Issue:
OPWDD is in the midst of developing a new rate methodology, which will have significant implications for voluntary provider agencies for years to come. Agencies have been engaging with OPWDD and other stakeholders during this process on the technical aspects of the rate redesign. The overall objective is to reform the reimbursement rate from a cost-based methodology to an acuity-based methodology.
However, provider agencies have expressed concerns about the potential outcome of the final rate methodology, which may result in significant long-term losses for provider agencies statewide. Agencies that have already invested in direct care wages above the regional average, will be penalized due to the proposed regional cost approach.
The Coordinated Assessment System (CAS) will be used to determine the relative acuity of a person, which in turn determines how much an agency must be reimbursed for supporting that person. However, it is not clear whether the CAS has the functionality to appropriately identify the level of support required for a person, leaving open the possibility of people being placed into lower tier classifications that do not reflect the level of staffing required, and improperly reimbursing providers at a lower rate.
Call to Action: Tell OPWDD to Reform Rate Methodology that Works with Providers and for People with I/DD
- The new reimbursement methodology must not contain any component that would remove or negate any investment the legislature or providers have made in the workforce.
- Continuing education, training, and opportunities for the direct care and other frontline workforce must be taken into consideration when determining rates in order to retain valuable talent and expand the ability for voluntary providers to support people with higher-need.
- Access to the methodology used by CAS to determine acuity assessments must be made available to providers. Greater transparency will lead to a continually refined and more equitable system.
- CAS assessments must accurately reflect the current acuity of a person and completed within a reasonable timeframe to ensure an appropriate placement and proper provider reimbursement.
- Changes to rates, including the implementation of the annual COLA must be completed in a timely manner within 90-days from the enacted budget or final rate approval.
The Arc promotes and protects the human rights of people with intellectual and developmental disabilities and actively supports their full inclusion and participation in the community throughout their lifetimes.
