People First Waiver - Home
About the People First Waiver Webpage
Welcome to the New York State People First Waiver Application Resource Page. The State Office for People With Developmental Disabilities (OPWDD), in consultation with the State Department of Health (DOH) and other stakeholders, has begun the process of seeking significant programmatic and fiscal improvements to our service system through the development of a new waiver, called the “People First Waiver.” This Web page provides information to those who are interested in the waiver application process and would like to contribute to the effort.
Concurrent 1915(b)/(c) Waivers
Based on feedback during negotiations with the Center for Medicare and Medicaid Services (CMS), OPWDD is seeking federal authority to operate a 1915 concurrent (b)(c) waiver that will allow the State to provide traditional long-term care benefits (like home health, personal care, and institutional services), as well as home and community-based 1915(c) services using a managed care delivery system, rather than fee-for-service.
States can operate concurrent 1915(b) and 1915(c) waivers as long as federal requirements for both waivers are met. States must submit a separate application for each waiver and satisfy all of the applicable requirements. Each waiver is approved for its respective time period, as such, OPWDD is working toward the approval of both applications as described below.
Application for a 1915(c) Home and Community-Based Services Waiver
OPWDD submitted the 1915(c) Home and Community Based Services (HCBS) Waiver Renewal application for the OPWDD Comprehensive Waiver on July 1, 2014. The desired effective date is 10/1/14. This application is under negotiation with the Federal Centers for Medicare and Medicaid Services (CMS), and therefore subject to updates and revision resulting from these discussions. Please refer to the following link to access the draft document:
The HCBS Waiver Application contains the HCBS Settings Transition Plan. For more detailed information on this topic please go the HCBS Waiver Setting page available at http://www.opwdd.ny.gov/opwdd_services_supports/HCBS/home
Application for 1915(b) Waiver Application
OPWDD continues to work toward the finalization of the 1915 b Application which will establish federal authority for Developmental Disabilities Individual Support and Care Coordination Organizations (DISCOs) to operate managed care beginning October 1, 2015. In preparation for this start date, OPWDD has released the Application for a Certificate of Authority for DISCOs/Start-up Grant Application. This comprehensive document will be used to qualify organizations that have met the criteria for becoming a DISCO and have applied to participate in the program. This document also includes criteria that will be used to award DISCO managed care start-up grants to eligible organizations as outlined in the Request for Grant Applications Managed Care Start-Up cost for DISCOs section of the “Becoming a DISCO” web page that can be accessed at: http://www.opwdd.ny.gov/opwdd_services_supports/people_first_waiver/Becoming_a_DISCO.
Home and Community Based Settings Standards
The Centers for Medicare & Medicaid Services (CMS) have issued regulations that define the settings in which it is permissible for states to pay for Medicaid Home and Community-Based Services (HCBS). The purpose of these regulations is to ensure that individuals receive Medicaid HCBS in settings that are integrated in and support full access to the greater community. This includes opportunities to seek employment and work in competitive and integrated settings, engage in community life, control personal resources, and receive services in the community, to the same degree as individuals who do not receive HCBS.
A description of OPWDD’s HCBS Settings Transition Plan as required by CMS’s recently adopted rules that contain standards for home and community based settings and that require the State to submit a transition plan at the time of an HCBS waiver renewal is available at: http://www.opwdd.ny.gov/opwdd_services_supports/people_first_waiver/news/application-1915c-home-and-community-based-services-waiver.
OPWDD has created a designated web page on this topic that can be accessed at the following link: http://www.opwdd.ny.gov/opwdd_services_supports/HCBS/home.
Public Outreach & Input
OPWDD has conducted several outreach opportunities for stakeholder input related to the HCBS Settings Transition Plan and the OPWDD’s 1915 (c) Comprehensive Home and Community Based Services (HCBS) Waiver Renewal. Specific activities include:
The March 2014 Joint Discussion Board/Provider video conference providing an overview of the Waiver and the HCBS Settings ruling as outlined in the sessions PowerPoint Presentation available on the OPWDD Webpage at http://www.opwdd.ny.gov/node/5253. A follow-up Question and Answer document reflecting public input received on the HCBS Transition Plan and changes to the waiver application posted at the following link: http://www.opwdd.ny.gov/node/5514.
A June 30, 2014 Joint Discussion Board/Provider video conference also outlining People First Waiver activities including the transition plan that can be accessed at http://www.opwdd.ny.gov/node/5464.
On May 2, 2014, OPWDD provided public notice and requested the receipt of public comments for consideration regarding OPWDD’s anticipated HCBS Settings Transition Plan and the OPWDD’s 1915 (c) Comprehensive Home and Community Based Services (HCBS) Waiver Renewal scheduled for renewal on October 1, 2014. A summary of the comments received are posted to the webpage and can be found at http://www.opwdd.ny.gov/opwdd_services_supports/people_first_waiver/news/hcbs-waiver-renewal-responses-public-comment. In addition a separate response to public comment on the HCBS Waiver Setting Transition Plan is available at http://www.opwdd.ny.gov/opwdd_services_supports/people_first_waiver/news/HCBS-SettingsPublicComments.
And most recently, OPWDD posted to its website on August 1, 2014, the Home and Community Based Services (HCBS) waiver application for the OPWDD Comprehensive Waiver which included the HCBS Settings Transition Plan. As part of this public comment period OPWDD has scheduled a Webinar for stakeholders to hear an overview of waiver changes. This presentation will be shared and a summary of questions and comments raised during the WebEx and throughout the comment period will be shared on the People First Waiver page. For additional information please refer to the following link: http://www.opwdd.ny.gov/opwdd_services_supports/people_first_waiver/news/hcbs-settings-transition-plan-and-1915c-renewal-application-webex-sessions The response to the questions and comments received during the August 1, 2014 public comment period is available here: http://www.opwdd.ny.gov/opwdd_services_supports/people_first_waiver/news/ResponseToPublicCommenOn TheOPWDDComprehensiveWaiver