iCircle Services - Supporting Individual Choice and Empowerment
January 2014

iCircle's
Community Connection

Issue #48

Message from the Board

Greetings! We hope everyone has stayed safe and warm during this exceptionally chilly Upstate New York weather. The iCircle Board of Directors held its first meeting of the New Year on Wednesday, January 8.  The Board meeting focused on updates on the development of iCircle’s Managed Long-Term Care (MLTC) plan.   We have been working closely with the Department of Health as they review our application and prepare for a readiness review process. It is our intent, if approved by the Department of Health, to start enrollment in the Managed Long Term Care plan in the Spring. In addition, we have been working on a new brand for iCircle and the two plan offerings! Stay tuned as we will launch the new brand in the coming weeks.

Even though updates and news surrounding OPWDD's DISCO development has been relatively quiet, we feel it is necessary to stay engaged, informed and updated as a board and with our network so we can continue to keep our promise of transparent community-based collaboration.   We would like encourage our network to continue to share stories, updates, and information by emailing info@icirclecny.org.   We love to showcase the wonderful work and success that is happening in our community.  

Thank You!

DISCO, MLTC - What Does All This Mean?

iCircle has received inquries from our DISCO providers for more information about the difference in an MLTC and DISCO and what it all means to the people they serve.   In an effort to help our network providers, who primarily serve people with developmental and intellectual disabilities, have a better understanding, we have compiled the FAQs below. We hope you find this helpful and please reach out to info@icirclecny.org for any additional questions.

What is MLTC?

According to the Department of Health, Managed Long-Term Care (MLTC) helps people who are chronically ill or have disabilities and need health and long-term care services, such as home care or adult day care, stay in their homes and communities as long as possible. There are several entities that currently offer or are in the process of being approved (like iCircle) that offer MLTC plans. The role of the MLTC plan is to arrange and pay for a large selection of community-based health and social services by providing choice and flexibility in obtaining needed services from one place.

Managed long-term care plans provide long-term care services (like home health and personal care) and ancillary and ambulatory services (including podiatry, and home delivered meals), and receive Medicaid payments.

Who is eligible for Medicaid Managed Long-Term Care?

According to the NYS Department of Health website, you are eligible to enroll in managed long-term care if you:

  • are Medicaid eligible.
  • have a chronic illness or disability that makes you eligible for services usually provided in a nursing home;
  • currently living in the community and are able to stay safely at home at the time you join the plan;
  • are expected to need long-term care services for at least 120 days from the date you enroll;
  • meet the age requirement of the plan
  • live in a county served by the plan;
  • have or are willing to change to a doctor who is willing to work with the plan

*Please note, individuals who are currently receiving services under OPWDD are not eligible to enroll in a MLTC plan. 

Learn more by clicking here.

What is a DISCO?

The Office of Persons with Developmental Disabilities (OPWDD) is currently working to transform the service system to align with the NYS Department of Health’s ongoing efforts to reform public health services. A Developmental Disabilities Individual Support and Care Coordination Organizations (DISCOs) will be a plan offering aimed to facilitate and manage care for people with developmental and/or intellectual disabilities.

Right now, OPWDD is still in the planning and negotiation phase with the Federal Centers for Medicaid Services (CMS) to finalize the transformation of services to managed care. As it stands currently, people do not have to enroll in a DISCO. Eventually, there will be mandatory enrollment into a DISCO.

What is the expected timeframe DISCO enrollment? OPWDD has stated they will start a pilot voluntarily phase of enrollment for this new managed care system in the fall of 2014.

What is iCircle’s Role?

iCircle Services of Central New York, upon approval from the NYS Department of Health, will become a licensed managed care organization who will offer two distinct health plans for Medicaid eligible individuals; a MLTC plan and a DISCO plan. Currently, iCircle’s application for the MLTC plan is under review and we hope to be approved and begin enrollment in April. We are currently awaiting the final Request for Application for the DISCO plan to be issued by OPWDD. It is iCircle’s intent to apply to become a DISCO plan.

Why Would iCircle Want to Offer Both a MLTC and DISCO plan?

iCircle Services believes in providing a comprehensive, accessible, and trusted system of Medicaid managed care that will help provide simple, local access to care for the entire family. Founded by a diverse group of service providers with decades of experience offering services to Medicaid eligible people, providing a choice of plans in the community under one entity will help to streamline care and support for people in our community.

We look forward to offering more information directly about our services to both the DISCO and MLTC provider networks when we have approval from the Department of Health.

Important Resource Links:

https://www.health.ny.gov/health_care/managed_care/index.htm

https://www.health.ny.gov/health_care/managed_care/mltc/aboutmltc.htm#what

http://www.opwdd.ny.gov/opwdd_services_supports/people_first_waiver/home

Program Spotlight:  The Coffee House

On any given afternoon you can find young adults, both with and without disabilities, participating together at Stepping Stones Learning Center's (SSLC) Coffee House. The Coffee House is a unique inclusive program that helps provide opportunities to build confidence, social skills and recreational activities for young adults with intellectual and developmental disabilities.

Several youth from the Coffee House reached a personal milestone when they participated in SSLC's annual Masquerade Gala. The youth who attended the event gained valuable experience working and interacting in large social events. Two youth even agreed to give short speeches in front of a packed house of over 200 people to help educate the community about disabilities and their personal goals. They did a fantastic job, were on top of the world at the end of the evening and left beaming with pride as they successfully achieved their goals. Due to the success of this event and other activities at the Coffee House, this year the youth are working together on developing a proposal for SSLC leadership to share their own ideas of how best they could participate, as well as, allow previous participants an opportunity to share feedback on last years’ experience. The exercise of presenting is a great way to help strengthen and achieve the goals they have set around increased communication, social and writing skills. Feeling ownership of this activity is helping to build confidence in their ability to participate and socialize together with peers in the community really represents the goals for the Coffee House program. Coffee House is helping to build emotional intelligence or soft skills that are so very necessary for these youth when they join the work force. In addition, the Coffee House helps to educate young adults who do not have disabilities on the importance and value their peers who have disabilities can bring to the community. Coffee House has helped to bring awareness to anti-bullying for young adults with disabilities. Being able to interact alongside their peers from other schools and colleges has been truly beneficial to the growth and self-esteem and education of everyone who participates. SSLC stated that many of the teenagers who come in to volunteer at Coffee House have done a great job bringing awareness back to their peers.

For more information about the Coffee House Program or to learn how to start something similar in your area, contact Rachel Chalmers, Associate Executive Director at Stepping Stones Learning Center at (585) 467-4567.

Thank you for your Support!

Sincerely,
iCircle Services

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Mission: iCircle Services is a service portal where individuals with developmental disabilities and their families can self-direct, advocate, and secure the supports and services that best fit their needs. We are guided by individual choice, inclusion, diversity, cultural competence, respect, community, learning and empowerment for those we serve.

Vision: iCircle Services will establish a comprehensive, sustainable, trusted, and compassionate system of supports and services that will help empower families and individuals with developmental disabilities to promote their happiness, independence and inclusion as productive members of our community.

Contact Us:
Phone: 1-855-775-3778
Email: info@icirclecny.org
Website: www.icirclecny.org


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