Newsletter Bulletin, Volume 9: Why do we provide Care Management?

ACA has released Newsletter Bulletin, Volume 9 for our affiliate network.

Read CEO Jay Nagy’s message below:

Keeping Perspective: Why do we provide Care Management?

Why do we do what we do in this field? What is the purpose of it all? The work requires a lot of us as people, so what drives us to invest ourselves in our jobs? 

These are provocative questions with many answers. I choose to answer them from the perspective of the people we support and their families: we do it to ensure that people have what they need to enjoy the lives they choose—and the lives they deserve! If the roles were reversed, we would want nothing less for ourselves and our loved ones. This reflects a principle that many of us were taught growing up: “Do unto others as you would have them do unto you.” The brief video above from Open Future Learning reinforces the idea with their typical humor.

The process of building a Life Plan for someone involves assessing needs, coordinating services, and then ensuring they’re delivered in a high-quality and timely manner. But are “services” really what someone experiencing a disability wants? Are they simply customers shopping for a product? The answer, of course, is a resounding “NO!” The services, supports, and programs are a means and not an end.

In every role within ACA, we should internalize, embrace, and keep this message top-of-mind. Yes, when someone calls to enroll in a program, they are literally asking for services. However, we should view these services in the larger context of helping people achieve the same things we all want in life. If someone calls their Care Manager to change the plan or find a new program, we shouldn’t just start processing the paperwork. We should take the time to ask why and assess the best course of action based on what they say. When we are auditing notes and records in Quality Assurance, we are not merely doing it to keep ACA in compliance—we are ensuring that documentation is accurate so we can be certain that people are actually getting what they need. 

We use labels like “enrollee” and “employee” to differentiate roles, but all of us are part of a community with one common mission: to help people lead more enriching lives.

—Jay Nagy, CEO

Newsletter Bulletin, Volume 8: Importance of a Shared Language

ACA has released Newsletter Bulletin, Volume 8 for our affiliate network. 

Read CEO Jay Nagy’s message below:

Importance of a Shared Language

The language that we use drives so much of how we think and behave. Without a doubt, anyone with even modest experience in this field has lived through several changes in the words we use to describe what we do and whom we do it for.Though it may seem small, having a common language and frame of reference will be critical as we come together as one ACANY.

The above illustration from Open Future Learning has two primary takeaways: the people we support do not belong to us and they don't deserve to be labeled as anything but "people” or preferably their own name. At its base, our treatment of people reflects how we think about them. Ingrained behaviors like language don’t change overnight, but when we train ourselves to be intentional in how we speak and think, our work becomes more person-centered as a result. Here’s a brief video from Open Future Learning that illustrates the same theme. 

Let’s all recommit to be more precise with the words we choose and to reflect on what they imply about our beliefs and attitudes. An easy way to do this is to reverse the situation: how you would feel if someone referred to you in the same way? If you wouldn’t like it very much, don’t assume their reaction would be any different.
 

—Jay Nagy, CEO

Newsletter Bulletin, Volume 7: What does it mean to be ‘Person Centered’?

ACA has released Newsletter Bulletin, Volume 7 for our affiliate network. 

Read CEO Jay Nagy’s message below:

What does it mean to be "Person Centered"? 


“Person centered” is a phrase that has become so frequently used in our field that its exact meaning is not always immediately clear. Over the coming weeks and months, ACA will sharpen our collective definition of what it means to be “person centered” by working together to support our community. In the meantime, I want to share a brief video by Beth Mount that outlines some ideas for us to consider.

A key theme in the video is the contrast between system-centered and person-centered ways of thinking and planning. System-centered thinking is very much rooted in the “medical model,” which was repudiated with the closing of the state schools and the shift toward greater community integration. That framework focuses on someone’s deficiencies and aims to “fix” them.  Too many in our field still think this way.  While the status quo does an okay job for many people with I/DD, we can do better for all the people and families we serve.

