Self-Direction – A service offered by OPWDD

Subjects to better understand:
Intellectual and Developmental Disabilities:

Disabilities identified in utero or in the very early stages after birth. Some
examples would include Down Syndrome, Williams Syndrome, Fragile X Syndrome, as
well as a Chromosomal Syndrome. Other disabilities that could be diagnosed at
any time during development could include Autism and Traumatic Brain Injury.It is important to understand that New York State recognizes development to
continue to occur until the end of a person’s 21st year. Therefore, and
diagnosis or occurrence during the developmental years could qualify as an
intellectual or developmental disability. An example of this could be that a
typically developing individual being involved in a devastating accident during
their teen years that causes a Traumatic Brian Injury.

Qualifying for OPWDD services:

Let’s begin by understanding the acronym of OPWDD. This is the NYS office
charged with overseeing the supports and services offered to the population of
individuals in the state of NY that have Intellectual and Developmental
Disabilities sometimes spoken of as IDD. OPWDD is the acronym for Office for
People With Developmental Disabilities. This office was previously called OMRDD,
Office of Mental Retardation and Developmental Disabilities. The office name
changed about 5 or 6 years ago. This change came from the efforts of the New
York State group, SANYS, Self-Advocates of New York State.
A family of individual, or the individual themselves can put forth an
application for approval at any time in the development of the individual. The
initial application is known as a Transmittal. The documentation that will be
requested by OPWDD will include a full scale IQ as well as a social history or
pyscho social. The social history of pyscho soc needs to be in narrative form
and signed by, minimally a LMSW. The full scale IQ should include and adaptive
behavior testing, there are a few acceptable tests for an ABS. In the full scale
IQ, it is important that the disability is recognized and the onset identified.
While qualifying numbers would be an IQ of 60 or below, and/or an ABS of 70 or
below, additional information may be requested by the assessor from OPWDD.
Note, that if an individual is identified for approval of OPWDD services before
the age of 11 it is considered provisional and will be reassessed.

Front Door and Waiver Services:

Your journey begins by making a connection with a representative with the Front
Door Dept at OPWDD. The FD will assess the need presented and equate the need to
a service provided by OPWDD. The FD will provide the individual with a vendor
list of Medicaid Service Coordinators, MSCs. This is found in a contracted
agency with OPWDD.
The MSC will guide the individual in the process of waiver approval. Each
service offered under OPWDD, needs the individual to be waiver approved. The
current waiver is the CBS waiver, Home and Community Based waiver. This waiver
is currently in an amendment process. There is great advocacy across the state
in ensure continuity of care throughout this process. (* In the state of New
York, there is still language consistent with the fact that an individual with
an intellectual or developmental disability has the right to be
institutionalized. It is for this reason that individuals waive that right and
instead, request that their services be provided for them in their home and
community.) When the MSC is able to secure waiver approval, the individual is
connected to the entity that will support the service that was originally
identified in the Front Door assessment.

OPWDD Waiver Services:

Waiver Services offered under OPWDD include, traditional day hab, day hab
without walls, com hab, Supported Employment, Residential living supports and
Self-Direction.

Self-Direction

When an individual decides that they are looking to receive self-directed
services, they are making a statement that they are choosing to live a
self-determined life. They are coming to OPWDD saying that their plan is to
build a circle of support around them. The will take on the responsibility of
Budget authority as well as Supervising, hiring, firing and training employer.
This individual understands that they will partner with a Fiscal Intermediary,
who will take on the roll of employer of record for Dept of Labor purposes. In
addition, the FI will support the individual in the areas of HR, payroll,
accounts payable and Medicaid compliance.

The individual will develop a relationship with a self-directed broker. This
broker will take on the responsibilities similar to that of a plan manager. The
broker should understand the goals and life plan of the individual as well as
the individual themselves. The broker should be moldable to the needs of the
individual and the level of support that they will need to be successful. The
broker should review the steps needed to create a successful life plan. These
steps are detailed below.

Person Centered Planning:

The broker and the MSC will work with the individual to identify a circle of
support. This circle should be positive thinkers within the family as well as
friends and neighbors. The broker should help open the individuals mind to
inviting community members that are somewhat involved in the individual’s day to
day. A person centered plan meeting should be scheduled. The meeting should
include all those identified. This meeting should be a brainstorming session
where ideas are born for the individual to take their thoughts and turn them
into concrete actions. This is a multi-sensory experience. As the conversation
is facilitated by the broker, the broker should be mapping out the plan on large
post it papers, using bright colored markers. This allows the members of this
circle the opportunity to fully participate in the creative process. It is
important for the broker and other professionals to balance the words and
thoughts of the individual with those of the well-meaning circle. Focus on the
positive and the can dos. If the conversation takes a turn that is stressful of
counterproductive for the individual the broker should do their best to
redirect. It is important to understand that this is a draining experience for
some and time should be considered.

Habilitative Plan:

The information gathered from the PCP should be compiled and structured into a
narrative. This should be approved by the individual. The pcp should be the
research used to then create valued outcomes. These valued outcomes must be
reviewed and agreed upon with the individual. The broker will then determine
what supports and services need to be implemented for those valued outcomes to
be successful. Professional positions will be identified. Safeguards will be
discussed with the individual and their circle to ensure success of the plan.

The Budget:

There is an assessment called a DDP2, Developmental Disability Profile 2. This
assessment is facilitated by the broker. The outcome of this assessment will
directly determine the overall budget needed for success of the individual’s
life plan. This is referred to as the PRA, Personal Resource Account. This is
consistent with OPWDD mission which includes the language, “the money follows
the people”. Each individuals plan is assessed individually and the budget
should be reflective of the need for support. The budget is a breakdown of the
services that will be required for success of the overall plan. Pay rates are
determined within Medicaid guidelines. This budget is a combination of federal
and state dollars.

Support Services

  • Point Broker: the broker working directly with you and your family
  • Staffing Broker: the broker you or your point broker goes to for staffing needs
  • Financial Broker: the broker that your point broker may rely on to review the monthly financial report and review css11s.
  • Community Broker: the broker you or your point broker goes to for community development needs
  • SMILE point broker will be available to you for all your general and ongoing needs. This will include developing and maintaining of the hab plan. Seek out staff, and interview. Continually train staff. Facilitate circle meetings, ideally every other month, but minimally 4 times a year. Keep attendance sheet and case notes, edit and present to FI. Have an ongoing relationship with the SD coordinator to insure that all necessary documents are in their possession. Connect with the clinician and other professionals on the circle to insure the continued implementation of the behavior plan.
  • SMILE will be prepared to have a broker on call for you staffing needs.
  • The SMILE staffing broker will accept calls and e mails from 8:00 AM thru 6:00 PM Monday through Friday for staffing needs including additional staff needed, replacement staff, as well as subs needed for future dates 2 days out. If an emergency occurs where in which staff is unable to make a shift the next day or the morning of, the SMILE staffing broker will accept text after 6:00 PM thru 10:00PM and as early as 7:00 AM.
  • SMILE financial broker will review the monthly fiscal report to insure that all lines are not being over spent or under spent. The financial broker will connect with the point broker to identify a potential need in moving money. The financial broker will assist and review the needed css11.
  • SMILE community broker will be on hand for individuals who find themselves in need of a creative connection being made to their community. If an individual is seeking an opportunity that may be volunteer in nature of simply a non paid work experience they are able to reach out to their point broker to have a community broker join the circle to assist in developing the needed opportunity. The community broker may be asked to adjust their level of involvement in the circle based on the current need of the individual.