The COVID-19 public health crisis is rapidly changing. This information represents the most up to date information we had at the time of publishing. We will update as new information becomes available.
Care Design NY is committed to staying in close communication with families and people we support through this public health emergency. We are committed to thorough and ongoing contact with all Care Design NY members (including Basic). Care Managers are following a carefully created assessment protocol and script to ensure Care Mangers screen for risk factors and also to coordinate supports and services. If there are issues identified, these will be elevated immediately to supervisors and leadership to respond quickly.
The person should call their Care Manager or the Supervisor and it will be addressed. We created a task force with our Provider Relations Dept. to work on this exact issue and will be pushing out resources to families to ensure they are safe and have access to needed supplies etc. We are reviewing the ever -changing situation daily.
We have data from DDP-2s and information from Medisked that gives us an initial area of focus for calls to families and information for Leadership to be continuously apprised. Care Managers have also been instructed to contact individuals in their care so this information can be reviewed and updated.
We are following the New York State Department of Health Guidance temporarily waiving face-to-face meetings for care coordination/health homes. We can use secure video technology for the meeting, so that we can visually see each other while still maintaining social distancing. If you have access to an I-phone or an Android phone we can see each other visually using an app called Microsoft TEAMs or through FaceTime on an I-phone or I-pad. However, we can also conduct the meeting by conference call if you prefer or the video options are not possible.
We are working with OPWDD, other government agencies, provider agencies and others on these emergency situations. As stated above, we will identify those most at risk of this situation and will coordinate our interventions to ensure individuals are safe and have the proper care.
Here is the message from OPWDD regarding day program closures:
https://opwdd.ny.gov/news/message-opwdd-commissioner-kastner-regarding-day-program-services
We have received guidance from OPWDD that all Life Plan due dates will be extended effective as of March 7th. This means the current Life Plan remains in effect even past the normal due date. For new enrollees, the initial Life Plan due date will also be extended. This includes the I AM Assessment. Life Plans due prior to March 7th still need to be completed and the I AM assessment reviewed as part of the annual review. The purpose of this extension is to allow care managers to focus on the health and safety of everyone served by Care Design NY in this time of crisis. Care Managers will be reaching out to families to ensure health and safety as their primary mission at the current time.
In July and August of 2019, Care Design NY held managed care focus groups in four regions throughout New York State (NYS), including Long Island, Manhattan, Hudson Valley and Capital District/ North Country.
The focus groups were facilitated by a neutral third-party contractor.
The goal of these focus groups was to offer individuals and families the opportunity to share with Care Design NY their thoughts, feelings, concerns, and questions about the anticipated roll-out of managed care in NYS for individuals with intellectual and/or developmental disabilities.
We would like to use the information learned in these sessions to produce meaningful education and outreach materials for individuals and families.
In the meantime, individuals and families should continue to build natural supports. The Care Design NY Care Manager will continue to assist with resources in the community i.e.; Guardianship, Special Needs Trust, and Supportive Decision Making
Given the long delay in circulating the revised application to the public, it is likely that NYS will host another public comment period.
Visit the New York State OPWDD and Department of Health (DOH) websites for information the agencies will post for individuals and families during the transition period. Information can be accessed from the following websites:
We will also keep individuals and families up to date through Care Design NY’s website, social media and other communications.
Answer:
This will depend on the plan that the individual chooses to utilize.
We will be updating individuals and families on the plans that will be available and ensure they have all the information needed to make an informed decision about the managed care plan that is right for them. Your Care Manager will be able to assist you should you have any questions when reviewing the plans. This includes a review of the doctors, specialists, dentists, etc. in the plan’s Provider Network.
Each managed care plan will be expected to build a Provider Network, including dentists. Once we have the information for each managed care plan, we will ensure that the information is shared in a timely manner so that informed choices can be made.
We will not have the final details on this until the revised application is released by NYS.
Once we have the information for each managed care plan, we will ensure that the information is shared in a timely manner so that informed choices can be made.
You should reach out to your Care Manager to discuss this further. We will also add this topic to future webinars that we conduct for individuals and families throughout the year. Individuals and Families can also connect with Advocacy Groups i.e. Parent to Parent and Self Advocacy Association of New York State (SANYS).
However, Medicare doesn’t pay for OPWDD supports and services, only Medicaid. Therefore, when the OPWDD supports and services are included in the managed care benefit package, the expectation is that individuals will need to enroll in a managed care plan to receive those services once there is mandatory enrollment.
Also, similar to Medicare, private insurance does not pay for OPWDD supports and services. Therefore, when the OPWDD supports and services are included in the managed care benefit package, the expectation is that individuals will need to enroll in a managed care plan to receive those services once there is mandatory enrollment.