IAC News

NEXT IAC MEMBERSHIP MEETING—IT’S A TUESDAY MEETING

2/1/2012 12:19:50 PM

It is unusual for IAC to hold a Membership meeting on a Tuesday, but this month our meeting will be Tuesday, February 7^th at 10:00 am (our usual time). The major focus of this meeting is to discuss our position on the Governor's proposed budget. This change in schedule is necessary in order for us to have sufficient time to finalize our position and have all documents ready to be distributed to our legislators in time for Lobby days on February 14^th and 15^th.

PUBLIC RELATIONS INITIATIVE

2/1/2012 12:18:27 PM

Approximately 25 IAC agencies have asked us work on a PR initiative that would counterbalance our field's recent negative media attention. To move this initiative forward there will be a meeting for those agencies to discuss next steps on 2/7/12-- immediately following IAC's membership meeting, Staff contact: wini@iacny.org

LOBBY DAYS ARE UPON US!

2/1/2012 11:30:42 AM

As our members know, this past year has been a very difficult one for OPWDD providers and there are serious issues in the coming budget regarding Early Intervention and Preschool Special Education. We intend to meet with our legislators to discuss all aspects of the budget. If you haven't already signed up for IAC's Lobby Days, please do so immediately! We need to maintain our united front and make sure that Albany knows we're here and we won't stop advocating for the people we serve. Everyone attending Lobby Days must attend one of three briefing sessions. They are:

· Friday 2/10/12 at 10 am at IAC's office

· Friday 2/10/12 at 3 pm at IAC's office

· Monday 2/13/12 at 7 pm at Hotel Albany (formerly the Crowne Plaza)

Staff contact: wini@iacny.org

OPWDD WAIVER DISCUSSIONS

2/1/2012 11:30:11 AM

There are still numerous discussions taking place on a very frequent basis between OPWDD and CMS regarding New York State's request for approval on its 1115 waiver application. These talks include topics such as managed care concepts, integration of services, quality indicators, financial assumptions, etc. While no approval has been received yet, we understand the discussions are generally going well with many issues yet to be determined. When they are ready, OPWDD will release another Q&A regarding their discussions with CMS like they had done several months ago. Most providers found that previous document to be extremely helpful and we look forward to the next one.

ALBANY REPORT

2/1/2012 11:29:40 AM

The Governor's Budget Proposal was presented on January 17th. Below is a summary of its provisions:

OPWDD

· Overall, there is a "less than 1%” reduction in overall funding to OPWDD which is the result of continuing savings from cuts in the last budget. While there is no new COLA or trend, there also are no new cuts to rates.

· Funds will be available to fund 5900 new opportunities:

o 3000 are naturally occurring openings in existing services

o 2900 new opportunities will be funded allowing 50 people to move out of developmental centers, 140 people to return from out of state schools or be placed after aging out of in-State residential schools in addition to other residential, respite, crisis, employment and community integration opportunities.

· There will be an additional 700 opportunities funded through last year's budget to be available this year.

· $334 million over 5 years (including $56 million this year) will be made available for enhanced fire safety efforts.

· The Executive's proposal contains language authorizing the establishment of pilot programs under the 1115 People First Waiver and

· Centralizes some functions such as IT, purchasing, hiring and staff training including new hiring screening and minimum qualifications and incident management and investigations and,

· Reconfigures existing OPWDD positions by creating 5 Regional Directors (overseen by Assistant Deputy Commissioner Jill Gentile) who will work with voluntary agencies, as well as Regional Directors of State Operations (overseen by Acting Deputy Commissioner John Gleason) who will oversee DDSO's and other State Operations.

· Administrative cost reforms (beginning in 2013 with a maximum administrative rate of 25% and working down to a maximum of 15% by 2015) and a $199,000 cap on executive compensation paid from State funds were outlined in the budget and in an Executive Order.

