Life is a journey. For those with severe developmental disabilities, the road traveled is a steep climb where hazards abound. In the State of New York, there are an estimated 250,000 residents diagnosed as developmentally disabled with serious physical, learning, language, or behavioral deficits. Some, however, qualify as “self-determined” people who have the opportunity to access support tailored uniquely and specifically for each individual.
Primarily funded through Medicaid, not-for-profit agencies like Monticello-based Independent Support Services (ISS) manage the patient-specific budgets approved for individuals enrolled in Self-Directed Services. The scope of this support includes:
- Hiring of support staff and other resources for the enrollee, including background checks
- Managing expenses and reimbursements for paid staff
- Compliance with Medicaid rules, employment laws and taxes
Prior to 2014, ISS served the needs of enrollees and the regulatory demands of Medicaid using Excel and reams of paper. The result was a ever-growing mountain of paper and an avalanche of inefficiency.
ISS recognized that their paper-based business model was untenable. In late 2013 they transitioned from Excel to a custom hybrid system. Focused on the meticulous compliance with rules issued by the state’s Office for People with Developmental Disabilities (OPWDD), their goal: create the Gold Standard.
While well received by accounting and payroll, everyone had to accept a dramatic shift in the way ISS staff handled payroll, reimbursement, and billing.
As weekly payments of expenses and the biweekly processing of payroll proceeded, a steady stream of modifications and innovations were introduced. The new system was evolving, adding efficiencies to every aspect of ISS support and services. The chaos of Excel and paper was a forgettable memory. The road to the Gold Standard had begun.
By early August and without warning, while members of the ISS staff was enjoying the full benefits of the new system, OPWDD published new and far more onerous rules. When the State of New York changed the rules, ISS saw an opportunity to do it right — but they only had six weeks to set the bar higher.
The plot thickens…
When the State of New York changed the rules, ISS saw an opportunity to do it right.