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Hamaspik Leaders Headline ‘CCO Summit’ on Big State Changes to Disability Industry OPWDD Acting Comm. Delaney Keynotes; Hamaspik Choice CEO Bernath Tops Panel

June 19, 2017            

By Mendy Hecht, Hamaspik Gazette

First it was “People First.”

 

Now it’s “People First Care Coordination.”

 

The former, implemented in recent years, reflects New York State’s official philosophy towards people with disabilities.  It reflects the ongoing national abandonment of phrases like “disabled people,” emphasizing humanity first and disability an increasingly-distant second.

 

The latter, a project spearheaded by New York State OPWDD Acting Commissioner Kerry A. Delaney, builds on that positive proactivity with progress of its own—by integrating and aligning the parallel paths of disability service coordination and health and wellness coordination.

 

In a state whose agencies repeatedly make history, New York State’s disability and health public-service bodies are poised to do it again—with the impending launch of People First Care Coordination.

 

That vast new project will pool the resources of both the New York State Office for People With Developmental Disabilities (OPWDD) and the New York State Dept. of Health (DOH).

 

And to understand how this watershed change will affect their beneficiaries and staff, hundreds of disability support industry leaders and other professionals from across New York State met June 13 at Manhattan’s Radisson Martinique on Broadway for an empowering, informative day-long summit.

 

The conference’s keynote address was delivered by Acting Commissioner Delaney, and a key panel discussion was led by professionals from Hamaspik.

 

What’s managed care?

Entitled “Navigating the Future: How Coordination Changes Care,” the event saw industry authorities from New York’s public and private sectors walk guests through the next big thing.

 

That big thing, of course, is the advent of People First Care Coordination—specifically, the care coordination organization (CCO) that is both its vehicle and engine under the hood.

 

When People First Care Coordination—currently in its earliest planning stages—eventually goes live, New York’s supports for individuals with disability will have shifted to CCOs.

 

To explain: In New York State, Medicaid Service Coordination (MSC) is the axis of the numerous disability supports currently provided statewide by non-profits like Hamaspik.  

 

For decades, Medicaid Services Coordinators (MSCs) have been the heart of the OPWDD, whether employed by Hamaspik or directly by the state—answering questions, providing support and otherwise advocating for each individual getting disability-related services.

 

Under People First Care Coordination, MSCs will do the same for health services, too.

 

For starters, non-profit MSCs will be transitioned out to work for CCOs, independent new non-profits that only provide Medicaid Service Coordination so as to avoid conflicts of interest. 

 

As independent, conflict-free employees of the new CCOs, non-profit MSCs will then be empowered by the new OPWDD/DOH partnership to preside over each individual’s Life Plan.

 

The Life Plan is basically a document detailing each individual’s basic information, personal life goals, and OPWDD services—with the critical new addition of physical, behavioral health and other healthcare/wellness services as provided through Medicaid by the Dept. of Health.

 

The Life Plan will significantly expand upon the Individualized Service Plans (ISPs) currently used in the OPWDD community—supported by improved information technology and allowing multiple providers to share important information, according to the Acting Commissioner.

 

“People First Care Coordination will retain the best of the current system of Medicaid Service Coordination,” Ms. Delaney wrote in a June 30 letter, “while building upon it to offer individuals and families a more comprehensive way of managing their services and supports.”

 

The CCOs are a primary vehicle for the OPWDD’s plans to change to managed care.

 

What is managed care?  Put plainly, disabilities services provided by the OPWDD, or by partner non-profits like Hamaspik, are paid for by Medicaid.  That state-federal program simply pays the services bills submitted by the OPWDD or Hamaspik—or “fee for service” in industry jargon.

 

Under managed care, though, each individual is allotted a maximum monthly stipend of sorts. 

 

Under reforms implemented by Gov. Andrew Cuomo’s Medicaid Redesign Team (MRT), the cost-cutting, care-enhancing payment model is already in use with managed long-term care (MLTC) plans—specialized healthcare plans for dual Medicare/Medicaid members needing nursing-home levels of care at home.

 

Meeting of minds

Hosted by The Bonadio Group, a Rochester-based CPA and consulting firm, the event brought together disability non-profit executives and program directors, industry experts and OPWDD Acting Commissioner Delaney for insiders’ insights on embracing coming change.

