Navigating the landscape of gaining supports and services for yourself or a loved one can be an exciting and overwhelming undertaking. The process begins with determining if you are eligible for services through the Office of People With Developmental Disabilities (OPWDD). Care Coordination Organizations (CCO) refer to this as the intake and eligibility process. With eligibility determined, or at least in process, CCO like Southern Tier Connect can begin connecting you with service providers offering programs across our fourteen county region, and finding the supports that will increase and maintain the quality of your life.
We are going to provide some insight on what the intake and eligibility process looks like with Southern Tier Connect. If you or a loved one is ready to learn more about accessing services, this article can serve as a primer to the process. Southern Tier Connect Care Coordination Supervisor Betty Davis reminds us that this is a general overview of course, “and no one person is going to have the same intake and experience as the next; Southern Tier Connect is proud to provide individualized Care Coordination to everyone who chooses our services!”
Step One: Getting to Know You
The first step for anyone who contacts Southern Tier Connect will be to get acquainted; we will need your name, date of birth, address, and social security number. This will also be when we find out if you or your loved one have contacted OPWDD through The Front Door. The Front Door is a crucial step is wherein NY State determines eligibility and ultimately approves services. If you have not yet started the Front Door process, Southern Tier Connect will further explain it. If you have started the Front Door process, we obtain a little more information about what you have already completed with OPWDD.
Step Two: Sharing Information
After getting to know you or your loved one and walking you through the Front Door, Southern Tier Connect will start collecting required permissions, evaluations, and forms. First, we will need a release signed so we can share pertinent information with OPWDD and service providers on your behalf. We will also need reports or evaluations that have been completed, as well as any documentation of a qualifying diagnosis of an intellectual or developmental disability. If these documents are not readily available, Southern Tier Connect will assist you in securing these documents.
When all required paperwork is collected, it is submitted to OPWDD for an eligibility determination. If there are gaps or questions, you might receive a letter asking for more information. If a sufficient amount of information is provided, a form is sent to Southern Tier Connect that is then submitted to you or your loved one’s Medical Doctor for signature.
As a general reference, here is a checklist of common documents that are needed to establish eligibility. Please remember that this is in no way exhaustive, but instead is a starting point for Southern Tier Connect as we meet with you and/or your loved one.
Step Three: Medicaid
If not already completed, the next step is applying for Medicaid. If you are seeking care coordination for a child, a parental deeming letter from OPWDD is necessary. This document informs the local Department of Social Services that OPWDD has determined that your child is eligible for services and that parental income should be excluded in the Medicaid application process.
Simultaneously, Medicaid will make a determination of disability and require documentation. Many of the documents needed for this process will be the same that were supplied to OPWDD during the Front Door process. Of course, Southern Tier Connect is here to help throughout these steps.
Step Four: Be Patient
The intake and eligibility process can be lengthy; sometimes taking upwards of 3-6 months for Medicaid alone. During this waiting period, we are available to answer questions, and there are Regional Family Council Meetings which take place. These meetings provide families with the opportunity to connect with each other and discuss emerging issues or opportunities with our Care Coordinators. Additionally, potential service provider options can be discussed, though no formal planning can take place until Medicaid is approved. After Medicaid is approved, Southern Tier Connect can register as the CCO of choice for you or your loved one and file for the start of Care Coordination!
We Are Here To Help
Reach out today, and you will connect with Administrative Assistant Danielle Jaszcar. She is happy to answer initial questions, begin processing paperwork, and will let a Care Coordinator Supervisor know that you are looking for Care Coordination. To further improve the intake process, Southern Tier Connect is currently searching for an Intake and Eligibility Coordinator. The addition of this key team member will bring an even more focused approach to this complicated and highly personal process. If you or someone you know has a working knowledge of the systems and processes outlined in this article, a friendly disposition to welcome families and individuals to Southern Tier Connect, and meet the minimum qualifications, apply today!
Step Five: The Life Plan
As CCO, Southern Tier Connect moves forward with the Home and Community Based Waiver Application to secure your services. A Care Manager or Care Manager Supervisor will meet with you, your loved one, and family to develop a Life Plan. The Life Plan is a comprehensive document which is used to identify your goals, skills, needs, and desires, and to determine the path you wish to take to advance your life to the fullest of your abilities. It also lists which supports and safeguards are necessary for achieving your goals and desires, as well as reflecting on what services and supports have been used in the past. This is a crucial time for self-advocacy in stating goals, hopes, and requirements.
Step Six: Your Services
Once created, the Life Plan, along with supporting documentation is submitted to OPWDD for approval of waiver services. Services could be, but not limited to, Respite, Community Habilitation, Self-Directed Services, Day Habilitation, along with a growing variety of medical and social programs.
The intake and eligibility process can seem daunting, but Southern Tier Connect is here for you; if you are ready to learn more, please contact us today!