Office for People With Developmental Disabilities

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Transformation Agreement

Road to reform

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. They include: 

  • Developing new service options to better meet the needs of individuals and families in a truly person-centered way, including allowing for more self-direction of services;
  • Creating a specialized managed care system that recognizes the unique needs of people with disabilities, and is focused on a habilitative model of services and supports;
  • Ensuring that people live in the most integrated community settings;
  • Increasing the number of individuals who are competitively employed;
  • Focusing on a quality system that values personal outcome goals for people, such as an improved life or access to meaningful activities; and
  • Working to make funding in the system sustainable and transparent. 

To support the transformation agreement, OPWDD will have access to additional funding and technical assistance through the federal government’s Balancing Incentives Program. OPWDD will also begin participating in New York’s Money Follows the Person demonstration, which lends federal financial support for individuals who wish transition from institutional settings into community settings. Updates will be posted in this section of our website. 


On March 17, 2014, CMS issued final regulations regarding requirements for home and community-based settings in Medicaid.  OPWDD is working with other state agencies on the New York State Transition Plan, but there are important resources related to the OPWDD Home and Community Based waivers: