Staten Island Family Forum Kate Bishop and Amanda Harper NYS Office for People With Developmental Disabilities 7/19/17

System Change Care Coordination Organizations 11/23/2018 System Change Care Coordination Organizations Builds from the experience and expertise in the field of developmental disabilities today Stronger coordination structures to support community based supports Strong person-centered practices with holistic view of person

5/19/17 What is a CCO? Care Coordination Organizations (CCO), a new organization to be approved by OPWDD To provide enhanced care coordination services Level of service tailored to individuals’ needs Regionally based / community resources expertise Personal choice Build on traditional MSC role IT enabled Conflict free Foster HCBS Rule attainment

Care Coordination Organizations (CCOs) 5/19/17 Care Coordination Organizations (CCOs) CCOs will be designed as specialized Health Homes, with their focus on coordinating care for people with developmental disabilities. CCOs will operate under the 1115 waiver. CCOs may subcontract with existing IDD MSC provider agencies for a period of time

Why Focus on Care Coordination? Provide services with a holistic view of the person– health, wellness, behavioral health and LTSS Community living has many moving parts Increased attention to a person’s life goals Offer improved career path for current service coordinators Build on strengths of current structure A path to managed care and Value Based Payments (VBP) Community- as we have more and more people exploring self directions and non certified living situations coordination needs increase Career path- with focus on health, wellness behavioral health there are more areas of specialty that can allow for advancement that isn’t currently available with in our typical MSC administrative structure. VBP- focused on outcomes vs dotting of I’s crossing of T’s. Our system has focused a lot on compliance vs quality and the outcomes of the people we support. Recognize that the system needs to move forward and to pay greater attend to goals and personal outcomes of the person served and the value in this. Rewarding providers for their hard work and doing well.

Benefits of Care Coordination Increased individual satisfaction and choice through person-centered planning Service authorization, activation and monitoring improved (more seamless, reduced paperwork) Improved access to services and providers and reduction of unnecessary delays Enhanced integrated opportunities for independence to the extent possible Support of meaningful outcomes and value-based performance metrics IT enabled communication & data sharing Increased accountability - Intention of care coronation to better streamline our system and get out of the way of the PCP process and increasing the independence of the people we support. Show of hands-providing services to someone who isn’t happy where they are, is getting more of less supports than they require. Still using paper to share plans and make changes? -through enhanced IT systems we can improve communication and efficiency while decrease deficiencies and compliance issues due to preventable systems issues that can be addressed using technology.

Health Care Transitions for People With Developmental Disabilities Disability is a lifelong condition Differences in individual abilities Co-morbidities and co-occurring conditions Over time, people’s health status & support needs change Someone with I/DD is more than twice as likely to be admitted when they present in hospital emergency departments People with I/DD in inpatient settings can be stable but not have appropriate long term supports and services identified

Underutilized Preventative Health Care Services 11/23/2018 Underutilized Preventative Health Care Services Preventive screenings Health promotion Dental Chronic care management Health optimization Maximize use of preventative services to maximize good health for optimum community life and independence

Care Coordination is a Comprehensive Model Care Coordination Functions Linkage and Referral Advocacy Care Planning Assess-ment Monitoring Record Keeping Coordina-tion with providers Cost Mgmt. Eligibility & Benefits Maint. Central Point of Contract

Comprehensive Care Management Includes Use of care teams comprised of individuals receiving support and services and their representative/circle of support, developmental disability service providers, and medical, behavioral health providers, social workers, nurses and other care providers, as appropriate Conflict-free care management services must be person-centered and person-driven Comprehensive care coordination that addresses the individual’s needs holistically, including better access to physical, behavioral health services, and wellness Support and care is detailed and monitored through the use of the OPWDD defined Life Plan that is integrated and electronic

Person-Centered Life Plan 11/23/2018 Person-Centered Life Plan Supports and services are detailed and monitored through the use of OPWDD’s Life Plan, an integrated and person-centered electronic service plan Care Coordination Organizations (CCO/HHs) will be responsible for the development of the Life Plan The Life Plan must include specific domain areas and be accessible electronically to all authorized members of the care team

11/23/2018 Timeline & Next Steps Now until August 4: Comments on the draft Application will be accepted—applications are not being accepted at this time. September 30, 2017: The final Application will be released and applications begin to be accepted. November 30, 2017: Last day for CCOs to apply. December 2017 – February 2018: Review and approval of Applications, Start-up Grant Awards. March-June 2018: Readiness activities. July 2018: Transition to CCO/HH.

11/23/2018 What Do I Need To Do? Attend upcoming Webinars offering additional details. Read the draft application to learn more about CCOs. Connect with potential CCOs in your geographic region. Reach out to OPWDD with questions. Check OPWDD’s website frequently for updates and new materials.

Questions/Discussion

11/23/2018 Kate Bishop Division of Person Centered Supports OPWDD Care. Coordination@opwdd.ny.gov