We have the potential to accelerate this shift in thinking and practice, under conflict-free Care Management. Our starting point should always be a person's capacities. This is followed by an assessment of their community and natural supports, tied together with their life goals and dreams. When this becomes the experience for everyone enrolled in ACA, we will have achieved success.

—Jay Nagy, CEO

Newsletter Bulletin, Volume 6: On Fostering Meaningful Relationships

ACA has released Newsletter Bulletin, Volume 6 for our affiliate network. 

Check out CEO Jay Nagy’s message below:

On Fostering Meaningful Relationships

In addition to practical information like announcements and advisories, we want to use this space to share stories and ideas as part of building a common language and framework for Care Management across ACANY.

In the short video above, David Pitonyak quotes Beth Mount: "Loneliness is the only real disability.” In fact, loneliness is increasingly being recognized as a public health hazard, especially among the elderly.

The factors that contribute to loneliness among the elderly are similar for people who experience disabilities. The need for us to "do better" is compelling in both cases. Do you remember the last time you asked someone you support about their friends and other relationships? Was it at their last planning meeting, or is it something you talk about on a regular basis? How many times does their ISP/Life Plan mention relationships?

One of the most provocative ideas in the video is that all the work we do–all the supports you coordinate for people–should be focused on developing meaningful and enduring relationships. Ensuring material needs like food and a home of one's own is important, but having people you can trust and cherish is the difference between having a life and just living.

—Jay Nagy, CEO

Newsletter Bulletin, Volume 5: Six Weeks of Progress

ACA has released Newsletter Bulletin, Volume 5 for our affiliate network. 

Read CEO Jay Nagy’s message below, reflecting on the past six weeks:

We are now six weeks in and CCO Care Management is a work in progress that is steadily advancing every day. As of the second week of August, over 70% of affiliated agencies have received at least one payment for the services rendered in July. Under MSC, this would have only been reimbursed in late August/early September. Almost every organization has documented activities in MediSked and training events have been very well-attended by a highly engaged and committed Care Management workforce.

On top of these extremely positive signs, there remain significant hurdles. Many are without CHOICES access, impacting the ability to conduct intake or update DDP2s and other OPWDD records. MediSked faces issues with basic functionality and critical reporting features are not yet available to our affiliates due to security requirements. Perhaps even more challenging is the fluid movement of members between tiers each month, with those designated as Tier 4 facing the potential of an unwanted change in Care Manager due to the caseload cap—even if they are not part of the Willowbrook class. Despite these challenges, the 7 CCOs are united and are actively coordinating to get these issues resolved expeditiously.

While the positive aspects are encouraging, we will not rest until these challenges are overcome. Each hurdle is a test of the resiliency of this new coordination model and the people whose hard work is bringing it to life.We are humbled by the responsibility NYS has placed on us to lead the way, identify solutions, and advocate for our affiliates and the 25,000+ people looking to us for support. As always, we thank you for your partnership in this enormous undertaking.

— Jay Nagy, CEO

Newsletter Bulletin, Volume 4: Milestones from Our First Month of Care Management

ACA has released Newsletter Bulletin, Volume 4 for our affiliate network.

Read milestones from our first month as a CCO, as recounted by CEO Jay Nagy:

The good news is that we all survived the first month of CCOs and Care Management! The bad news is that it's going to take more work to really deliver on the potential that Care Management holds for the people we support and their families. If you're like me, you may focus on the challenges—all the work still to come. But as we look past this first month, it's important to recognize what this team has already accomplished: 

  • Thousands of activities were logged in MediSked and ACA has been billing claims on a weekly basis. More importantly, the State has been paying claims about 10 days after submission. The first checks from ACA are on their way to providers at this very moment. 

  • Hundreds of Care Managers participated in the ACA webinar training earlier this month. We're constantly exploring ways to connect such a vast, dispersed team. Stay tuned for more on that over the coming weeks. 

