Senate Bill S4868

                                 
BILL NUMBER: S4868

SPONSOR: FAHY
 
TITLE OF BILL:

An act to amend the mental hygiene law, in relation to requiring the
office for people with developmental disabilities to develop and main-
tain a community residence opportunities waitlist

 
PURPOSE:

The purpose of this bill is to require the Office of People with Devel-
opmental Disabilities (OPWDD) to develop and maintain a Community Resi-
dential Opportunity Waitlist (CROW) and a CROW placement report identi-
fying all individuals eligible for obtaining a certified residential
opportunity in the OPWDD certified setting.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 of this bill would add a new section 16.15 to the Mental
Hygiene Law providing statutory authority for OPWDD do develop and main-
tain a community residence opportunities waitlist and placement report,
              

procedures for providers of residential services to offer eligible indi-
viduals a placement in a supervised living facility and provide due
process appeal rights to individuals seeking enrollment on the CROW.

Section 2 of this bill would provide a transition of individuals
currently on a OPWDD developed Certified Residential Opportunity Process
list to the new statutorily created CROW.

Section 3 of this bill provides that the effective date shall take
effect April 1, 2026

 
JUSTIFICATION:

In 2015 OPWDD brought together a group of stakeholders to examine ques-
tions fundamental to the service system regulated and operated by the
OPWDD. Between February and December of 2015, the panel met extensively
to delve into questions surrounding residential services, care coordi-
nation, employment-related transportation, the workforce and self-direc-
tion. The Transformation Panel recommendations were released by OPWDD in
a report to the Legislature in February of 2016 titled Raising Expecta-
tions, Changing Lives. At the same time, OPWDD released a report to the
Legislature on its Residential Request List. At that time, OPWDD indi-
cated:

OPWDD "as it seeks to evolve its housing strategies to better respond to
demand and changing models of support that can be more tailored to the
individual, has heard concerns from many individuals and families who
fear that they will be unable to access residential supports when they
are needed or plan a future for their loved one."

To assist in meeting residential service needs and to further its hous-
ing, planning process. OPVVDD surveyed the more than 11,000 individuals
on the Residential Request List (RRL). The RRL, formally known as NY
CARES (Creating Alternatives in Residential Environments and Services)
was launched in 1998 and served for many years as the primary initiative
creating certified residential opportunities in the OPWDD system. While
OPWDD indicated over time the development on which OPWDD based the
development of certified residential opportunities changed as OPWDD's
commitment grew to support people in more individualized and person-
controlled settings, 62% of the respondents surveyed indicated they
would prefer a residential setting where services and supports are
provided by an agency and 33% sought to own or rent a home where needed
supports and services would be available. 48% of family caregivers
reported that their family member on the RRL need help with almost all
basic activities and 46% of family caregivers reported being over the
age of 60. At the time, OPWDD also indicated the available supply of
residential opportunities, consisting of vacancies in existing capacity,
and opportunities created through the development of new capacity would
meet the priority one demand (now identified as "Emergency Need").
Recognizing the need to address new resources to assist in meeti ng the
needs of individuals living at home with family caregivers, 810 million
in new funding was then proposed in the FY 2017 Executive budget dedi-
cated for the development of residential opportunities for people with
priority two (now Substantial Need) and priority three (now Current
Need) status.

In its February 2016 report to the Legislature, OPWDD also reported that
in May of 2015, the agency had implemented the Certified Residential
Opportunity (CRO) protocol to provide direction and create consistency
in the management of certified housing opportunities. OPWDD indicated:

"The CRO process is one tool used to assess overall need for certified
residential services and inform the need for new residential service
capacity in the system. The CRO protocol is designed to ensure timely
response to urgent needs; to understand and address the unique needs of
each individual; and to apply consistent, statewide standards that allow
equal opportunity."

According to OPWDD, the CRO protocol reinforces the principles of indi-
vidual choice and the importance of helping individuals seek opportu-
nities to live in the community in the least restrictive environment.
The CRO protocol uses a system of priority level determinations based on
individual circumstances as determined by the OPWDD Front Door process.
In 2016, OPWDD indicated nearly 41,000 individuals received housing
supports, with approximately 38,000 individuals receiving services in
certified group residences and another 2,800 receiving rental subsidies.
In January of 2017, OPWDD provided an update to the Legislature on the
progress of the Transformation Panel's recommendations, indicating that
it anticipated, in the next three years (FY 2018 - FY2020) "approximate-
ly 4,900 individuals living at home may require a certified residential
opportunity and 1,400 individuals living at home may require a more
independent supportive housing opportunity.  OPWDD told the Legislature,
"OPWDD intends to meet these residential supports through a mixture of
existing and newly developed ooportunites accessed based upon a person-
centered process." OFWE.-C, indtated. the FY201.E; Executive Budget
would support approxirnately 2 100 1.1:▒vidLaLls req,L4ing certified and
non-residential opportunities. OPWDD also indicated it would continue to
provide the Legislature with quarterly updates on the progress of the
Transformation Panel's recommendations.

Unfortunately, it appears the promise of changed lives and raised expec-
tations, especially in relation to an evolving housing strategy as envi-
sioned by OPWDD in the winter of 2017 has been dashed. The CRO protocol
as implemented by OPWDD has not operated as it was intended when it was
created in 2015. Funding and housing opportunities for priority two and
priority three individuals have not materialized as the CRO protocol
prevents residential opportunities to be offered in a timely. person
centered process to individuals living at home with aging caregivers,
who are not in "Emergency Need" for a housing opportunity. The current
CRO protocol. combined with recently announced reductions in certified
residential provider rates are reducing residential opportunities within
the OPWDD service system.  Recently, in response to questions raised at
the FY2022 Executive budget hearing, OPWDD indicated it currently
supports "approximately 35,000 certified residential opportunities", a
3.000 bed reduction in certified residential opportunities compared to
2016. At the same time, OPWDD indicates nearly 5300 individuals are
currently seeking a certified residential opportunity, far in excess of
the current system vacancies that can be filled.

OPWDD has ignored the Transformation Panel recommendations to develop a
Five Year Plan for meeting the housing needs of those living in or seek-
ing residential services; has failed to update the Residential Request
List to assist in long-term planning; has failed to evaluate the priori-
tization of access to residential services to ensure that those now at
home are treated fairly by reviewing the prioritization criteria which
drive the allocation of residential services; has failed to ensure that
individuals living at home and those living in institutional settings
have access to residential services based upon need. For over 4 years,
OPWDD has failed to provide promised updates to the Legislature on the
progress of the Transformation Panel's recommendations.

The legislation is necessary in order to reform the CRO process in ways
that comport with the needs of individuals and their families, partic-
ularly those whose housing needs are not being currently meet because
OPWDD has ignored the policy recommendations of the Transformation Panel
and to provide appropriate Legislative structure and oversight for the
delivery of residential supports in the OPWDD service delivery system.

 
LEGISLATIVE HISTORY:

2023-24: S.3142

2021-22: S.6305

 
FISCAL IMPLICATIONS:

To be Determined.

 
EFFECTIVE DATE:
This act shall take effect April 1, 2026.