May 9, 2023

Dear Members & Families:

I hope this letter finds you well and looking forward to warmer days ahead.

As you may know, the federal government announced that the Federal Public Health Emergency (PHE) will end on 5/11/23. The Office for People With Developmental Disabilities (OPWDD) has confirmed that several of the flexibilities established during the pandemic will be transitioned to pre-pandemic requirements. 

During the next several weeks you will hear more specifically about the return to in-person Life Plan (LP) meetings and other meetings related to you or your loved one. Additionally, now that the PHE is ending, OPWDD guidance no longer allows for verbal agreement of the Life Plan, therefore Care Managers will be required to obtain a signature to finalize the Life Plan. Additionally, it is extremely important to be aware of a return to previous requirements for Medicaid Recertification.

Here are a couple of points to be aware of:

• At the end of the PHE, Care Coordination Organizations (CCOs) will be expected to adhere to guidance issued by OPWDD on 1/1/2021, which details requirements regarding in-person visits, defined as physically being with the other person for a meeting/discussion.
• Virtual face-to-face visits, defined as a video visit where you can see and hear the other person via secure technology like Teams or FaceTime, will continue to supplement the required in-person visits.
• The frequency of in-person and/or face-to-face visits varies depending on several variables related to OPWDD assigned tier levels and other factors.
• The key thing to know is everyone at Care Design NY must have their annual Life Plan meeting in person and at least one other in-person meeting about six months later. This meeting may be the semi-annual review but does not have to be if it meets the specified timeframe.
• After the Life Plan is written, you will need to sign and return it to the Care Manager to ensure compliance with OPWDD regulations.
• Automatic Medicaid extensions are ending.  Anyone who does not receive Supplemental Security Income (SSI) will have to recertify Medicaid eligibility every year, beginning with cases with expiration dates of 6/30/2023 or later.  Please be sure to watch your mail for anything related to Medicaid and be sure to respond to all requests from Medicaid right away.  Your Care Manager is available if you have questions about this or need assistance.
• People who receive Supplemental Security Income (SSI) do not have to recertify their Medicaid as long as they are still eligible for SSI, so there is no change for people who get SSI.

Care Managers are aware of the post-PHE expectations for the people on their caseload and are working now to meet them. They are scheduling annual in-person LP meetings and semi-annual reviews as well as other in-person meetings where needed.  

Please feel free to reach out to your Care Manager for additional information. 

I hope to see many of you at future family and member meetings.

Sincerely,

Cathy Varano
Chief Administrative Officer