Medicaid is the official funder that provides financial access to disability services in all states. The Medicaid program is jointly funded by the federal government and states. Each state has an office that is responsible for disbursing Medicaid Dollars. In New York State, the Office for People with Developmental Disabilities, OPWDDD. OPWDD has various regional offices (DDRO) that are assigned to cover different geographical locations.
In New York State specifically, the process is a follows:
The reimbursement rate for each service varies, but the process of securing funding is similar. Typically, the Sheltered Workshop staff will work with Service Coordinators/Case Managers to develop Individualized Service Plans (ISP), or create Addendums to the ISPs to reflect the service being requested.
Combined with the ISPs or ISP Addendums, are other pertinent documentation that should be submitted to the State Office that is responsible for disbursing Medicaid dollars. After review the office, an authorization for service delivery, along with the rate at which services will be established and forwarded to the new program staff for the individual to begin utilizing the service.
The Sheltered Work Shop supervisor will need to work with the individual’s Service Coordinator to develop an ISP or an addendum to the individual’s ISP, indicating the waiver service and the start date of the service that the individual will be accessing. The ISP, along with the addendum to the ISP should be obtained by the appropriate staff of the chosen waiver service. That staff will need to work with their local Developmental Disabilities Regional Offices (DDRO) to submit the required justification documentation, which may include, but is not limited to the following documentation:
- Transmittal form
- ISP addendum
- Program Schedule
- Justification form
- DDP 1 & DDP 2
- DDP 1 Supplemental Form
If you are a New York State agency, please see the link below for examples of documentation that is required by the New York State Office for People with Developmental Disabilities:
For agencies outside of New York State, the following websites may be of assistance: