NYS has high hopes for new CHOICES case management system

New York’s Office for People With Developmental Disabilities (OPWDD) is a big operation. OPWDD has 22,000 state employees, 800 not-for-profit partners and an annual budget of just over $8 billion. The Office is responsible for helping developmentally disabled New Yorkers receive care and services that will allow them to live richer lives. This means helping people with disabilities live independently or with families; find jobs or receive vocational training; and participate in their communities how they choose all while providing the supports, services and direct care that address their disabilities.

As with any state agency, especially a human services agency, paper and documentation burdens are heavy. Coordinating care for all levels of developmentally disabled people is a daunting task, with many of them eligible for a wide spectrum of state and federal aid. Like many health care organizations, OPWDD wanted technology to help improve services and lighten the administrative load.

“Our system was much more patriarchal than it should be,” OPWDD Acting Commissioner Max Chmura told CivSource in an interview. “Historically, decisions are made for the customer by a professional…We needed to move our system to be much more customer-centric, where information availability is key.”

In late 2009, OPWDD entered into a multi-year partnership with Microsoft and the Mid-America Consulting Group to develop such a system. Dubbed CHOICES, the new case management system allows people with disabilities and their families to be more proactive in their service decisions, creating an electronic record for private and public sector agencies to share case-specific information in real-time.

“We put our money where our mouth is,” Mr. Chmura said. “We built our first investment in electronic records as a platform to help people make choices and then share information that lead to those choices with the appropriate parties.”

According to Mr. Chmura and his Chief Information Officer, Robert Vasko, CHOICES is HIPAA and Hi-TECH compliant so that sensitive patient information is only available to authorized persons. Another important factor, Mr. Chmura said, was the system’s interoperability.

“Its ability to link directly into legacy systems and leverage existing platforms was really significant,” he said of the Microsoft technology. “Three years ago the system was outdated by at least five years and the Dynamics platform helped integrate information from both old and new systems.”

Administrative benefits

Because OPWDD is a Medicaid financed operation, the ability to link their records to administrative and client records in other sister agencies was vital, Mr. Chmura said. “When you think about the general health care field and private sector, investing in customer care is important for profits and efficiency. In New York State government, we’re trying to make those same kinds of investments for the same reasons. We really see this CHOICES investment as our first technology investment that leads us down that path.”

Mr. Chmura said his Office has suffered an 18 percent cut in case management funding for the SFY 2010-11 budget (equal to about $30 million) and that the rollout of CHOICES would be a major factor in being able to absorb those cuts without undermining the quality of care. In addition to the ability to support better decisions about services that people need, OPWDD hopes the audit and accounting abilities of the new system will eliminate 30 to 40 percent of the errors found in typical audits, and cut time spent on Medicaid Service Coordination business processing in half.

“CHOICES is one of the ways we are streamlining business practices to make our service more efficient – going from a hard copy world and making it a technology-driven world.”

Rollout and cross-jurisdiction coordination

Phase I implementation of the case management system is underway in three regional offices, known as Developmental Disabilities Services Offices (DDSOs), Mr. Vasko said. And the plan is to follow that route and continue expanding into the non-profit community, then parents and families. This spring will be a threshold for OPWDD as the system expands beyond beta users.

“CHOICES will be a huge advantage for people with disabilities, families, and state users,” Chmura said. “As it rolls out, this system is giving partners an opportunity to reengineer a lot of their own processes,” Mr. Vasko added.

Beyond New York sister agencies, such as the Office of Mental Health, the Office of Children and Family Services, the Office for the Aging, and the Office of Alcohol Abuse, OPWDD is already getting inquires from other states, Chmura indicated.

“There is a clear sense of this project’s importance in transforming the way we do business,” he said.

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