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OPWDD and Transition Planning

OPWDD and Transition Planning. Joanna Di Gianni. OPWDD-Office for People with Developmental Disabilities. The NYS agency responsible for coordinating services to 126,000+ New Yorkers with intellectual and developmental disabilities.

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OPWDD and Transition Planning

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  1. OPWDD and Transition Planning Joanna Di Gianni

  2. OPWDD-Office for People with Developmental Disabilities • The NYS agency responsible for coordinating services to 126,000+ New Yorkers with intellectual and developmental disabilities. • The NYS agency responsible for certifying and overseeing approximately 800 voluntary agency providers. • A provider of residential/day services for a small percentage of people served.

  3. Developmental Disabilities • Is defined as a severe, chronic disability which: originated at birth or during childhood, is expected to continue indefinitely. • Will restrict the individual's functioning in several major life activities. • Is a severe, chronic disability which: • is attributable to a mental or physical impairment or a combination of mental and physical impairments; • is manifested before the person attains age 22; • Results in substantial functional limitations in three or more of the following areas of major life activity: • self-care • receptive and expressive language • learning • mobility • self-direction • capacity for independent living, and • economic self-sufficiency

  4. Developmental Disabilities cont. • Examples of developmental disabilities include: • Autism • Behavior disorders • Brain injury • Cerebral palsy • Down syndrome • Mental retardation • People with developmental disabilities benefit from comprehensive long-term services. With such services, people with disabilities are often able to be more active, productive, and independent, which benefits their communities

  5. Educational definitions and OPWDD Definitions • OPWDD Definitions of a disability: • Developmental disabilities are a variety of conditions that become apparent during childhood and cause mental or physical limitation. These conditions include autism, cerebral palsy, epilepsy, mental retardation, and other neurological impairments. • People with developmental disabilities may not learn as quickly as others or express themselves clearly. Some people may have limited ability to take care of their physical needs or may have limited mobility. Many have more than one disability. • Individuals with Disabilities Education Act (IDEA) (P. L. 101-476) • identified specific categories of disabilities under which children may be eligible for special education and related services. • The IEP lists the child's disability category for example : OHI or Speech and Language Impairment

  6. THE ELIGIBILITY DETERMINATION PROCESS • Let’s outline the 3-Step Eligibility Determination Process and describe the type of information OPWDD will need to determine that an individual is eligible for OPWDD services.

  7. 3 STEPS IN DEVELOPMENTAL DISABILITY DETERMINATION

  8. REQUIRED DOCUMENTS • Psychological reports which include an assessment of intellectual functioning (“IQ test”) • For conditions other than Intellectual Disability, a medical or specialty report that includes health status and diagnostic findings to support the qualifying diagnosis • A recent general medical assessment report should be included in all eligibility requests • A developmental/ psychosocial history report, or other report that shows that the person became disabled before age 22 (this is required for all eligibility requests) • Adaptive behavior functioning assessment • In some cases, the DDRO may require additional information to determine eligibility

  9. Once a person is determined eligible to receive OPWDD services, an assessment is completed to help identify the person’s strengths, needs and the natural or community supports available to him or her. • 1.   The Developmental Disabilities Profile (DDP-2) is a brief assessment used by OPWDD to identify the challenges that an individual with developmental disabilities may have and to identify their service needs. OPWDD staff  then works with the individual and their family to complete the DDP-2 during the initial assessment process. • 2. The Coordinated Assessment System (CAS) is a comprehensive assessment tool used by OPWDD to identify an individual’s strengths, needs and interests and to assist in person-centered planning for care. The CAS asks many questions about a person, their living situation, their needs and interests, and their challenges so that the services that will best meet their needs can be identified. The CAS is now being used for individuals who are 18 years of age and over, newly eligible, or transitioning to adult services

  10. NEXT STEPS IN OPWDD PROCESS… • Once eligibility has been determined, the DDRO will direct you to an Assessment Specialist to initiate the assessment process.

