Provider Association Meeting
March 21, 2016
Acting Commissioner Kerry Delaney- General Comments
Transformation Panel- Implementation plan is in development phases. Committee meeting to be held in December and will continue to meet regularly. Several of the Panel’s recommendations are already in effect: regular data reports will be available on OPWDD website and regular communication will continue.
Budget- Can not speak in any detail on minimum wage. Everything is still under discussion. There is additional housing $ in Assembly proposal of $100 M over 5 years, but no one is sure if it will be in the final budget.
Medical Marijuana-
Jill Pettinger- OPWDD has been meeting with Bureau of Narcotics Enforcement and SED (Office of Professions) for several months. Many issues with individuals in certified residential programs using medical marijuana. It is not approved by the FDA, so SED does not feel RN’s or LPN’s could legally administer, therefore DSP’s would not be able to administer either.
Also, it is not covered by any commercial insurers or Medicaid. The pharmacies must be paid in cash only. It appears that a typical dose would cost about $400 a month. OPWDD appears to be willing to pay for it, but are looking at ways to do that.
As it is a Schedule 1 drug, you need a 750 lb. safe to store it in. Both MD prescriber and patient need to be registered. At present, a parent can come to the residence to administer as long as they keep the medication.
OPWDD is supportive of its use, but it may take a long time to come up with realistic ways to administer.
Payments to Fiscal Intermediaries-
JoAnn Lamphere & Joanne Howard-
Mini CFR’s yielded many questions, even after talking with some specific providers. Not sure the reports are reliable. OPWDD will look at certified data from 2015 CFR’s. Concerns with the allocation of agency administration (ratio value method). Many agencies say that’s not accurate and would prefer to direct charge admin for the program. This is a possible solution for many issues. Agencies would need to re-certify their CFR’s. Some disagreement between OPWDD and PA’s –as OPWDD feels that agencies are overstating FI expenses. PA’s say no! Lots of concerns with agencies ability to take high need individuals. Next meeting they will have much more specific information. The Commissioner reported that this is a priority area for OPWDD and they want to assist agencies to provide this crucial service. They want more agencies to encourage people to self directed vs. agency supported.
Background Checks for Volunteers-
Megan O’Connor- Guidance will be coming out very soon. There may be an advance draft for PA’s to review with their memberships.
Medicaid Transportation Vendor Enrollment Update-
JoAnn Lamphere- Workgroup has been meeting since February. Close to resolution. Issues are compliance, insurance and training.
Justice Center –
Jay Kiyonaga & Megan O’Connor- Many questions were submitted by PA’s, which Jay put into general categories.
1. Does JC have concerns with transportation (as suggested by DOH proposed requirements for agency provided transportation?)
DOH is looking for increased accountability on transportation. JC sees “bad things” happening on vans. Accountability is the key. Video cameras and GPS monitoring are good tools. Minimally, there should be logs.
2. Case closure- cycle time
JC feels it is getting better, but not where it needs to be. Sometimes delay is due to agencies not providing enough information. Jay suggests that you contact him with cases (including case #’s) for significant outlyers. He feels 2 -3 weeks is a reasonable time. Obviously criminal cases take much longer. Cycle times in NYC area are particularly bad. More resources have been allocated downstate. All over the state there is significant turn over in staff and lots of new hires. JC is changing the way they review the investigations- rather than just one phase- they will look at it in 8 steps.
3. Reporting-
JC is working on putting out better data. They have had multiple IT issues.
4. Law Enforcement Training-
Disability Awareness training have been provided to 191 officers since September in the Albany area. JC working with DCJS on on-line training for all officers.
5. Obstruction-
Some reports of investigators using obstruction to get people to cooperate with an investigation. It should not be used as a threat. Obstruction shouldn’t be a secret either.
6. Communication-
Regional Chiefs (Mark Case for our area) are the general “communicators”. Also ICMU is available.
7. Conduct between consumers/Substantial Diminution -
Guidance should be out soon. Similar to the 626 interpretive guidelines.
8. SEL
221 individuals are currently on the list. There are another 106 who are have pending appeals. There are 1400 people who have Category 2 results.
9. Criminal Cases-
Since 6/30/13- there have been 102 closed criminal cases (arrests and prosecution)- 39 state ops and 63 voluntary agencies. There have been 45 convictions (mostly felony), 23 ACD’s, 21 convictions that are violations (not a crime) and 13 dismissed.
Jay would not address inconsistencies in motor vehicle incidents as each circumstance is unique. Megan said she would address individual provider issues. Jay volunteered to attend PA meetings on a regular basis to address issues.
Rate Transformation/Fiscal-
Donna Cater & Laura Rosenthal-
7/1/15- Respite and Pre-Voc revisions are in eMedNY. Some rates don’t have PPA’s. However, those providers should have been contacted by OPWDD.
7/1/14- 6/30/15- Residential rates with vacancy and retainer days should be loaded this week and should be paid in the next month. Providers do not need to do anything.
1/1/17- re-base rates. Donna is sending out a work plan for this and is looking for provider input on issues like hospitalization days. DDAWNY will send out work plan when it is received.
There is a draft process for addressing high risk individuals in residential settings (see attached). CMS seems to have some latitude with acuity factors. You would submit request to OPWDD in May and November (for changes in July and January). Will be reviewed by staff from Jill Pettinger’s office. This is only for individuals who would be new to your agency. Donna is looking for input.
Respite rates- OPWDD will continue to fund rates above the cap until 7/1 when new rate structure will be in place. DDRO’s working with agencies who have significant outlyers. Discussion of costs not covered in new rates for Free Standing Respite. These had not been considered. Will explore.
People First Community Service Fund Phase 2 for SEMP, Respite, Pre-Voc, etc should be out this week. Still working on mechanics of ICF community Fund.
Joanne Howard-
New policy on late CFR’s. OPWDD will not get FFP funding when CFR (all components) is not submitted on time. Current 2% penalty will go to 50%. Information to be sent out soon on this.
Pat Sarli/Kevin Valenchis/Abiba Kindo-
Increases to Capital Thresholds. First since 2008. About 20% increase for acquisition/re-hab/new construction. And 17% for leases. OPWDD is committed to updating this more frequently in the future. There will be a more thorough architectural/engineering review by OPWDD to ensure that health & safety issues are addressed, but that properties are not “over built”. Must ensure that taxpayer money is being used responsibly. No memo yet, still working on, so exact figures were not shared.
IPSIDD update-
300 individual clinicians have applied to date. Only 1 group practice so far.
FIDA update-
30 individuals enrolled. Year 1 has projected enrollment of 1000. Still voluntary. OPWDD helping to make sure individuals make informed choices.