Sept. 28th Deadline! IDGS Service Documentation Rule Changes
Urgent Deadline Approaching! IDGS Rule Changes!
We are calling on OPWDD to withdraw ADM #2015-05R2 IDGS Service Documentation and make corrections to increase transparency and reduce this proposal’s systemic barrier to true self-determination and choice!.
The proposal requires Fiscal Intermediaries to certify that a request "does not duplicate Medicaid State Plan, HCBS Waiver, or other public funding". The proposal also names duplication as a reason to deny services in 4 different places. Unfortunately, the ADM fails to define duplicative. Without a concrete, measurable definition, FIs are disposed to being overly cautious in denying self-directed services out of fear of audits and clawbacks. A clear, measurable definition of duplicative will support the important work of FI’s across the State.
Together We Can Fight Back
Public Comment on This Rule Change is Ending Monday Sept 28th. You must act now! Our Community needs more flexibility and less bureaucracy!
Please take just a minutes or two to send an email to rau.unit@opwdd.ny.gov. You need to write “ADM #2015-05R2 IDGS Service Documentation” in the subject line so OPWDD knows you’re writing about this issue. And please, we’d love you to CC: us on your email at info@c4sd.org to show our solidarity and to help organize our voice!
Share your comments and your lived experience, and while you’re at it, we’d love you to include these suggestions for a more effective and individualized approach:
OPWDD has an affirmative responsibility to supply a definition of duplicative. The Center for Medicaid Services (CMS) has clearly defined covered, non-duplicative services as distinct when "the scope of the waiver coverage is materially different," "the providers of the waiver service are different," or "the method of service delivery is different."
Ask OPWDD To - Include a clear, measurable definition of duplicate services that aligns with the CMS definition above.The proposal creates an unreasonable and unnecessary barrier to community participation by now requiring Community Classes to "support increased independence or reduce the need for staff assistance." This restriction contradicts the ADM's definition of a community class as one "in any subject area that relates to a person's valued outcomes."
Ask OPWDD To - Remove this new requirement and expand opportunity for choice and self-determination.The proposal fails to support and require due process by not requiring a Notice of Decision (NOD) that tells people who are denied IDGS services about their right to a Fair Hearing. Of the 90 different reasons for denial of IDGS services just one of those requires a Notice of Decision; one that almost never occurs. The internal Dispute Resolution and Administrative Review process in the policy is welcome but not sufficient.
Ask OPWDD To - Require that a written, formal Notice of Decision by given to all applicants who are denied IDGS services.