  11. ACCESSING OPWDD SERVICES

  12. OPWDD Family Support Services OPWDD Family Support Services can be accessed once your child has OPWDD eligibility, regardless of his/her Medicaid status. These services include: • After School/Respite Programs • School vacation Respite • Crisis intervention • Family Counseling, Training & Advocacy • Parent Training • In-Home Respite • Overnight Freestanding Respite • Weekend/Recreation Respite • Family Reimbursement

  13. FRONT DOOR During the eligibility process and/or immediately after obtaining eligibility, parents or guardians need to go through the “Front Door”. This process includes attending an in person seminar on OPWDD supports and services at your local DDRO and an over the phone assessment of your child’s individual needs. Front Door Contact Numbers are as follows: Queens: Kings: 718-217-6485 718-642-8576 Manhattan: Bronx: 646-766-3220 718-430-0757 Richmond: Long Island: 718-982-1913 631-434-6000 (Counties: Nassau, Suffolk) 631-434-6100

  14. Steps you need to take when applying for services • Submit paperwork stating that your family member has a developmental disability • Fill out special state OPWDD forms • Apply for government benefits which pay for the services that you need (SSI or Medicaid) • Sign up for Medicaid Service Coordination with help from your provider

  15. AGENCIES THAT CONDUCT PSYCHOEDUCATIONAL EVALUATIONS AHRC Cathy Shannon (212) 229-3250 or Clara Cordon (212) 780-2387 http://www.ahrcnyc.org/default.html Quality Services for the Autism Community (QSAC) Dr. Kristen DuMoulin (718) 728-8476x1517 http://www.qsac.com/ Young Adult Institute (YAI) (866) 2-YAI-LINK; (212) 273-6182 http://www.yai.org/ Queens Centers for Progress (QCP) Joanna Barberii (718) 380-3000, x269 http://www.queenscp.org/ Promoting Specialized Care and Health (PSCH) Michelle Cash (718) 777-5243, x210 http://www.psch.org/ New York State Industries for the Disabled (NYSID) Elizabeth Sunshine (718) 464-6457 http://www.nysid.org/ Cerebral Palsy Associations of New York State (CP Association) RoniZarbiv (718) 447-0200, x236 http://www.cpofnys.org/Home.aspx

  16. Medicaid • An assistance program that pays for medical services, supplies and medications for New Yorkers who are disabled and or meet financial requirements. • Medicaid Waiver • A program that removes some of the usual requirements for getting Medicaid services. The purpose of waiver programs is to help people stay in their home community by paying for home and community based services, instead of intuitional care.

  17. MEDICAID AND HCBS WAIVERELIGIBILITY • Many services are available from OPWDD and agencies in the OPWDD system. • Most OPWDD services are provided through the Home and Community Based Services (HCBS) Waiver, which requires Medicaid eligibility and enrollment. • OPWDD requires individuals to enroll in the right type of Medicaid coverage for the services they need. • Often, individuals need to enroll in both Medicaid (MA) and HCBS Waiver. • Care Coordination and/or OPWDD resources are available to help individuals and families work through these eligibility processes.

  18. Medicaid Applications • NY State of Health, The Official Health Plan Marketplace (855) 355-5777 • Managed Care Organization (MCO) • Navigators and Certified Application Counselors • Medicaid Helpline (800) 541-2831 • Local District Social Services Offices • New York City Human Resources Administration, (718) 557-1399 (within the five boroughs of New York City) • Nassau County Nassau County DSS, 60 Charles Lindbergh blvd., Uniondale, New York 11553-3656, (516) 227-7474 • Suffolk County Suffolk County DSS, 3085 Veterans Memorial Highway, Ronkonkoma, New York 11779-8900, (631) 854-9700

  19. In Person • Visit your local District Social Service office. To submit your forms for Medicaid applications at an official location, review the listings online. Those who live in New York City's five boroughs can also find offices managed by the Human Resources Administration.  • If you have access, you can print your Medicaid application forms from a computer, and get started on your own – instead of going to a local office. You are not required to submit Medicaid applications in person, although you are encouraged to bring your paperwork in if you need assistance with different fields on the document. If you cannot print your NY Medicaid application online, you can retrieve one in person, fill it out and then bring it back to a representative to file on your behalf. If you prefer to simply pick up your Medicaid application in person, you can also send it in by mail, if that is a more convenient submission option for you. 

