Self-Direction – A service offered by OPWDD
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.