 

After morning registration and continental breakfast, Bonadio Group CEO and Managing Partner Thomas Bonadio welcomed the crowd and introduced the event’s objectives.

 

Arthur Webb, owner and principal of the eponymous Webb Group, Ltd., next shared “Confessions of an Optimist,” the title of his take on “Making Sense of Managed Care and Care Coordination.”

 

Because a critical part of transitioning to CCOs is the moving of MSCs to said CCOs, effectively closing down MSC departments at providers statewide, a panel discussion on that transition—and how to best strategize for it—was held next.

 

Panelists were: Bonadio Group partner Gerald Archibald; Donna Colollna, President/CEO of Services for the UnderServed; Anna Keith, VP of IDD Product Development and Implementation at LifeShare; and the OPWDD’s Katherine Marlay, Deputy Director of Person Centered Support and Director of its People First Waiver Implementation Unit.

 

The hour-long panel was moderated by Stephen Freeman, President of the Stephen Freeman Group, LLC.

 

But with the new services delivery model will come a new Person Centered Individualized Service Plan (ISP), the critical document that details the specific wishes, needs, goals and more of each individual getting OPWDD services and supports.

 

The ISP is typically prepared by the individual, with support primarily by the MSC, and backed by his or her caregivers and family members (who are often the same people).  But with MSC services now to be absorbed into CCOs as part of managed care, the OPWDD will be deploying the revamped Life Plan ISP documentation.

 

Helping participants understand how the Life Plan works was Consultant Dr. Jan Abelseth and Chief of Care Coordination Karleen Haines, both of the Partners Health Plan of CareDesign NY.

 

The CareDesign NY presentation was followed by a networking luncheon for presenters and participants alike.

 

Acting Commissioner Delaney of the OPWDD took the floor following lunch for a birds-eye view of Care Coordination.  Her presentation, reflecting the former disability attorney’s record of innovation since assuming state-agency leadership, conveyed not just the whats and whens but the whys of the changes, too—giving listeners first-hand knowledge of exactly what to expect.

 

Hamaspik Choice was up at bat next.

 

In a panel discussion entitled “Back to the Future,” agency mainstay Yoel Bernath and colleagues presented on how their collective century-plus of experience allowed an agency “with OPWDD roots” to transition “from provider to payer,” and the lessons learned on the way.

 

Mr. Bernath, currently serving as Executive Director of the successful and growing Hamaspik Choice managed long term care (MLTC) plan, was flanked at the dais by Director of Clinical Management Chaya Back, R.N., Director of Strategic Planning Bob Manley, R.N. and Regional Manager of Business Development Maureen White.

 

In their 30-minute discussion, the MLTC contingent talked about Tri-County Care, the CCO sponsored by the New York State Hamaspik Association (NYSHA)—and how the collective industry experience and authority behind it culminates in an agency perfectly poised to realize the OPWDD’s newest transition mission.

 

Framed against the bigger picture, Bernath and colleagues touched upon non-profits’ continuity of care for beneficiaries and job retention for staff as they gear up for the transition—as well as CCOs that share their philosophy, mission and vision.

 

In a timely presentation that followed, Bonadio Group Principal Brett Coburn discussed “Data Security in a World of Change”—talking, among other things, about the massive “ransomware” attack that hit Great Britain’s healthcare system recently, and how providers here could prevent similar attacks.

 

Steven Vernikoff, Executive Director of the Center for Family Support and Board President of the Advance Care Alliance (ACA), spoke next about provider collaboration—how providers can not just survive but thrive under the waves of coming industry changes.

 

“Care Coordination Organizations—Transition to a Managed Care Environment” was the conference’s closing session.  Presented by Bonadio Group principal Gerald Archibald, the session recapped the day’s proceedings and laid out a vision of what the near future would be.  That final session was followed by a 20-mnute Q&A.

 

Looking to the future

In a May 5th letter this year about CCOs to the entire OPWDD community, Acting Commissioner Delaney wrote that her agency “will continue to support providers and the MSCs throughout this process.”

 

And in her June 30th missive, the Acting Commissioner wrote that “with your support and insight, we can move into the future under a framework that offers more flexibility and choice and preserves the great gains made for New Yorkers with developmental disabilities over the past forty years.”

 

But her personal presentation to the industry’s movers and shakers, that process and framework—made more understandable by presenters like Hamaspik Choice’s Tri-County Care—is now less daunting.