  20. HCBS Waiver Services: Home and Community Based Services • HCBS is a funding mechanism that provides payment for community services through Medicaid. • In order to apply for these services you must have Medicaid and a Medicaid Service Coordinator. The Care Coordinator will complete the enrollment packet and compile the information for processing. The Care Coordinator will also help you identify what services are appropriate. • HCBS Services include: • Residential habilitation - Pre- vocational training • Supportive employment - Respite • Environmental modifications - Adaptive devices • Family education and training - Plan of care support services • Transitional services - Fiscal employer agent

  21. Care Coordinator • Assists with the arrangement, coordination, monitoring, and evaluation of supports and services to meet an individual’s needs. • Service Coordination is about helping people with developmental disabilities live successful lives in the community according to their own dreams and desires. • Providers a service that is available through provider agencies which assists persons with developmental disabilities in gaining access to appropriate services and supports. • Your child first needs OPWDD eligibility and Medicaid in order to obtain a Care Coordinator.

  22. Supplemental Security Income (SSI) • SSI assists children who are disabled or blind • A child under the age of 18 may be found disabled if he or she has a physical or mental impairment or a combination of impairments that causes marked and severe functional limitations and that can be expected to last for a continuous period of at least 12 months. • In New York state, all SSI recipients are eligible for Medicaid • Parental income and resources are considered in eligibility however some types of income and resources are not applied.

  23. What you need when applying for Medicaid or SSI • File with the responsible Medicaid district • Document all information on application • Disability determination may be required • Complete the appropriate application • Income • Resources • Citizenship • Age • Social security number • Living arrangements • Child’s disability determination

  24. Start the Process… • In order to obtain a Medicaid number you must go to your local Medicaid office and pick up an application, this includes a packet for your child or you can apply online. • After the packet is completed you must return to the Medicaid office and submit the forms for approval. • Once you obtain a Medicaid number, then a Care Coordinator can help you start a file for Medicaid Service Coordination.

  25. Why should I establish Medicaid eligibility? • Ongoing comprehensive care • Case management • Cost effective • Access to services for your child and your family • Facilitates job training and living arrangements for adults who are developmentally delayed

  26. Steps Simplified… • If you don't already have one, apply for a Medicaid number for your child. • Once you have a Medicaid number call the Care Coordinator to have them start building a file for Medicaid Service Coordination • Once that file is submitted and approved your child can start receiving services.

  27. ACCESS-VR Adult Career and Continuing Education Services-Vocational Rehabilitation (ACCES-VR) offers access to a full range of employment and independent living services that may be needed by persons with disabilities through their lives. Through its administration of vocational rehabilitation and independent living programs, VR coordinates policy and services relating to: • transition and youth services for high school students and youth up to age 25 with disabilities from school and post school to adult services; • vocational rehabilitation services for working age individuals with disabilities; • independent living services for people with disabilities of all ages; and • business services for hiring a qualified diverse workforce. • The seeds of adult success are sown during the school years. The system established by the Board of Regents to administer education and vocational services for people with disabilities fosters this and has evolved into a national model, designed to focus on our customers and produce results.

  28. Applying for Vocational Rehabilitation Services • Adult Career and Continuing Education Services - Vocational Rehabilitation (ACCES-VR) is part of the New York State Education Department. ACCES-VR, formerly known as the Office of Vocational and Educational Services for Individuals with Disabilities (VESID), assists individuals with disabilities to obtain and maintain employment. • Individuals can apply for ACCES-VR services themselves, be referred by their physicians and/or treatment providers, or be referred by their schools if they are students. ACCES-VR offers orientation sessions where individuals can learn about the types of services available. Applications and related forms are available at the orientation sessions, or they can be downloaded to complete to bring to ACCES-VR. • ACCES-VR will need to following information to process your application: • a signed application (, 103KB, 2pg) that includes at minimum, your name, address, date of birth, gender and referral disability; and • a signed release of information • the VR-21 (, 171KB, 1pg) for general health impairments and/or • the VR-22 (, 161KB, 2pg) for substance use disorders and mental health conditions; and • a completed confidential health assessment form VR-26 (, 621KB, 2pg). • To begin the application process: contact your district office for information on orientation sessions. http://www.acces.nysed.gov/vr/

