Implications for New York
The New HCBS Waiver
Community Settings Definition and
The Rhode Island Settlement
NYS-APSE Annual Conference
May 5, 2013
Presented by Ceylane Meyers-Ruff and Tonya Obey
Today
IS NOT
• A typical presentation about
OPWDD employment policy
• Just an update on the new
CMS Regulation and Rhode
Island Settlement
IS
• Opportunity to think about
the implications of 2
significant federal policies
• Opportunity to have a
discussion about how these
national trends could
impact the future of DD
services
• Brainstorm ways to prepare
for possible changes in the
future
2
CMS Home and Community Based
Setting Requirements
A Home and Community Based Setting:
• Is integrated in and supports access to the greater
community
• Provides opportunities to seek employment and
work in competitive integrated settings, engage in
community life, and control personal resources
• Ensures the individual receives services in the
community to the same degree of access as
individuals not receiving Medicaid home and
community based services
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Settings PRESUMED NOT to be Home
and Community Based
• Settings in a publicly or privately owned
facility providing inpatient treatment
• Settings on grounds of, or adjacent to, a public
institution
• Settings with the effect of isolating individuals
from the broader community of individuals
not receiving Medicaid HCBS services
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Timeline
January 2014- Final Regulation Released
March 2014- Final Regulation Took Effect
April 2014 – Present
• Awaiting CMS guidance on the impact on day
services
• CMS guidance will shape OPWDD guidance
• Now is the time to start thinking about the
possible implications of the regulation
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Implications of HCBS Community Settings
Definition
1. What does this mean for employment placements
and how we currently define competitive
employment ?
2. How should this impact the way we think about
prevocational services?
3. What could this potentially mean for day hab?
4. What do we need to start doing differently today in
order to prepare ourselves for the future?
6
Dept of Justice and Rhode Island
Settlement
1. Consent Decree covering 3,250 individuals with DD
over 10 years
2. Supported employment placement for 2,000
individuals including:
 At least 700 people currently in workshops;
 At least 950 people currently in facility-based nonwork programs
 Approx 300-350 students leaving high school
 Transition services for 1,250 youth ages 14-21
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Rhode Island Dept of Education
• Adopt an Employment First Policy
• Implement school to work transition planning
with specific timelines and benchmarks for
youth age 14-21
• Including: integrated vocational and
situational assessments, trial work
experiences and other services
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Supported Employment
Requirements
Supported employment placements must be in
integrated employment settings where people:
• Are paid at least minimum wage,
• Work the maximum number of hours consistent
with their abilities and preferences, and
• Interact with peers without disabilities to the
fullest extent possible.
9
Work Hours
As a group (not individually), persons receiving
supported employment placements under the
consent decree will average 20 hours of work
per week in integrated employment settings.
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Non Work Activities
All persons receiving supported employment
placements will also be provided with
integrated non-work services, ensuring that
individuals have access to integrated work and
non-work hours for a total 40 hours per week.
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Maintaining Site Based Day Hab
To ensure informed choice, individuals with I/DD
may remain in segregated programs if they
request a variance after they have received a
vocational assessment, a trial work experience,
outreach information and benefits counseling.
• Does this only apply to day hab?
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Other Components of the Agreement
1. Outreach, Education and Support to the benefits of
supported employment
2. Creation of an Employment First Task Force comprised of
stakeholders
3. Creation of a Workshop Conversion Institute to assist
providers in converting to SEMP services ($800,000 for start
up costs and TA training assistance for providers
4. MOU between DD, Education and VR agencies
5. Reallocation of workshop funding to SEMP and integrated
day services (money follows the person w/o increased cost)
6. Funding must include transportation and adequate job
coaching supports (including none face to face activities)
7. Quality Assurance and Data Collection
Implications of Rhode Island
Settlement
1.
2.
3.
4.
What does this mean for employment placements?
What does this mean for prevocational services?
What could this potentially mean for day hab?
What do we need to start doing differently now to
prepare ourselves for the future?
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Contact Information
• Ceylane Meyers-Ruff
ceylane.meyersruff@opwdd.ny.gov
Tonya Obey
Tonyamaree.obey@opwdd.ny.gov
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