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Ask the Expert: Eligibility Specialist

By: Marc Katz

Published in the September issue of the Jewish Press Building Blocks

Q:

I am the father of a ten-year-old girl with a developmental disability. I have been trying to get clear answers about the Front Door Process since I read your article in the last edition of Building Blocks. It seems that everyone I talk to on the phone or contact via e-mail has conflicting information about this process and expected time frames. I just don’t know where to begin and need immediate assistance to obtain services for my daughter from the Office for People with Developmental Disabilities (OPWDD).

A: 

As others may not know, in the spring of 2013, 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 single point of entry is known as the Front Door Initiative. The Front Door’s key components are: (A) eligibility determination (B) assessment (C) identification of service needs (D) service authorization, and (E) implementation. 

Since 2013, there has been a learning curve for both parents and agencies as the Front Door process continues to evolve to meet the current and anticipated needs of others. Although there are links to the Front Door Process on the OPWDD website to assist family members, like yourself, there is an overwhelming amount of information that further contributes to everyone’s confusion. OPWDD and service providers recognize these concerns and have made some modifications to better accommodate those they intend to serve. For example, OPWDD has been offering two-hour informational sessions at remote locations, specifically at various agencies which families may have initially contacted to secure services for their child. Families are even allowed to participate in this required session over the telephone to expedite the process. Additionally, OPWDD intends to develop a Front Door Manual to alleviate the aforementioned concerns.

In the interim, I recommend that you either call the Front Door contact person in your region, or an intake specialist at an agency of your choice (please see the Resource Directory in the back of this issue) to offer initial guidance and direction. It is also highly recommended to first establish OPWDD eligibility prior to registering for this almost two-hour informational session. Once eligibility is established and you have participated in this session (registration can be expedited online at www.opwdd.ny.gov), you can expect an initial phone call from a Front Door Team Member, in which you will go over basic demographic information, your child’s needs and interests, various natural and community supports in place, and types of requested services for your child, known as the Eligibility Assessment and Authorization Tool (EAA). 

In addition, a needs assessment (a.k.a. Developmental Disabilities Profile – DDP 2) is to be conducted shortly thereafter via telephone, which is intended to measure your child’s adaptive skills and typical behavior. In response to these questions, it is important for you to answer according to her needs and typical behaviors, and not present her behavior under ideal circumstances. This is difficult for many parents to do, but one must be honest regarding their child’s true abilities and not overestimate their everyday living skills. The results of this assessment will determine which services will be authorized to facilitate greater independence and strengthen and maintain the family unit. A Front Door summary report will be developed based on the information from the EAA and DDP2. Once receiving this report, you will share it with an agency of your choice to coordinate each service identified in the report. This summary report will serve as a guideline for intake specialists, case managers/ service coordinators to develop a prescription for treatment. 

This person-centered plan will further serve as a snapshot of your daughter and identify various requested services that require OPWDD approval. The case manager will submit it to the Front Door Team for review. Upon their review, you and an agency of your choice will receive an authorization letter of the approved service(s) with additional instructions about enrollment, which requires specific assistance from a service coordinator to implement the newly authorized services. This multistep process can take an average of six months, the range depending on whether or not you have Medicaid. Ultimately, the approved services will serve as a lifeline to your entire family. Good luck!

Marc R. Katz, a NYS Certified School Psychologist, is a Director of Access at OHEL Bais Ezra. For more information about evaluations, intake, or referral of services, please call 1.800.603.OHEL, visit www.ohelfamily. org, 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. By Marc R. Katz Eligibility Specialist 

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