PEF leader emphasizes member input in OPWDD plan
By DEBORAH A. MILES
PEF leaders remain vigilant when the state develops plans that exclude the expertise of professional PEF members, promote privatization and could possibly deteriorate the level of care for vulnerable consumers.
Randi DiAntonio, a PEF Executive Board member, was among the dozens of people who testified September 25 at a state Office for People With Developmental Disabilities (OPWDD) public hearing/statewide video conference.
DiAntonio is a licensed master social worker at Finger Lakes Developmental Disabilities Services Office in Rochester. She testified on behalf of PEF-represented OPWDD staff statewide as a representative of PEF’s labor-management committee.
“We remain skeptical about the use of Medicaid Managed Care organizations or Care Coordination Organization Health Homes,” DiAntonio said. “PEF supports the general idea of care coordination, as the state workforce plans and coordinates the day-to-day services for individuals. We are the clinical experts in this field and should be the driving force for any transformation plan that aims to put consumers at the center of care decisions.
“Unfortunately, inclusion of the professional state workforce has been the critical missing piece in all of the transformation plans that have been put forward during the past six years.”
DiAntonio reminded the public hearing panel that OPWDD has limited the number of choices for consumers with its numerous versions of transformation plans that included closing and downsizing Intermediate Care Facilities, altering workshops and day treatment programs and privatizing effective state services.
“PEF is concerned that the community infrastructure necessary to care for high-need individuals does not exist within the OPWDD system, and that there remains a potential for compromised care and safety for consumers and employees.
“OPWDD’s “comprehensive and holistic” plan to coordinate care by placing individuals in Health Homes using integrated care, individual life plans and care managers are terms and services already provided and implemented by state professionals.
“The clinical teams, comprised of many professional titles within PEF, coordinated the client’s services and worked together with the state’s Medicaid Service Coordinator (MSC). Clients and their families were familiar with us. But as state services were slashed, and MSCs were reassigned to other functions, the state stopped providing this service, and, instead leaned on not-for-profit voluntary agencies to provide these services within our residential settings. This shift has resulted in a gap in communications, accountability and services,” DiAntonio said.
Throughout her testimony, DiAntonio reiterated and gave examples of how the state workforce provides unequaled care coordination and maintains integrity within the system of services because it has no financial incentive to steer individuals into inappropriate or unnecessary care.
“State care coordinators will protect the quality of care and services provided, but also serve as the necessary oversight to protect against organizations that exist because they protect their bottom line,” DiAntiono said.
Her testimony was fortified with information from related articles that appeared in The Washington Post and the Journal of Autism and Developmental Disorders, both of which pointed out how young individuals, without proper support and care, end up in emergency rooms, homeless shelters and sometimes in prison.
DiAntonio said it is unclear how the state-operated programs will fit into OPWDD’s new proposed model, but that it may result in the disruption of services for high-need individuals.
“The most recent plan for Care Coordination Organization Health Homes makes broad assumptions about the availability of services in the private network system with no explanation of how or by whom these services will be provided.”
DiAntonio ended her testimony urging OPWDD to “invest in state-operated residential and clinic-based programs to build the complex service provider bandwidth that will be necessary for any successful coordinated care model.”