Improve the Service Delivery System

Overview

OPWDD will invest a portion of the enhanced FMAP funds in a variety of important service system enhancements:

Supported Decision-Making Facilitation Pilot

OPWDD will dedicate a percentage of funding to develop Supported Decision-Making (SDM) facilitation as an effective way to ensure that people are supported to implement effective and sustainable supported decision-making agreements. Facilitation is an essential part of ensuring that individuals who execute SDM agreements are appropriately prepared for the challenges of making their own decisions with supports. 

OPWDD will fund a 3-year facilitation pilot program to prepare to develop policy and regulations defining the scope of facilitation services to be made available under the HCBS waiver. Supported Decision-Making New York has operated the existing 5-year SDM pilot program in New York and will be funded to expand that pilot to further advance the field of SDM with a focus specifically on facilitation. The new pilot will allow OPWDD to refine its understanding of SDM facilitation, implement facilitation training materials, identify and equip providers of facilitation services, develop a Supported Decision-Making facilitation resource center model, embed the use of SDM in existing systems, and advance the use of SDM as an alternative to adult guardianship.  

Self-Direction

In order to deliver a more consistent and sustainable self-direction service model, OPWDD is dedicating a percentage of the enhanced FMAP funds to examine how its current self-direction model compares to the models used by other states and countries. The study will analyze similar successful models and identify service gaps, potential efficiencies, and areas of inconsistency across OPWDD’s Fiscal Intermediaries (FIs) and geographic regions. The project will also evaluate the sustainability of self-directed supports for people whose self-direction programs depend on their parents’ support and suggest needed supports to assist when their parents can no longer help.  Based on this analysis and stakeholder engagement, the grant recipient will make recommendations for changes to the OPWDD model to ensure consistent practices across FIs and geographic regions and policy modifications that can improve the sustainability of the program. 

Acceleration of CANS implementation

OPWDD will use a portion of the enhanced FMAP funding to accelerate the completion of the Children and Adolescent Needs Assessment System (CANS). The enhanced funding will support OPWDD, in collaboration with DOH, to use the CANS instrument to conduct assessments and store assessment data.  Funding will also help train staff to assure that there are assessors and Quality Assurance managers to support OPWDD’s CANS implementation.  Use of the CANS will provide functional needs assessment data that can help standardize OPWDD service authorization practices and develop improved provider reimbursement methodology. The collaboration between OPWDD and DOH also establishes a process to support “Right-time” assessment which will support better IT connection between New York’s Unified Assessment System (UAS) and OPWDD’s Tracking and Billing System (TABS) and promote timely assessment processing and accurate documentation and reporting.

CCO Program Evaluation

OPWDD will use a portion of the enhanced FMAP funding to evaluate New York State’s Care Coordination Organization (CCO) program for people with developmental disabilities. The evaluation will build on the results of OPWDD’s quality survey information, data sources and other qualitative and quantitative program information that the State already has available. The evaluation will examine how well each CCO has fully implemented the core functions of the Intellectual and Developmental Disabilities Health Home Program, including comprehensive care management and health promotion, how effective each CCO has been in meeting the needs and goals of its participants, how each CCO is addressing needs related to diversity, equity and inclusion, and how well each CCO provides conflict-free connection to and coordination of services. OPWDD will also collect information related to the outcomes of care management services for key subpopulations (e.g., children, adults who reside in certified settings, adults who self-direct, etc.) to help inform potential program improvements.

Improving Processes for Assistive Technology/Environmental Modifications/Vehicle Modifications

OPWDD is dedicating enhanced FMAP funding resources to the evaluation and redesign of the business functions and policies related to the review, approval and delivery of Assistive Technology, Environmental Modifications and Vehicle Modifications. OPWDD will contract with a consulting team to conduct a hands-on analysis and prepare written recommendations. The evaluation will: 

  • Assess program and policy guidance associated with these services to make recommendations for changes to improve the efficiency of operations and to expand the availability of these services in ways that promote independence and reduce reliance on paid staff.  
  • Develop a plan to implement recommended operational changes that increase efficiency and eliminate redundancy of OPWDD business functions. 
  • Develop training materials and guidance for OPWDD staff engaged in processing service requests and Care Managers and clinicians involved in the application process for these services.