MARK PATTISON & HENRY HAMELIN ON FOR MARCH 5 FISCAL MANAGEMENT COMMITTEE MEETING

2/1/2012 11:28:36 AM

On March 5^th, IAC's Fiscal Management committee will be joined by the newly appointed Deputy Commission for the Division of Enterprise Solutions (read that fiscal) Mark Pattison and acting Associate Commissioner Henry Hamelin. For those of you who do not know Mark, he worked at the Rensselaer County chapter of NYSARC for 20 years, is a past president of NYSACRA; was mayor of Troy for seven years, and most recently was the Executive Deputy Comptroller for the Office of State and Local Government Accountability. Henry is a long-time friend of our members in OPWDD's capital unit, and before that at Division of Budget. The committee will prepare a number of questions in advance for Mark and Henry, which they will address. No RSVP required. Staff contact: richard@iacny.org

FAMILY ADVOCACY DAY HAS NEW SIGNIFICANCE THIS YEAR

2/1/2012 11:28:13 AM

The in-district Family Advocacy Day event is currently in the planning stages and will again be organized through the borough DD Councils and county representatives outside of NYC. Negative media coverage has led some to believe that the field as a whole is broken and has put us in a difficult position where advocacy is concerned. A sure way, however, for Legislators to understand that isolated issues are not typical, is for them to hear about the good work we do directly from families whose lives have been changed for the better. More information on this important initiative will soon be available so please begin to reach out to your families as their participation is important to help maintain the supports they have come to depend on. Staff contact: wini@iacny.org

FAMILY ADVOCACY DAY HAS NEW SIGNIFICANCE THIS YEAR

2/1/2012 11:28:04 AM

A FRESH LOOK AT ADULT SERVICES

2/1/2012 11:27:39 AM

Thanks, in part, to the work of IAC's Adult Day Services Committee, OPWDD has formed a work group, headed by Ceylane Meyers, that is looking at re-envisioning adult day services. In the discussion stage is a new seamless system where day services and supports (that transcend the current "silos” of day hab, pre-voc, SEMP, etc.) would be available that maximizes the possibilities for employment, while allowing individuals of all capacities to engage in meaningful, productive activities of their choosing. Emphasis would be placed on removing current obstacles that prevent people from becoming more independent. The desired goal is to create a system which allows individuals to move in and out of supports as their needs change throughout their adult lifetime. We are hopeful that the result will be a new system enabling people of all abilities and interests to engage in activities that are meaningful and productive! Staff contact: wini@iacny.org

ARTICLE 16 UPDATES, MRT AND APG

2/1/2012 11:27:07 AM

OPWDD held a conference call with Article 16 clinic providers to update them on the status of CMS approval for APG and the target date for claim reprocessing. It was reported that CMS approval should be coming shortly and once approved APG reprocessing should happen automatically by eMedNY. Provider liability will be taken back all at once, therefore providers who anticipate a payback should manage their cash flow accordingly. In addition, providers should expect some small revisions to the Article 16 manual; however, these revisions should not directly impact the delivery of service or billing requirements.

Along with the reprocessing of APG claims, OPWDD believes that CMS approval for the MRT State Plan amendment (SPA) is coming soon. Once approved, those providers who have opted to receive the rate reduction (did not request the waiver) will receive the reduction retroactive to April 1 2011. As of the approval date, providers will see the reduction in their actual rate going forward. In addition, future remittances will be reduced by up to 15% until the entire retroactive liability is paid.

In order to determine if providers were indeed able to decrease their services to (or below) the required threshold, OPWDD will need to review data from the prior year. Exactly how to review last year's clinic utilization holds a challenge for OPWDD. Because providers were not informed of the thresholds (which went into effect on April 1, 2011) until July 2011, they had no opportunity to correct the issue until after that point. As a result, any review of data before that time would automatically demonstrate negligible change in provider utilization. IAC, along with its clinic providers, has suggested that a later time frame be utilized in order to adequately determine if clinics were able to decrease utilization. IAC is waiting for OPWDD to identify the most rappropriate period to review. Staff contact: hope@iacny.org

CQC, NO MORE PAPER

2/1/2012 11:26:32 AM

Commission on Quality Care (CQC) has established direct access to OPWDD's Incident Report and Management Application (IRMA). On January 13^th 2012 Roger Bearden, Chair of CQC, sent out correspondence informing providers that effective immediately, agencies that are certified, operated or funded by OPWDD should no longer submit paper copies of incident reports ( both 147 and CQC-100 death reports) to CQC's office. As long as providers are in compliance with Part 624 reporting regulations, they meet CQC‘s reporting obligation. No more paper forms should be sent or faxed to their office.