  • As of today, ACA employs almost 50 full-time staff members (48, to be exact). It's hard to believe we began this undertaking less than a year ago, with only one person on staff until April 2018. By this time next year, we will number around 1,000!

Thank you for your continued partnership and patience. Nothing as important as the work we do changes overnight and each of us plays a crucial role in ensuring the long-term success and sustainability of this transition. 

— Jay Nagy, CEO 

Experienced Information Technology Professional from the NYS Human Services Sector Named Chief Information Officer of Advance Care Alliance of New York

NEW YORK – Advance Care Alliance of NY Inc. (ACANY), a not-for-profit corporation and alliance of providers serving people with intellectual and/or developmental disabilities (I/DD), has named David Wallach as Chief Information Officer (CIO). With over two decades of experience planning, implementing and managing the technology systems of New York State human services providers, Mr. Wallach brings the requisite skills and expertise to enable ACANY to implement its care management platform—MediSked—in time for its July 1, 2018 launch under New York State’s Care Coordination Organization (CCO) program.

Most recently, Mr. Wallach served as Chief Technology Officer for Saint Christopher’s, Inc., which provides clinical, educational and residential services for children and adolescents. In that position, he was instrumental in developing the organization-wide information technology strategic plan, established security procedures and served as HIPAA Security Officer, planned and managed information system and technology upgrades, and led staff technology training. Prior to joining St. Christopher’s, he served as Vice President of Information Technology at Saint Dominic’s Family Services and prior to that, Director of Information Technology for Abbott House.

Mr. Wallach is a Licensed Master Social Worker with an MSW from Adelphi University and a BA in Psychology from Manhattanville College. He has many technology certifications in Networking and Security from ComtTIA and Microsoft.

“I am eager to apply my broad technology experience to this new type of Health Home. Under the CCO model, technology will empower Care Managers and other staff, Health Home members and their families to develop and implement more dynamic and meaningful Life Plans”, said Mr. Wallach. “It is exciting to play a part in positively transforming care management in the I/DD sector.”

“ACANY welcomes David to our leadership team as we move closer to launching the CCO,” CEO Jay Nagy said. “With his clinical background and varied technology capabilities, we expect David to play a key leadership role in implementing ACA’s care management platform and facilitating workforce transformation.”

About Advance Care Alliance of NY

ACANY is a 501(c)(3) not-for-profit organization that was designated as a CCO earlier this year and expects to begin offering comprehensive, person-centered care management services on July 1, 2018. As part of this transition, ACANY has signed affiliation agreements with more than 100 provider agencies who serve 25,000+ people with I/DD and their families in Downstate New York.

ACANY was established in 2013 to enable not-for-profit organizations offering high-quality, culturally competent community-based services to people with I/DD to meaningfully participate in New York State’s (NYS) planned transition to a managed care delivery system. Together, ACANY’s founding agencies represent about 25% of the total OPWDD voluntary sector in NYS.

Contact: Jay Nagy at jnagy@advancecarealliance.org or (833) MYACANY | 833-692-2269

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Download the press release here

Seasoned Professional in Care Coordination and Human Services Named Chief Operating Officer of Advance Care Alliance

NEW YORK – Advance Care Alliance of NY Inc. (ACANY), a not-for-profit corporation and alliance of providers serving people with intellectual and/or developmental disabilities (I/DD), has named Mathew Smith as Chief Operating Officer (COO). Mr. Smith’s nearly two decades of experience managing large teams to ensure delivery of timely, value-based interventions make him an ideal leader to support ACANY’s July 1, 2018 go-live under New York State’s Care Coordination Organization (CCO) program.

Most recently, Mr. Smith served as Vice President of Operations for Coordinated Behavioral Care (CBC), the largest Health Home in NYC serving over 17,000 people with chronic health care conditions. Prior to joining the CBC leadership team, he was the Senior Vice President for Integrated Health Services at HeartShare St. Vincent’s Services, overseeing community mental health clinics, substance use disorder clinics, and health care services. In that role and previous positions at the agency, he systematically redesigned service models and strengthened the fiscal management of behavioral health and community programs. Most notably, he introduced outcomes measurement that improved the health status of individuals served by the agency.

