Provider Association Meeting
September 21, 2015
Transformation Panel-
Still behind in getting minutes posted. Should be updated soon
Listening Sessions- will compile all responses for review by entire Panel
2007 Amendment should be approved by CMS soon and then OPWDD can move to working on approval of 1915 C renewal
Need to schedule Listening Sessions on Integrated Employment
November 8th – Symposium in Albany on making Transformational goals & objectives “real” for people with more significant challenges. There will be 2 Key Note speakers (General Overview on national trends and Technology) and several breakout sessions. Save the Date cards are out, more information should be forthcoming. They will be live streaming the conference. Main topics are Housing, Alternative Service Models, Workforce, Employment & Meaningful Activity and Self-Direction. A white paper will be developed afterward.
ICF Conversions- Input from the field
Agencies are “watching” each other to see how process goes.
Issues include: renovations while ICF are easier, clinical service provision, if your ICF rate is being increased under rate rationalization- why would you convert, capital $.
The fiscal policy is posted on OPWDD site.
They will continue to work on these issues to help agencies feel more comfortable in the conversion.
SEMP-
Transition to new billing has been difficult with many agencies reporting a 50% decrease in first months billing. Concerns that perhaps agencies can get more efficient at the billing- how do we make up that lost revenue.
Day Hab/Article 16
Building capacity vs. Authorization- still confusion in the field. You can “over enroll” as long as you do not exceed your building capacity. Still unclear on Day HabWithout Walls in the building. Will clear up policy.
Are regions only approving DHWW? No more site based day hab is the message in many DDRO’s. This is not true.
Clinical Services – survey going out on 9/25 to Day Habs and Supervised IRA’s on direct and indirect services.
Cleared up confusion on designated vs. dedicated space for Article 16 clinics in certified Day Hab programs. Designated space is ok.
OPWDD is actively working with DOH on rates for Preventative services. This is a DOH service.
Bureau of Narcotic Enforcement-
In some regions, the Bureau has told OPWDD residential providers that they are considered an institutional setting and must get a Class 3A license to administer controlled substances. OPWDD has not been successful in proving that we are not providing institutional care. OPWDD advice is – if Bureau of Narcotic Enforcement tells you to get a license, then you need to get a license.
Justice Center-
Continuing issues with inconsistency among categorization of incidents- working on new 624 Handbook, which will have better interpretive guidelines
If you feel you are given incorrect information by IMU or have any questions, please elevate them to Leslie Fuld.
Workshop Guidance-Ceylane(Hopefully I captured all of this correctly. She said a lot and I struggled to get it all down)
Forums will be held in near future. Announcements to go out this week. There will be draft information to review prior to the Forums.
Integrated Business Standard- 2 models
- How many of the employees receive OPWDD services (40% or less). Must be opportunity for employees with disabilities to interact with co-workers and customers. Same opportunity as all employees to set schedule, days, off etc. Not isolated in separate room.
- 41 – 75% of workforce receives OPWDD services. This will likely have a heightened scrutiny process. How do employees have access to greater community? Do they have annual reviews, opportunity for promotion, etc?
Self Direction-
New guidance that is more user friendly. Website has been updated.
Live In Caregivers- need to do new ADM due to DOL issues
Site Selection Hearing Officers-
Looking to hire outside attorneys to handle hearings. Will be contracted.
Residential Request List-
Believed there were 11,400 on original list. Much of their information is outdated. Working with MSC’s to update contact information. There are 43 agencies who have 50 or more people that the contact information is outdated. They will be sending lists to provider associations.
As of 9/12- they had made 11,000 phone calls and had 2400 surveys completed. They will attempt to contact each person/family 3x.
If you have families who have not been contacted, they are encouraging them to call directly. 1-844-OPW-DDNY.
Heightened Scrutiny & HCBS Settings –
1st week in October a revised memo will be issued based on CMS clarifications. DQI is working on a Provider Self-Survey before end of the year.
Property Thresholds-
Issues with rent increases, especially in NYC area. Thresholds are NOT a hard cap. Recognize that many DDRO’s don’t realize this. Can go to DOB, after OPWDD Architectural & Engineering reviews.
DOH- Rate Issues- Donna Cater (DOH)-
ICF draft rates should be out soon
IRA- working on draft rates. Will be setting up meetings with agencies. Change in acuity factors. If more than one standard deviation away from the average- your rates will have 85% of your hours and 15% of the average (rather than 75/25). No more use of E-scores. I will be forwarding a spread sheet that shows CFR hours per person per month.
Family Care- Regions 3 & 4
Should be another increase for most agencies. 7/1/15 rates should have been loaded in this week.
Respite- still looking at regional rates for January 2016. 1:1, 1:2, 1: group and transportation are all being considered. They will schedule a call in the future when they have more information.