It is important, however, for providers to remember that CQC can still request written records and additional information from an agency. Contact CQC's Technical assistance department at 1-800-624-4143. Staff contact: Hope@iacny.org

BEHAVIOR MANAGEMENT-OPWDD PROPOSED REGULATIONS

2/1/2012 11:26:05 AM

OPWDD has proposed regulations concerning the management of maladaptive or inappropriate behavior. Comments are due to OPWDD by February 13, 2012. IAC met with a group of member representatives to review the regulations and identified our questions, concerns and issues. Following, are several of these:

· In general, IAC agrees it is important to establish comprehensive requirements for the management of maladaptive and inappropriate behavior. However, it is important to note that although OPWDD has clearly stated that this will require agencies to incur additional expenses, these regulations pose an even greater challenge to smaller agencies that do not currently operate residential programs. IAC supports the requirement for a functional behavioral analysis for all individuals who require a behavior plan. The language is sufficient to allow agencies to conduct the assessment as they determine to be clinically appropriate, as long as the assessment meets all the required elements identified in the regulations.

· We support the language used with regard to the ABSS definitions and the oversight of a PhD psychologist. We do, however, have concerns regarding the determination of capacity to give informed consent. Some of the requirements are onerous and do not contribute to the protection of persons we support.

· In addition, IAC has many issues and concerns regarding the use of medication to treat co-occurring diagnosed psychiatric conditions. Upon review of the regulations, it appears that a person must have a behavior support plan if they are prescribed medication for a psychiatric condition whether or not there are associated behaviors with their diagnosis. The assumption that all those receiving medication have a behavioral issue and require a behavior plan is not appropriate and has serious implications for those persons living in supportive settings.

· Questions and concerns regarding semi-annual medication review and the consultative panel should be reviewed by OPWDD to determine if professional prerogatives of an ABSS on the panel are appropriate.

The entire proposed regulations can be found on OPWDD's web site, and a full list of issues submitted to OPWDD by IAC can be obtained by contacting hope@iacny.org.

NYEIS, GETTING BETTER?

2/1/2012 11:25:32 AM

The LEICC has established a NYEIS Provider Advisory Subcommittee to help improve the programmatic aspects of the NYEIS system. The committee met on January 10^th to develop a list of priorities that would enhance work flow and alleviate data entry errors. The group will be reviewing program functions but is not looking at billing and coding issues. The focus is on those issues that could easily be remedied given limited resources at the state level to make programming changes. Some of the suggestions are:

· Provider access and roles need to be enhanced to allow more access to agency information by an administrator or director;

· Data entry problems are not flagged until the completion of the entire packet and then submitted. In addition, no identification of the exact problem or error is given. It was suggested that the errors be highlighted;

· Develop standardization with regards to the NYEIS conversion in all regional offices;

· Create an ability to generate reports to allow providers to track key activities;

· Create an excel spreadsheet function to facilitate providers' ability to sort the data in order to create QA and other reports within time sensitive requirements.

In the future the state and the city will begin to post FAQs on their web site in order to assist providers with answers to common questions being asked at the help desks. The next meeting is scheduled for February. Staff contact: hope@iacny.org

IAC ANNUAL CONFERENCE: BUILDING ON STRENGTHS, PREPARING FOR THE FUTURE

2/1/2012 11:22:11 AM

IAC's annual conference will be held at the Fashion Institute of Technology on June 14th and 15^th. Our confirmed speakers thus far include: James Cox, Medicaid Inspector General, and Julia Paradise, Associate Director Kaiser Commission on Medicaid and the Uninsured. Over 15 presentations are anticipated including topics as diverse as remote monitoring; Early Intervention-- a city and state perspective; innovative residential alternatives; Health Information Technology and preparing for managed care; Supported employment; CFR allocations and related documentation requirements; special education models in other states. Be on the lookout for a full description of speakers, and topics and registration material. Staff contact: hope@iacny.org

LEGISLATION WE ARE WATCHING

2/1/2012 11:21:37 AM

· A.6553-A/S.3167-A (Ortiz/Huntley): Requires OPWDD to submit an updated waitlist and placement report to the senate and assembly. (we support this bill)

