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  1. 1. <ul><ul><li>Independence Care System: </li></ul></ul><ul><ul><li>A Managed Long-Term Care Program </li></ul></ul><ul><ul><li>For Adults with Physical Disabilities </li></ul></ul><ul><ul><li>Presentation by Rick Surpin, President </li></ul></ul><ul><ul><li>surpin @ icsny .org </li></ul></ul><ul><ul><li>Fulfilling the Promise of Community Living Conference </li></ul></ul><ul><ul><li>March 26, 2002 </li></ul></ul>
  2. 2. Independence Care System (ICS) <ul><li>A nonprofit managed long-term care plan for adults living in New York City who: </li></ul><ul><ul><ul><li>Are eligible for Medicaid </li></ul></ul></ul><ul><ul><ul><li>Are eligible for placement in a nursing home </li></ul></ul></ul><ul><ul><ul><li>Need home care services </li></ul></ul></ul>
  3. 3. <ul><li>Focus on adults with physically disabilities </li></ul><ul><ul><ul><li>Severe trauma and/or injury </li></ul></ul></ul><ul><ul><ul><li>Degenerative neurological and muscular diseases </li></ul></ul></ul><ul><li>Sponsored by: </li></ul><ul><ul><ul><li>Cooperative Home Care Associates – a worker-owed home care agency </li></ul></ul></ul><ul><ul><ul><li>Paraprofessional Healthcare Institute – a policy analysis and advocacy organization focused on paraprofessionals in long-term care </li></ul></ul></ul><ul><li>Began Operations in April, 2000 </li></ul><ul><ul><ul><li>350 Members as of March, 2002 </li></ul></ul></ul>
  4. 4. Profile of the ICS Member <ul><li>Ages 21-84; 50% between 30-50 </li></ul><ul><li>60% female; 40% male </li></ul><ul><li>40% African American; 45% Latinos </li></ul><ul><li>50% live alone; 50% with family </li></ul><ul><li>20% have multiple sclerosis; 20% have spinal cord injury </li></ul><ul><li>60% Medicaid only; 40% dually eligible </li></ul>
  5. 5. Lack of an Adequate Service System for Adults with Physical Disabilities <ul><li>Primary care practitioners often have little training or knowledge about various physical disabilities </li></ul><ul><li>Specialists typically treat the disability only </li></ul><ul><li>Very few providers of preventive services – e.g., dentistry, mammography – with accessible equipment </li></ul>
  6. 6. <ul><li>Many adults with physical disabilities do not meet the Medicare homebound criteria for services from Certified Home Health Agencies </li></ul><ul><li>Medicare regulations for rehabilitation services focus on restoration of ability; maintenance therapy is not considered reimbursable. </li></ul><ul><li>Very few social day care centers that will serve younger adults. </li></ul>
  7. 7. <ul><li>Wheelchairs are fitted without home visits to ensure that it will fit through hallways or elevators </li></ul><ul><li>Maintenance and minor repairs of wheelchairs are not Medicaid-reimbursable </li></ul><ul><li>Transportation services consistently arrive late and leave consumers stranded in hospitals or physician offices for long periods </li></ul>
  8. 8. Key Program Elements <ul><li>Member is primary manager of own care </li></ul><ul><li>Interdisciplinary care management involving: nurse, social worker, physician, clinical specialists and home care aides </li></ul><ul><li>Comprehensive range of health and social services </li></ul><ul><li>Responsibility for the quality of every service we coordinate </li></ul><ul><li>Collaborative practice between our Members, our staff and our key providers </li></ul>
  9. 9. Consumer Direction <ul><li>Member as Consumer-Customer </li></ul><ul><ul><ul><li>Voluntary enrollment and voluntary disenrollment </li></ul></ul></ul><ul><ul><ul><li>Major role in determining own needs </li></ul></ul></ul><ul><ul><ul><li>Major role in choosing which services and providers best meet their needs and interests </li></ul></ul></ul>
  10. 10. <ul><li>Member Management of Services </li></ul><ul><ul><ul><li>Member manages, if chooses, special activities or services, for example: </li></ul></ul></ul><ul><ul><ul><ul><li>Consumer-directed personal assistant services </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Transportation </li></ul></ul></ul></ul><ul><li>Member Feedback </li></ul><ul><ul><ul><li>Satisfaction with specific services </li></ul></ul></ul><ul><ul><ul><li>Overall experience with MLTC plan </li></ul></ul></ul><ul><li>Participation in Governance </li></ul><ul><ul><ul><li>Consumer advocates on Board of Directors </li></ul></ul></ul>
  11. 11. Mission <ul><li>ICS collaborates with people with disabilities in building a specialized system of care to support their full participation in community life. Members plan and manage their own health care and social supports in conjunction with care coordinators and service providers, and participate in the governance of the organization. We strive to be the preferred source of comprehensive, coordinated care for people with disabilities and chronic illness in New York City and a national model of managed long term care for individuals with complex needs. </li></ul>