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Family Forums: Designing the Future. Agenda. NYIN.org Value-based Business M odel Care Coordination Model Response to the NYS Transformation A genda . NYIN.org. NYIN: Value-based Managed Care.

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

Family Forums

nyin org
NYIN.org

Family Forums

nyin value based managed care
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

a picture of the new world
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

care coordination model
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

what is care coordination
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

responses to nys transformation agenda
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

what you can do going forward
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

contact the nyin agency you know
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

agencies you know
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

business council members
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

business partnership

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

acronyms
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

developmental disabilities individual support and care coordination organization disco
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