Office for People With Developmental Disabilities

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People First Transformation - Home

About the People First Transformation

Welcome to the New York State People First Transformation Resource Page. The State Office for People With Developmental Disabilities (OPWDD), in consultation with the State Department of Health (DOH), the Centers for Medicare & Medicaid Services (CMS), and other stakeholders, has begun the process of identifying and developing significant programmatic and fiscal improvements to our service system through the development of new initiatives, called the “People First Transformation.” This Web page provides information to those who are interested in the transformation process and would like to contribute to the effort. 

Transformation Agreement

New York State and the Centers for Medicare & Medicaid Services (CMS) have identified a series of shared goals that will improve opportunities for individuals with developmental disabilities in the areas of employment, integrated living, and self-direction of services. These goals are captured in a Transformation Agreement:  /transformation-agreement/home

Transformation Panel

The OPWDD has made great strides in accomplishing many of our transformation goals.  To further our progress, the Commissioner has convened a panel of experts to examine the challenges we face in implementing the Transformation Agenda, offering managed care in our system and ensuring its long-term fiscal sustainability for people currently receiving services and those who will need to access our services in the coming years.  More information on the panel may be found at: /opwdd_about/commissioners_page/transformation-panel

Care Management Program Development

OPWDD has been working toward implementing the New York State goal of Care Management for All.  Care Management for All began as a Medicaid Redesign Team (MRT) proposal to improve benefit coordination, quality of care and individual outcomes over the full range of health care; including developmental disability, mental health, substance abuse, and physical health care services.   Included on the OPWDD Care Management programs page /opwdd_services_supports/people_first_waiver/care_management is information on the progress toward implementation of the State’s Care Management for All initiative, including the FIDA-IDD.

New York’s Balancing Incentive Program

Over $65.3 million has been awarded to 106 organizations for a variety of initiatives supporting our system’s transformation as part of the federal Balancing Incentive Program (BIP).  The projects stemming from these awards are designed to advance our system’s transformational goals of supporting people to live in the most integrated community settings, obtain competitive employment, and take control of their services through self-direction. 

BIP Transformation projects include initiatives that support increased efficiency and effectiveness efforts in the areas of expansion of available housing, employment, self-direction, deinstitutionalization/community integration and training, and enrollment into care management programs. 

More information on the BIP programs may be found at:


1915(c) Comprehensive Home and Community-Based Services Waiver and Transition Plan

The 1915(c) waiver application is under negotiation with the Federal Centers for Medicare and Medicaid Services (CMS), and therefore subject to updates and revision resulting from these discussions.  Information on the current waiver application may be found at /opwdd_services_supports/people_first_waiver/approved_renewal

The HCBS Waiver Application contains the HCBS Settings Transition Plan.  For more detailed information on this topic please go the HCBS Waiver Setting page available at /opwdd_services_supports/HCBS/home

Public Outreach & Stakeholder Input

OPWDD has conducted several outreach opportunities for stakeholder input related to the HCBS Settings Transition Plan and OPWDD’s 1915 (c) Comprehensive Home and Community Based Services (HCBS) Waiver Renewal.  Numerous webinars and meetings have been held for public input.  Other activities include but are not limited to:

Stakeholder Workgroup /opwdd_services_supports/HCBS/stakeholder-workgroup-resources

Public comment on the waiver/HCBS Transition Plan /opwdd_services_supports/HCBS/announcement-for-public-content

Agency Quality Performance Workgroup


Joint Advisory Council for Managed Care