Family Forums: Designing the Future

1. Family Forums: Designing the Future Title of Presentation

2. Agenda • NYIN.org • Value-based Business Model • Care Coordination Model • Response to the NYS Transformation Agenda Family Forums

3. NYIN.org Family Forums

4. NYIN: Value-based Managed Care NYIN is driven by a simple idea that providers listening to and working with individuals & families can create and design a viable business model that works for everyone. We hold to the ideals of choice, access, and quality of life Family Forums

5. A picture of the new world NYS Medicaid $$$ NYIN DISCO* with Insurance License Network of Providers (Agencies you know) Medicaid Recipients = Enrollees (Persons Served and Families) Access and Choice of Service • * DISCO - Developmental Disabilities Individual Supports and Care Organization Family Forums

6. DISCO Benefit Package Family Forums

7. Care Coordination Model Current Anticipated Advocacy/ Life Planning Community Linkages and Referrals MSC (Case management) Designated Care Coordinator: Central point of contact Eligibility and Benefits Management/Assessment Coordination with Providers Family Forums

8. What is Care Coordination? • Provides a person-centered, integrated system for medical, health and social support services • Creates an individual care plan • Connects individuals with all their providers • Ensures timely communication with providers and community supports • Measures, monitors and improves quality informed by individual outcomes • Utilizes electronic information to support integrated and coordinated care Family Forums

9. Responses to NYS Transformation Agenda NYIN will continue to take a leadership role in: • Individual Services and Supports (Self-Direction) • Employment Opportunities: Cleaning with Meaning a “green” home cleaning business run by people with disabilities. • Community Integration: Our Place a new day services model using neighborhood spaces and self-directed activities. Family Forums

10. What you can do going forward • Take advantage of these Family Forums. Ask questions. • Stay connected to NYIN – NYIN.org • Ensure eligibility for services is formally established through the local DDRO • Stick with or get connect to an agency you know - to maintain continuity of services • Keep informed • Be an advocate Family Forums

11. Contact the NYIN Agency You Know YAI LINK 212.273.6182 info@yai.org www.yai.org SUS 212.633.6900 info@sus.org www.sus.org Lifespire 212-741-0100 info@lifespire.org www.lifespire.org IAHD 718-741-0100 andre.thompson@iahdny.org www.iahdny.org UCP of NYC 212.683.6700 ext 202 Abittigner@ucpnyc.org www.ucpnyc.org HeartShare 718-422-3204 Olga.Golubeva@heartshare.org www.heartshare.org CBHS CBHS@occupations.org 1-888-750-2266 http://www.occupations.org/pdf/CBHS_brochure.pdf Family Forums

12. Agencies You Know * CBHS is a consortium which includes Abilities First, Crystal Run Village Inc., New Hope Community, Occupations Inc., and Westchester Jewish Community Services Family Forums

13. Business Council members • Ability Beyond Disability • Birch Family Services • Camp Venture, Inc. • CP Associations of New York State • Children’s Village • Community Based Services, Inc. • Edwin Gould Services • Epilepsy Foundation of Metro NY • F.R.E.E., Inc. • Hawthorne Foundation • Head Injury Association • Opengate, Inc. • Richmond Community Servies • The Rose F. Kennedy Center • St. Vincent’s Services • A Very Special Place Family Forums

14. Business Partnership Business Partnership Life- spire UAM Bd. Observer UCP of NYC Heart Share IAHD YAI SUS CBHS Owners OPWDD NYIN Loans UAM Reinsurance Agreement DISCO Application Business Plan Costs of Application split 50/50 by NYIN and UAM $ $ Administrative / Management Services Agreement4 Family Forums

15. Acronyms • ADA – American with Disabilities Act • AT – Assistive technology • CASA – Community Alternative Systems Agency • CDPAP – Consumer Directed Personal Assistance Program • CDS – Consumer Directed Services • CMS – Centers for Medicare and Medicaid • CR – Community Residence • CSS – Consolidated Supports and Services • DC – Developmental Center • DD – Developmental Disabilities • DDRO – Developmental Disabilities Regional Office • DISCO - Developmental Disability Individual Support and Care Coordination Organizations • DOH – Department of Health • DQA – Division of Quality Assurance • EI – Early Intervention • FIDA – Fully Integrated Dual Advantage Programs • FSS – Family Support Services • HCBS – Home and Community Based Services • HIPAA – Health Insurance Portability and Accountability Act • HUD – Housing and Urban Development • ICF – Intermediate Care Facility • ICS – Individual and Community Supports • IEP – Individual Education Plan • ILC - Independent Living Center • IRA – Individualized Residential Alternative • ISE – Individualized Service Environment • ISP – Individualized Service Plan • ISS – Individualized Support Services • IWRP – Individual Work Related Plan • LCED – Level of Care Eligibility Determination • MA – Medicaid • MLTCP – Managed Long Term Care Plan • MSC – Medicaid Service Coordination • NCI – National Core Indicators • OPWDD - Office for People with Developmental Disabilities • PCP – Person Centered Planning • PCP – Primary Care Physician • PCSS – Plan of Care Support Services • POM – Personal Outcome Measures • SA – Self Advocacy • SCAP – Service Coordination Activity Plan • SCBA – Service Coordination Basic Agreement • SD – Self Determination • SE – Supported Employment • SSDI - Social Security Disability Insurance • SSI – Supplemental Security Income Family Forums

16. Developmental Disabilities Individual Support and Care Coordination Organization (DISCO) NYIN, as a DISCO, has developed plans to: • Enroll individuals who voluntarily opt to enroll in 2014-15 • Provide person-centered planning for all individuals enrolled • Handle the flows of funds (per member, per month) • Promote living and active engagement in the most integrated setting • Ensure that each individual who chooses to do so can self-direct his or her services Family Forums