  29. Additional Important Locations, Phone Numbers & Websites • NYC and the Five Boroughs Service Delivery Integration Solution Center 75 Morton Street New York, NY 10014 (212)229-3216 • Nassau County DDS 60 Charles Lindbergh Blvd Uniondale, NY 11533 (516)227-8000 • Suffolk County Offices & Institutions: Medicaid Eligibility 200 Wireless Blvd #1 Hauppauge, NY 11788 (631)853-8730 - http://www.health.state.ny.us/forms/doh-4220 all.pdf - http://www.opwdd.ny.gov/ - http://www.health.state.ny.us/health_care/medicaid/ - http://www.ssa.gov/ssi/

  30. Brooklyn Medicaid Offices • Coney Island*3050 W 21st St.Brooklyn, NY 11224Phone: 929-221-3790Monday – Friday 9:00am to 5:00pm • East New York404 Pine Street2nd Floor Brooklyn, NY 11208Phone: 929-221-8204Monday – Friday 9:00am to 5:00pm • Kings County Hospital441 Clarkson Ave."T" Building, Nurses' Residence, 1st FloorBrooklyn, NY 11203Phone: 718-221-2300Monday – Friday 9:00am to 5:00pm • Brooklyn South*785 Atlantic Ave.Brooklyn, NY 11238Monday – Friday 9:00am to 5:00pm • 243 Schermerhorn Street4th floorBrooklyn, NY 11201

  31. Bronx Medicaid Offices • Lincoln Hospital*234 E. 149th St.(Basement, Room B-75Bronx, NY 10451Phone: 718-585-7872Monday – Friday 9:00am to 5:00pm • Morrisania1225 Gerard Ave.BasementBronx, NY 10452Phone: 718-960-2799Monday – Friday 9:00am to 5:00pm • North Central Bronx Hospital3424 Kossuth Ave.(1st Floor, Room 1A 05 Bronx, NY 10467Phone: 718-920-1070Monday – Friday 9:00am to 5:00pm

  32. Queens Medicaid Offices • Queens Community*32-20 Northern Boulevard1st FloorQueens, NY 11101Phone: 718-784-6729Monday – Friday 9:00am to 5:00pm

  33. Manhattan Medicaid Offices • Chinatown*115 Chrystie St. 5th FloorNew York, NY 10002Phone: 212-334-6114Monday – Friday 9:00am to 5:00pm • Manhattanville Community*520-530 W 135th St.1st FloorNew York, NY 10031Phone: 212-939-0207Monday – Friday 9:00am to 5:00pm • Metropolitan Hospital1901 First Ave.1st Floor Rm 1D-27New York, NY 10029Phone: 212-423-7006Monday – Friday 9:00am to 5:00pm

  34. Staten Island Medicaid Office • Staten Island Medicaid Office 215 Bay Street (718) 420-4660/4732

  35. Nassau County Hospitals • Mid-Island Hospital (516)579-6000 • Nassau University Medical Center (516)572-0123 • Glen Cove Hospital (516)674-7300 • Long Beach Medical Center (516)897-1000 • North Shore University Hospital (516)562-0100 • Winthrop University Hospital (516)663-2200 • Long Island Jewish New Hyde Park Medical Center (718)470-7000 • Schneider Children’s Hospital (516)470-3000 • South Nassau Communities Hospital (516)632-3980 • North Shore University Hospital of Plainview (516)719-3000 • Centre Mercy Medical Center (516)705-2525 • St. Francis Hospital – The Heart Center (516)562-6000 • Massapequa General Hospital (516)520-6000 • Franklin Hospital Medical Center (516)256-6000

  36. Suffolk County • MEDICAID - SMITHTOWN CENTER     Suffolk County Department of Social ServicesP.O. Box 18100Hauppauge, New York 11788 • RIVERHEAD CENTER   893 E. Main StreetRiverhead, NY 11901-2542Telephone: (631) 852-3710 New ApplicationsTelephone: (631) 852-3570 Open Cases • SMITHTOWN CENTER     200 Wireless BoulevardHauppauge, New York 11788Telephone: (631) 853-8730 New ApplicationsTelephone: (631) 854-0555 Open Cases

  37. STILL HAVE QUESTIONS? • Taylor Eichenlaub • Teichenlaub@tiegerman.org • 718-476-7163 x436

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