OPWDD Provider Association Meeting
April 20, 2015
Welcome – Acting Commissioner Kerry Delaney
- Welcomed Joann Lamphere, new Deputy Commissioner (replacing Jerry Huber).
- Transformation Panel – OPWDD has held several meetings and the next two will highlight managed care, including why the State has moved in this direction. The Commissioner encourages people to check the website for summaries and information.
- NYS has reached a settlement agreement on the audit disallowance for $1.26 billion for Medicaid costs overcharged in prior years for State-Operated Intermediate Care Facilities. An $850 million payment will be made this year, and $100 million per year for 11 years. Payments will be made from the State’s General Fund. The settlement resolves additional audit periods for 2012 and 2013.
- The Commissioner strongly encourages participation in the May 8 Sheltered Workshop conference. The conference will help shape the future changes to comply with the HCBS Settings rule.
SEMP Audit – Ceylane Meyers-Ruff
- There remains concerns that the OMIG audits used differing criteria than the OPWDD standards, which didn’t require each individual to earn at least minimum wage. OMIG was resistant to changing this because they say it’s required by federal rules. Provider associations and OPWDD asked the OMIG to agree not to extrapolate based on an employer or provider paying less than minimum wage. The OMIG denied this request. A bigger issue may be that providers weren’t required to document wage levels, so many agencies would have all claims disallowed. OPWDD will set up a conference call with OMIG and providers, to discuss it further. Roger Bearden will be the contact person to coordinate new discussion.
New PPA Lein Documents – Roger Bearden
- Providers have raised many issues with the documents. OPWDD will address the issues one at a time, as they arise. OPWDD has changed the language to be clear that OPWDD is subordinate to any financial institution. PPA’s in progress are being released and lein contracts are being signed. Scott Sandwik of OPWDD reported that the subordination agreement will be forwarded later this week.
2015-16 State Budget Update and Plans – Kevin Valenchis and Helene DeSanto
- Kevin recapped the budget highlights. OPWDD still has little info on the Infrastructure grants. $50 million will be available for larger agency networks and $10 million for behavioral health managed care technical assistance. The budget also included funds to require a residential requests list update and OPWDD is planning to reach out to do this.
Nurse Practice Act – Roger Bearden
- With the Legislative changes, the actual MOU has been developed, but not issued yet. Megan O’Connor is preparing a process to allow certification of community based programs. DQI will need to determine logistics for med storage and transportation. The process to issue operating certificates that create the structure to provide this service must be in place before AMAP services can be provided. Agencies that choose to offer the service will be required to submit a notice of formal intention. An explanatory memo is being prepared and will be sent soon.
Chapter 394 Implementation – Megan O’Connor
- This law, passed last year, required the Justice Center to develop protocols when interviewing an individual with special needs. OPWDD has been working with the Justice Center on this. The process will begin in July, where individuals can select a representative to support them during the interview process. Confidentiality issues may occur when a personal representative accompanies the individual to the interview. Therefore, the personal representative may be present for only a part of the interview and their role could include ensuring the individual is comfortable. An explanatory memo will be issued in May, followed by training in June for investigators and QA staff.
MFP Report – Dixie Yonkers
- OPWDD is not getting proper reporting from agencies on MFP funded people. This is a requirement by CMS for receiving funds and participating in the MFP program. A reminder will be sent to all participating agencies.
Certified Residential Opportunities Protocol – Abiba Kindo
- OPWDD has held video conference training on this and the protocol will be distributed. The Priority One list will go into effect along with the protocol. The process hopes to give more choice to people, particularly for uncertified options.
DDP1 Supplement – Sally Berry
- This new form will be used when enrolling a person in a new service or when changing the service amount for an existing service. For most services, the attachment to the DDP1 can be submitted through Choices. If an agency is not using Choices, the agency must submit the attachment as paper copy.
HCBS Settings Update – Mary Ellen Moeser
- They have completed the public comment period with a larger than usual number of comments. Comments focused on main topics including residential options, sheltered workshops, and self-direction. A summary of all comments, with OPWDD’s response, will be published.
- The OPWDD Heightened Scrutiny group has been meeting to develop plans for sites under scrutiny in accordance with the HCBS Settings rule. The working group has met three times. Maria Torgalski of Aspire is the DDAWNY representative to the group. As of 4/17, they have reviewed +700 sites for compliance.
Planned Changes to Clinical Services in Hab. – Kate Marlay
- CMS is taking issue with “hands-on therapy” within Res. Hab. They understand clinical support within Res. Hab. in terms of training staff, but want therapy to be delivered consistently in or out of Res. Hab. As of 10/1, nutrition, nursing and psychology services will be folded into Res. Hab. Carved out of Res. Hab. will be any OT/PT rates. Day Hab. will be different; no hands-on therapy will be included in rates.
Rate Discussion – Donna Cater, Laura Rosenthal
- Fiscal Intermediary rates – DOH will be asking agencies to provide cost information before considering any rate increases.
Community Pool Fund
- Applications are being reviewed. They may be asking for more information where the application is unclear. They hope to make awards by late May, mid-June.
2% COLA – Donna Cater
- All rates with 2% COLAs, except IRA’s and Day Hab.’s, have been loaded and new fee schedules are on the DOH website. IRA and Day Hab. will be done soon. Also, Room and Board re-calculations will be included in IRA rates.