Independence Care System:

1

• Independence Care System
• A Managed Long-Term Care Program
• For Adults with Physical Disabilities
• Presentation by Rick Surpin, President
• surpin_at_icsny.org
• Fulfilling the Promise of Community Living
  Conference
• March 26, 2002

2
Independence Care System (ICS)

• A nonprofit managed long-term care plan for
  adults living in New York City who
• Are eligible for Medicaid
• Are eligible for placement in a nursing home
• Need home care services

3

• Focus on adults with physically disabilities
• Severe trauma and/or injury
• Degenerative neurological and muscular diseases
• Sponsored by
• Cooperative Home Care Associates a worker-owed
  home care agency
• Paraprofessional Healthcare Institute a policy
  analysis and advocacy organization focused on
  paraprofessionals in long-term care
• Began Operations in April, 2000
• 350 Members as of March, 2002

4
Profile of the ICS Member

• Ages 21-84 50 between 30-50
• 60 female 40 male
• 40 African American 45 Latinos
• 50 live alone 50 with family
• 20 have multiple sclerosis 20 have spinal cord
  injury
• 60 Medicaid only 40 dually eligible

5
Lack of an Adequate Service System for Adults
with Physical Disabilities

• Primary care practitioners often have little
  training or knowledge about various physical
  disabilities
• Specialists typically treat the disability only
• Very few providers of preventive services e.g.,
  dentistry, mammography with accessible equipment

6

• Many adults with physical disabilities do not
  meet the Medicare homebound criteria for services
  from Certified Home Health Agencies
• Medicare regulations for rehabilitation services
  focus on restoration of ability maintenance
  therapy is not considered reimbursable.
• Very few social day care centers that will serve
  younger adults.

7

• Wheelchairs are fitted without home visits to
  ensure that it will fit through hallways or
  elevators
• Maintenance and minor repairs of wheelchairs are
  not Medicaid-reimbursable
• Transportation services consistently arrive late
  and leave consumers stranded in hospitals or
  physician offices for long periods

8
Key Program Elements

• Member is primary manager of own care
• Interdisciplinary care management involving
  nurse, social worker, physician, clinical
  specialists and home care aides
• Comprehensive range of health and social services
• Responsibility for the quality of every service
  we coordinate
• Collaborative practice between our Members, our
  staff and our key providers

9
Consumer Direction

• Member as Consumer-Customer
• Voluntary enrollment and voluntary disenrollment
• Major role in determining own needs
• Major role in choosing which services and
  providers best meet their needs and interests

10

• Member Management of Services
• Member manages, if chooses, special activities or
  services, for example
• Consumer-directed personal assistant services
• Transportation
• Member Feedback
• Satisfaction with specific services
• Overall experience with MLTC plan
• Participation in Governance
• Consumer advocates on Board of Directors

11
Mission

• 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.