Medicaid Service Coordination

Wendy, Kelly and Richard in Albany.

Wendy, Kelly and Richard in Albany.

Medicaid Service Coordination (or MSC) is a Medicaid-funded service provided by the Office of People with Developmental Disabilities (OPWDD). Opengate is a certified vendor of MSC, subcontracted by OPWDD. Full-time staff work directly with the individual and, collaboratively, with the person’s circle of support to realize programming tailored to the individual’s needs and preferences.

The MSC spends a lot of time creating a working alliance and formulating a deep understanding of the individual and an environment that will be most conducive for his or her growth. Having this person-centered knowledge, the MSC sets out to secure access to necessary services and supports through assertive advocacy with both public and private organizations. More specifically, the MSC exposes and links the person to a broader horizon of options that exist within the community and fosters opportunities for true community integration.

The MSC’s interactions are informed by the notion that growth is possible regardless of the presence of disability. One of the mainstay documents that is continuously revised is called the Person-Centered Plan (PCP); which replaces the Individualized Service Plan (ISP). “In the creation of this plan, a Person-Centered process unfolds as the MSC facilitates and the individual directs the development, implementation, and revision,” says Amy Ruppmann, Corporate Compliancy Specialist/Compass Coordinator. “This practice promotes choice, self-determination, and self-advocacy that not only instills greater intrinsic motivation in the individual, but also likelier attainment of a felt sense of satisfaction.”

The MSC is committed to helping individuals achieve their goals and will advocate on behalf of the individual for their rights. The MSC develops, implements and maintains the PCP; completes and keeps up-to-date all required MSC documents including the agreement, activity plan, observation report, and application; actively advocates for the individual served; ensures continuity of an individual’s benefits without interruption including eligibility for Medicaid, Medicare, and Social Security entitlements; ensures the individual’s Home and Community-Based Services (HCBS) Waiver eligibility is maintained; and collaborates with the local Developmental Disability Revenue Office (DDRO) on the newly established Front Door process that streamlines access to funding for various programmatic needs.

Moreover, the MSC ensures that a plan of protective oversight is replete with provisions for individual’s safeguards residing in an Individualized Residential Alternative (IRA); ensures continuity of follow-up on an individual’s present needs and documenting monthly service coordination activities including face-to-face contact. He or she also reviews the PCP and the MSC vendor agreements; maintains a separate record for each individual served; and ensures paperwork is completed and distributed within required deadlines.

Finally the MSC is responsible for obtaining signatures from individuals, their guardians, family members, and service providers on the PCP and all of its supplemental plans and reports to show proof of their review; participating in monthly visits with the individual served at the home, day habilitation, or their vocational program site; and acting as liaison with all service providers, as needed.

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