Medicaid Waivers

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OPWDD
Office for People with Developmental Disabilities
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OPWDD
– What is it?
– Eligibility requirements
– How to apply
– Self-Determination
– People First Wavier
By: Kathleen Quinn 516-248-2222 ext. 15
FEGS Health and Human Services
System’s
FAIR Program
Family Advocacy Information and Referral Program
• What is FAIR?
• What services does FAIR provide?
• What are OPWDD’s Family Support
Services (FSS)?
• How can FAIR help you and your
family?
Stacey Astachovsky, MSW
sastachovsky@fegs.org
516-496-7550, ext. 240
• 1) Supplemental Needs Trusts
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▪ What are they and how do they work?
▪ Coordination with an estate plan
▪ Different types of supplemental needs trusts
▪ Strategies for funding the trusts
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• 2) Government Benefits for a Disabled Individual
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▪ SSI vs. SSDI – rules and eligibility
▪ Medicaid – why it is so important
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• 3) Guardianship
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▪ What it is and why it’s needed
▪ SCPA 17A Guardianship
▪ Article 81 Guardianship
F∙E∙G∙S
Health and Human Services System
Medicaid
 Overview
• An insurance program funded by the federal and
state governments for individuals who can not
afford medical expenses based on their household
income
 Eligibility
 OPWDD services funded by Medicaid
 Medicaid Buy-In program
Jamel White, MSC Supervisor
jwhite@fegs.org
631-691-7080 Ext. 312
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Medicaid Waivers
 Overview
• State authorization that waives Federal limitations and
enables a specific class of people to receive services that
Medicaid usually does not provide.
 Eligibility
 Examples of New York State Medicaid Waiver Programs
• Lombardi – Medically fragile individuals
• Traumatic Brain Injury (TBI)
• Nursing Home Transition and Diversion (NHTD)
• Care-At-Home
• Home and Community Based Services (HCBS)
• 1115 People First Waiver
FEGS Health and Human Services System
5
Supplemental Security Income (SSI)
 Overview
• Supplemental Security Income (SSI) is a Federal
income supplement program funded by general tax
revenues that helps aged, blind, and disabled people,
who have little or no income by providing cash to
meet basic needs for food, clothing, and shelter.
• Administered by the Social Security Administrations
 Eligibility
 Application process - (paper or electronic)
FEGS Health and Human Services System
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Why do I need a Medicaid Service Coordinator (MSC)?
By: Celeste Grant, MSC Sr. Program Mgr. Head Injury
Association
• Assists with obtaining & maintaining benefits (i.e. Medicaid, SSI)
• Assists with application process for various programs (day
habilitation, community habilitation, residential habilitation,
supported employment, medical services, transportation services,
recreational/respite, etc.)
• Refers to various community resources (i.e. legal services for
guardianship, SNTs)
• Develops & maintains Individualized Service Plan (ISP) –
prescription for services: reviewed/updated every 6 months; includes
background information, valued outcomes, lists Medicaid & HCBS
waiver services
• Meets/contacts regularly with son/daughter to ensure all needs are
being met
• Advocates for son/daughter in order to help them to live productive
lives in the community according to their own dreams & desires
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Wavier Programs
By: Alana de Sciora
Residential Services
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ICF- Intermediate Care Facilities
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IRA- Supervised Individualized Residential Alternatives
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SUPPORTIVE IRA- Supportive Individualized Residential Alternatives
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ISS – Individualized Support
Services
Community Services
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Community Habilitation
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Hourly Respite Programs/ Recreational Respite Services
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Overnight Respite Services
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Crisis Residence
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Mobile Crisis Services
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30 day Assessment House
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Medicaid Service Coordination
Day Services
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Day Habilitation Sites
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PWW( Program Without Walls) Community based day programs.