Mr. Smith received a Master’s Degree in Social Work from Hunter College and an MBA from Columbia University’s Executive Education Program.

“I’m excited to apply my experience in Health Homes and behavioral health care to support people with I/DD and their families leading richer, heathier, and more fulfilling lives,” said Mr. Smith. “I look forward to working with ACANY’s Board of Directors, senior executives, and affiliated provider agencies to ensure a smooth transition of services as Health Home operations begin in July 2018.”

“ACANY is very fortunate to have Matt’s leadership as the organization enters a critical phase of readiness preparations,” CEO Jay Nagy said. “Matt’s unique background in behavioral health care and human services will further ACANY’s mission of creating a CCO that puts people with I/DD and their families at the center of both care coordination and the longer-term transition to managed care.”

About Advance Care Alliance of NY

ACANY is a 501(c)(3) not-for-profit organization that received initial designation as a CCO earlier this year and expects to begin offering comprehensive, person-centered care management services on July 1, 2018. As part of this transition, ACANY has signed affiliation agreements with more than 100 provider agencies who serve 25,000+ people with I/DD and their families in Downstate New York.

ACANY was established in 2013 to enable not-for-profit organizations offering high-quality, culturally competent community-based services to people with I/DD to meaningfully participate in New York State’s (NYS) planned transition to a managed care delivery system. Together, ACANY’s founding agencies represent about 25% of the total OPWDD voluntary sector in NYS.

Read the press release here.

Managed Care Leader Appointed to Launch Health Home Serving People with Intellectual and Developmental Disabilities

NEW YORK – Advance Care Alliance of NY Inc. (ACANY), a not-for-profit corporation and alliance of providers serving people with intellectual and developmental disabilities (I/DD), has named Jay Nagy as CEO.

Mr. Nagy, a graduate of The Wharton School at the University of Pennsylvania, most recently served as Senior Director of Provider Strategy at CareCentrix, a benefits manager specializing in post-acute care coordination. Prior to that, he was Associate Principal, New Product Development at The Advisory Board Company, a health care best practices research and technology firm, where he launched programs that empowered hospitals and physicians to better measure and improve patient experience and outcomes.

“I’m thrilled to be joining ACANY at such a pivotal time for people with I/DD and their families— as well as the providers who serve them,” said Mr. Nagy. “I look forward to working with ACANY’s members, the larger provider community, and state and local government agencies to build a platform for person-centered care management that ensures a smooth transition of services for people with I/DD and ultimately drives improved outcomes for this population with unique needs.”

Mr. Nagy was trained as an investment banker and had extensive experience in finance prior to embarking on his career in health care.

“We’re excited to have Jay’s leadership as ACANY finalizes its application to the Office for People with Developmental Disabilities (OPWDD) to be designated as a Care Coordination Organization/Health Home,” ACANY Board President Steven Vernikoff said. “With his unique set of talents and focus, we will be able to create an organization that reflects the values of our community and member agencies—one that puts people with I/DD at the center of the transition to managed care.”

ACANY was established in 2013 to enable not-for-profit organizations offering high-quality, culturally competent community services to people with I/DD to meaningfully participate in New York State’s (NYS) planned transition to a managed care delivery system. Together, ACANY member agencies represent about 25% of the total OPWDD voluntary sector in NYS.

About Advance Care Alliance of NY

ACANY was formed by three service networks—Advance of Greater NY (AGNY), Alliance Care Network (ACN), and Long Island Alliance (LIA)—that collectively serve over 25,000 people with I/DD and their families in New York City, Long Island, and the Lower Hudson Valley.

Contact: Steven Vernikoff at svernikoff@cfsny.org

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Download the press release here.