· A.8495 (Morelle): Amends the previous legislation passed last session which requires insurance coverage of autism spectrum disorder to include the commissioner of education in the promulgation of regulations. (we support this bill)

· A.4206-A/S.3405 (Rivera/Parker): Establishes an advisory panel on health insurance coverage of autism spectrum disorder, which will ensure that successful treatment and therapy options will be covered by insurance and will set up a hotline for families who have complaints about coverage. (we support this bill)

· A.413/S.6169 (Gunther/Bonacic) in relation to the development of four comprehensive autism assessment centers across the state which would serve as short term diagnostic centers for children five through eighteen to develop appropriate short-term interventions and individual treatment plans designed to manage and improve functioning. (We support this bill with the inclusion of children with other developmental disabilities who exhibit similar behaviors and could benefit from services offered at these proposed centers.)

· A.7257 (Cusick): Requires counties to maintain a voluntary confidential registry of people of all ages with disabilities for evacuation and sheltering during disasters. (we support this bill)

· A.8851 (Paulin) Requiring insurance coverage for Early Intervention services. The Governor's Budget requires insurance coverage but with additional requirements like providers having to negotiate rates, that we do not support. (We do support this bill, Governor's proposal notwithstanding)

JUST WHAT IS THE FUTURE OF ADULT TRANSPORTATION IN OUR OPWDD UNIVERSE?

2/1/2012 11:21:07 AM

IAC expects there will be a need for safe and effective transportation whatever the future direction of day supports to adults with developmental disabilities. In an effort to provide a platform for discussion, and act as a responsible catalyst for change, in the near future IAC will be reaching out to our membership to brainstorm and explore the possible shapes, prospects and expectations of transporting our adult population in this presumed next iteration of day programming. Staff contact: glenn@iacny.org

COMMISSIONER BURKE FILLS THE DDSO DIRECTOR VACANCIES

2/1/2012 11:20:41 AM

On January 25^th, the commissioner announced the following appointments: Bob Lopez will be the acting director for the Long Island DDSO; Michael Kirchmer will be the acting director at Taconic DDSO and will continue as director of Hudson Valley; Sheryl Minter-Brooks will become the acting director at Staten Island DDSO; and Janet Zampella will be the acting director for the Metro DDSO. Congratulations all!

OPWDD TO ALLOW JOB POSTING ON ITS EMPLOYMENT WEBSITE

2/1/2012 11:20:09 AM

With the commissioner's announcement that the OPWDD employment page is now live, she also stated that providers that already have accounts with OPWDD can now start posting their jobs, and those providers without accounts can now establish their own accounts on the site to post their employment opportunities. Account applications are available at http://www.opwdd.ny.gov/gl/images/userid_form.pdf. Completed applications can then be emailed to: external.account.provisioning@opwdd.ny.gov or faxed to Mary Ann Riviello at 518-486-7963.

PLEASE, PLEASE, PLEASE--- READ THE LOAN AGREEMENT BEFORE YOU SIGN!!!

2/1/2012 11:19:33 AM

There have been several examples of member agencies wanting to refinance a bank loan to secure a lower interest rate, only to discover that the prepayment clause contains a "make whole” provision (i.e., must pay the bank all the interest it would have earned for the entire period of the loan). Now one of our providers has discovered a new trick by the banks: prepayment penalties for bridge loans! This seems to meet the classic definition of an oxymoron, right? Banks are not producing the same amount of interest income from their loan portfolios as they did previously, so apparently this is one alternative. Read before signing!

NON-PPA PROJECTS SOUGHT FOR NEW POOLED FINANCING

2/1/2012 11:19:05 AM

IAC is seeking projects not eligible for the DASNY rated pool (i.e., those without OPWDD PPA) to participate in a new pooled program with the Build NYC Resource Corporation, a new entity under the NYC Economic Development Corporation (EDC). Benefits of the program include lower cost of issuance created by the efficiencies of a pooled program; providing access to tax-exempt financing market to smaller providers and projects which would not qualify as a stand-alone; and of course, the benefits of fixed interest rates. Projects may include administration buildings, schools, clinics, residential programs outside the OPWDD world, and many others. Please contact Richard Bosch (richard@iacny.org) for more information and a preliminary application.