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Traditional Day Programs
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Supportive Employment
ACCES by: Marlene Johnston
ACCES-VR works with students, families and school districts to coordinate appropriate services for
students with disabilities who are leaving secondary education and entering adult vocational
rehabilitation and related services. These efforts are crucial to enable students to achieve
maximum success in post-school activities consisting of integrated employment (including
Transition services are a coordinated set of activities for secondary students with disabilities,
designed to achieve specific outcomes, which promote movement from school to post-school
activities.
The coordinated set of activities is based upon the individual student's needs, taking into account
the student's preferences, potential, abilities and interests. These activities include
instruction, community experiences, the development of employment and other post-school
adult living objectives, and, when appropriate, acquisition of daily living skills and functional
vocational evaluation. The goal of transition services is not simply a referral to ACCES-VR,
but rather post-secondary education, adult education and training, adult services,
independent living, community participation, a specific job or career, and/or integrated
community living.
The goal of transition services is to ensure that students with disabilities are prepared for
employment, post-secondary education, or community living when they leave school. As a
participant in this process, the ACCES-VR counselor can:
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Contribute knowledge of rehabilitation services and outcomes;
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Identify the need for involvement by other state agencies, adult service programs,
independent living centers and community based services whose resources can assist
students with disabilities, their families and educational personnel during the transition
planning and service delivery process;
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Provide information to assist in the selection of suitable vocational goals that are consistent
with labor market needs and integrated community living opportunities, including providing
information about: work site accommodations; employer expectations; labor trends and
occupational outlooks; job entry qualifications; job placement analysis; and other vocationalrelated issues.
DAY HABILITATION
WHEN TO START LOOKING
In junior year attend as many open houses as you can
WHAT TO LOOK FOR
Evaluate your son's/daughter's capabilities
Community vs center based program
Level of assistance your child needs
Staffing ratio and availability of clinical staff
PAPERWORK REQUIREMENTS
Completed agency or universal application with supporting documentation
SCREENING PROCESS
In person interview on site
ASSESSMENT PROCESS
Individual attends program for designated time and participates fully to
determine if they are a good fit for the program
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By: Florence Faga
YAI - Long Island Employment Services
By: Madeline Rosensweet
• About YAI
• Long Island Employment Services Programs
– Pre-Vocational Services/Day Habilitation Without
Walls
– OPTS Vocational Program
– Supported Employment
– Eligibility
– Contact Bonnie Holtzman, Program Supervisor, at
(516) 338-9264 or email at
bonnieholtzman@yai.org
Special thanks to the committee
that coordinated tonight’s event:
Administration:
John Felicciardi, Director of Special Education and Pupil Personnel, BMCHSD
Ivy Cohen, District Chair of Special Education, BMCHSD
David Seinfeld, Principal, Calhoun High School
Emily Paluseo, Chairperson of Special Education, Calhoun High School
SEPTA Committee:
Jerry Clare, President Paula Stillwaggon, Secretary
Ellen Carr
Meryl Yoffe
Ellen Proszak
Michelle Walsh
Alissa Blowers
Melissa Joy
Susan Astre
Social Work Interns:
Karen Yorio
Lauren Eastman
Secretarial Support:
Patty McGrath
Technical assistance:
Paola LoPiccolo
Custodial assistance
Leonard Heide and staff
Special thanks to the committee
that coordinated tonight’s event:
Special thanks to our Student Volunteers
Erin Murphy
Carly Schoenfeld
Ashley Florscher
Derek Ha
Tomer Yoffe
Maria Mazzeo
Kevin Flay
Justin Katzman
Ricky Beneventano
James Roeder
Frank Badalamenti
Nicholas Astre
Student Photographer
Vinny Ruvolo
Ashley Gitlitz
Special thanks to our Calhoun Clubs
Express Yourself, Ms. Simson
Prep Computer Club, Ms. Funk Ms. Blowers
Prep Entrepreneur Club, Ms. Joy & Ms. Natof
Daily Living Skills Class, Ms. Blowers
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