“Knock, Knock” “Who's There?” OPWDD: Welcoming the Front Door Initiative

By: Marc R. Katz, MA 

Published in Jewish Press’s Building Blocks Magazine, March 2014  

“What is the Front Door?” “Why is this change being made?” “How does this new approach affect me and my child with special needs?” These are some of the questions asked by parents of children with special needs as they embark upon the tedious process of establishing their child’s eligibility for services from the NYS Office of People with Developmental Disabilities (OPWDD), which serves 126,000+ New Yorkers. With the right information and understanding of key Front Door concepts, parents will be able to use the front door to unlock the services their child so desperately needs.

What is the Front Door?

OPWDD has redesigned how they offer services to individuals in order to promote greater awareness and choice for individuals and families, with a strong emphasis on self-direction, employment, and community integration. This is known as the Front Door initiative. The Front Door builds on the philosophy of person-centered planning, and the understanding that individuals with developmental disabilities have the right to enjoy meaningful relationships with others in their lives, experience personal growth, fully participate in their communities, and live in the home of their choice. The Front Door’s key components are: (A) eligibility determination (B) assessment (C) identification of service needs (D) service authorization and (E) implementation.

Who must go through the Front Door?

Individuals who are seeking services for the first time or who are interested in modifying current services are the first to use this new process. An individual is considered “new” to OPWDD if: -Eligibility has not been established yet -Eligibility has been established but one is requesting Medicaid Service Coordination (MSC) or has MSC and now requesting Waiver services for the first time -Young adults who are transitioning from public or residential schools into the OPWDD adult service system.

Why is this change being made?

Prior to the Front Door, voluntary agency staff was responsible for conducting a formal assessment for those requesting services. However, service recipients typically receive a multitude of services from several OPWDD funded agencies resulting in several different assessments from various agencies. These different assessments on the same person often yielded discrepancies about one’s overall level of functioning. In fact, OPWDD recently initiated pilot studies across various regions in order to analyze this data, suspecting that there were service recipients who were under-supported or over-supported based on these inconsistent assessments. Changes are therefore being made to ensure that service recipients are provided appropriate supports that meet their actual needs in the most integrated, appropriate settings possible during these fiscally chal- designed to support those with higher needs (e.g., day rehabilitation and supervised residences) now require a more careful review process than less intensive home-based supports prior to authorization. Although the previous assessment tool (DDP-2) is currently being used, it will soon change to a more standardized assessment tool (CAS) for reliability and validity purposes to better accomplish equitable access of services to all. It is also expected that OPWDD, rather than contracted agencies, will maintain responsibility of eligibility determination and assessment even for people with existing services as the system moves to a managed care model. Managed care entities (e.g., Developmental Disabilities Individual Support and Care Coordination Organizations - DISCO) will authorize services in the near future and will shift away from OPWDD’s fee for service model. The Front Door will help facilitate this transition and promote greater uniformity and accountability by being the sole assessment provider.

The Role of Parents during the Assessment Process

A determination of a developmental disability is still the first step (Phase A) in securing OPWDD services. Your child must meet a Level of Care Eligibility Determination (LCED) which is determined by OPWDD’s local developmental disabilities regional offices (DDRO) based on one’s psychological evaluation, medical report, and psychosocial assessment. Once your child is deemed eligible for OPWDD services, family members are now encouraged to partake in an almost two hour “Front Door” information session at one of OPWDD’s regional offices. Familes may attend these sessions even before eligibility is determined and will find it helpful too. Please see side bar: Front Door Contact Information and Resources. In the back pages of this issue, you will find a resource directory that consists of various agencies which provide assistance with evaluations, intake, and referral of services. Upon completion of the two-hour training session, a DDP2 assessment is typically conducted via phone interview or in person with Intake Specialist, Individual/ Family, and OPWDD’s Front Door Access team member. While the response of your child is the determining factor during the IQ testing, parents still play an important role during the assessment process, and are the primary source of information for those making the Front Door assessment. Parents know their children best and provide information which supplements the clinical impressions of the professionals who have earlier interacted with them in testing sessions. Yaakov, a 4 year-old boy, was recently tested due to suspected global developmental delays. However, Yaakov’s father and mother were too embarrassed to indicate their son’s everyday weaknesses during the phone call/ Front Door assessment process. As a result, the testing results did not accurately reflect Yaakov’s daily functioning and did not give him access to the services he needed. This resulted in further delay and unnecessary testing to justify Yaakov’s eligibility for desperately needed services. It is important to note that the phone interview and assessment are intended to measure your child’s adaptive skills and typical behavior, not his/her behavior under ideal circumstances. While it is natural for parents to want to portray their child in the best light possible, in this case, it is in their child’s best interest that they not overestimate their child’s everyday abilities, but rather depict the child’s usual functioning level accurately. Regarding those who only or will soon receive Medicaid Service Coordination (MSC), the role of MSCs will evolve due to the Front Door process. MSCs are traditionally responsible for helping others explore what they want and need in life, and then assist them with getting it. Although MSCs are not part of the Front Door Team, they are involved during the assessment process, as they work in partnership with families to make informed choices (based on needs, interests, and desires) and further assist in OPWDD service planning and identification of services. See At A Glance: The Front Door Process, which serves as a snapshot. While the Front Door Process is still striving to streamline the way people learn about OPWDD services, there is no greater feeling of accomplishment for empowering parents than translating this rebranded approach into the reality of critical services enabling them to better cope with the demands of caring for a child with a disability.

Marc R. Katz, an NYS Certified School Psychologist, is a Director at OHEL Children’s Home and Family Services. For more information about evaluations, intake, or referral of services, please call 1-800-603-OHEL, visit www.ohelfamily.org for live help online, or e-mail access@ohelfamily.org. OHEL delivers a breadth of community and residential services through OHEL Bais Ezra, OHEL Lifetime Care, OHEL Foster Care, OHEL Mental Health Services, OHEL Institute for Training, Camp Kaylie, and Etta at OHEL.