update the person’s current Life Plan as well as review all relevant and pertinent information about the person to best inform the development of the Life Plan.  A person-centered approach must be used in the development and review of a Life Plan. This is the care planning team’s opportunity to listen to the person’s perspective and discover and focus on areas of the person’s life that may need special attention and are meaningful to the person.  In order to do so, the person’s care planning team must be organized and prepared to review, share and update necessary information, documents, and reports to best support and advocate for the person.

Program Implications: 

It is the responsibility of the Care Manager to support the individual to facilitate his/her meeting to the extent he/she prefers and to also ensure that all relevant and pertinent information is gathered from habilitation providers and reviewed to inform development of the Life Plan at the Life Plan meeting.  Such information may include but is not limited to:

  • Medical/health status;
  • Plan of Nursing Services;
  • Behavioral Support Plans;
  • Medication updates/changes;
  • Habilitation needs;
  • Safeguard needs;
  • Staff Action Plans.

Habilitation providers are often best positioned to know the clinical, medical and health status of those they support and are responsible for communicating that information to the Care Manager and care planning team at the time of the Life Plan meeting.  This will ensure that the most current information regarding the person’s clinical, medical/health, safeguard needs, habilitation needs, etc. are integrated into the Life Plan by the Care Manager.

It is the responsibility of the habilitation provider to share relevant and pertinent information with the Care Manager prior to, during, and/or after the Life Plan meeting to support development of a comprehensive, person-centered Life Plan by the Care Manager. It is to be established by the care planning team the timeframe in which all needed and/or requested information or documents are to be shared/distributed. If there are other members of the care planning team that should also have this information, this should be discussed, and arrangements made at the time of the Life Plan meeting for sharing.

Ensuring that all members of a person’s care planning team have the necessary information to effectively participate in the person-centered planning process and in the development of the individual’s Life Plan to support comprehensive care planning is essential to effectively meeting the needs of persons receiving habilitation services.  Establishing cooperative and collaborative relationships and agreements between habilitation providers and Care Managers is critical to achieving this outcome.

This memo is immediately effective and its content will be incorporated into the next revision of the CCO/Health Home Provider Policy Guidance and Manual available at this link: https://opwdd.ny.gov/providers_staff/care_coordination_organizations/providers/cco-manual.