What is PCS of WNY? • Person Centered Services of Western New York (PCSWNY) is a collaborative organization established by a group of local nonprofit service providers for people with developmental disabilities. • PCSWNY was established to respond to New York State’s People First Waiver program. • Comprised of ten developmental disabilities agencies throughout Buffalo, Rochester, and Finger Lakes working together to build a stronger and sustainable healthcare & service environment for the individuals and families we serve. PCS of WNY Board Members Buffalo/WNY • Aspire of WNY, Inc. • Cantalician Center for Learning Inc. • Community Services for Developmentally Disabled Inc. • People Inc. • Suburban Adult Services Inc. Rochester • Heritage Christian Services Inc. • Hillside Family of Agencies • Holy Childhood • Lifetime Assistance Inc. Finger Lakes • Pathways, Inc. People First Waiver • The People First Waiver will allow OPWDD to craft a new, more efficient system design that will protect the health and safety of all individuals while increasing the effectiveness and sustainability of supports and services for future generations. • New design will provide managed care through the establishment of managed care organizations called DISCO’s. • Why Managed Care? What is a DISCO? • Developmental Disabilities Individualized Support and Care Coordination Organization (DISCO) • The DISCO will function as a fiscal intermediary and service delivery network providing comprehensive Care Coordination to individuals with disabilities and their families. • DISCOs will be equipped to serve individuals with all levels of need by providing supports and services directly or indirectly through sub-contracts with provider agencies. DISCO Services OPWDD Auspice Services DOH Auspice Services OMH/OASAS Auspice Services • • • • • • • • • • • • Voluntary Operated OPWDD Comprehensive Waiver Services Voluntary Operated Day Treatment Voluntary Operated ICF/MR Art 16 Clinic Services: OT, PT, SLP, Clinical Social Work, Psychology, Nutrition, Rehab, Counseling, Podiatry, and Dentistry. Care Coordination provided by the DISCO • • • • • • • • • Adult Day Health Care Assisted Living Facility Dentistry DME and Hearing Aids Home Care (nursing, Home Health Aide, PT, OT, SLP, nutrition, Medical Social Services and associated ancillary services such as home delivered meals and social day care) (offered under any auspice: hospitalbased, nursing ho me-based, and free-standing programs) Non Emergency Transportation Optometry, Eyeglasses OT, PT, SLP Personal Care Personal Emergency Response System Private Duty Nursing Psychology and Clinical Social Work Respiratory Therapy Skilled Nursing Facility • • • OASAS Inpatient OMH Institutional Program (PC/RTF) and private psychiatric hospitalizations Psychology and Clinical Social Work. OMH day treatment PROS Coordinated Assessment System • Universal Assessment Tool - interRAI Assessment Suite o Consists of 16 separate “domains” o Each domain will contain specific items o Items will identify information to be gathered • Assessments will be conducted by trained specialists employed by the State. • Assessments will be person-centered and involve individuals, family, staff, clinical team, records, and observations. • Assessment Supplements Coordinated Assessment System Phasing Plan of Coordinated Assessment System Phase I Select Case Studies Phase II DISCO Pilot Project Participants Phase III Individuals newly entering the service system Phase IV Over time, assessments will be conducted for individuals who currently receive services. The purpose of the new assessment system is to help identify opportunities for greater integration and independence based on strengths, needs, and individual interests. Functions of Care Coordination Linkage and Referral Eligibility and Benefits Maintenance Advocacy Cost Management Care Planning Central Point of Contact Coordination with Providers Assessment Record Keeping Monitoring Geographic Breakdown PCS of WNY Intent • A Gateway to Choice… • The future DD service system will be driven by missionbased, experienced service providers, using a network of providers that embrace a person-centered philosophy and maximize efficiencies while protecting what is unique and important to serving people with developmental disabilities. Mission and Vision MISSION Person-Centered Services of Western New York is applying to be one of the first Developmental Disabilities Individual Support & Care Coordination Organizations (DISCO) in New York State and the first serving the 17 counties of Region 1. VISION All individuals in Region 1 with developmental and/or intellectual disabilities will have access to the residential and direct services they require - including care coordination, mental health and physical health – and the greatest possible choice of quality providers. Goals of PCSWNY Appropriate access to care Assume risk Results-based New ideas Guiding Principles for Agency Participants • Maintain respect for the identity and continuity of all agency participants while working together toward the best possible regional approach. • Preserve respect for the values and principles of our various network providers. • Uphold confidentiality while maintaining openness to sharing of information that is necessary for moving forward in a collaborative manner. Guiding Principles for Service Delivery • Ensure that the individuals who are receiving and/or needing services in the forefront of our planning o Better outcomes o Better supports o Person-centered • Seek inclusion and diversity in governance and networks along with the capacity to support the entire region. • Understand that participating agencies will be moving forward with other options within the DISCO environment Organization of PCS of WNY OPWDD Other DISCO(s) Advisory Board Network – DD (17 counties) Network – Non-DD Why PCS of WNY? No outside organizations Maximize choice Competitive environment Connections to the region Advantages of PCS of WNY • Geographic distribution – across 17 Region 1 counties • Established networks and relationships of the founding members • Combined service portfolio of founding agencies • Two Compass agencies (Heritage Christian Services, People Inc.) • Senior and housing services • Prepared to be an early adopter; we can move as fast as OPWDD requires Next Steps • Network Development o DD Agencies o Other Providers • Education • Pilot DISCO Application Timeline for Transition DISCO Pilot Phase Full Implementation (Non-Pilot DISCO Roll out Services Included OPWDD and DOH long-term supports and services and other behavioral supports OPWDD and DOH long-term supports and services and other behavioral supports – to phase into comprehensive services over time Initial Enrollment November 2013 November 2015 Questions? Contact Information Sara Randolph Director of Business Development 716.817.7415 sara.randolph@pcswny.com Tess Fraser Director of Marketing 716.817.7496 tess.fraser@pcswny.com Website: www.pcswny.org www.facebook.com/PCSWNY