ON THIS MONTH'S EDITION OF CONNECT-NEW YORK, WE EXPLORE THE RANGE - AND QUALITY - OF SERVICES PROVIDED TO MORE THAN ONE MILLION NEW YORKERS IN THE STATE'S CARE.

ALL THAT, AND MUCH MORE, COMING UP NEXT.

♪ ♪ WELCOME TO CONNECT-NEW YORK, I'M DAVID LOMBARDO - HOST OF WCNY'S THE CAPITOL PRESSROOM, A DAILY PUBLIC RADIO SHOW, BROADCASTING FROM THE STATE CAPITOL.

ON TODAY'S SHOW WE'RE GOING TO HIGHLIGHT THE CARE PROVIDED TO VULNERABLE NEW YORKERS, INCLUDING PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES, STRUGGLES WITH ADDICTION, MENTAL HEALTH CHALLENGES, AND OTHER CONDITIONS.

BEFORE WE HEAR FROM OUR PANEL OF STAKEHOLDERS, WE'RE GOING TO BRING YOU THE STORY OF THE ARC OF ONONDAGA COUNTY, WHICH IS CONTRACTED WITH THE STATE TO PROVIDE SERVICES TO THOUSANDS OF PEOPLE WITH DEVELOPMENTAL DISABILITIES.

OUR PRODUCER SUSAN BITTER HAS THIS STORY ON THE WORK THEY DO AND HOW THEY DO IT.

>> ARC OF ONONDAGA IS AN AGENCY THAT PROVIDES SERVICES TO CHILDREN AND ADULTS WITH DEVELOPMENTAL DISABILITIES.

WE CURRENTLY PROVIDE A FULL ARRAY OF SERVICES FOR PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES, INCLUDING RESIDENTIAL SERVICES, EMPLOYMENT TRAINING AND SUPPORT, COMMUNITY SUPPORTS, WHICH INCLUDE THINGS LIKE DAY HABILITATION, COMMUNITY HABILITATION.

WE HAVE AN ARTS PROGRAM, RECREATION AND RESPITE PROGRAM.

WE HAVE A SUMMER FUN PROGRAM AND ARTICLE 16 CLINIC WHERE WE PROVIDE SOCIAL WORK, OCCUPATIONAL AND PHYSICAL THERAPY SERVICES.

CURRENTLY THE SERVICES ARE MOST OFTEN PROVIDED RIGHT IN THE COMMUNITY IN A PERSON-CENTERED MANNER.

SO WE BUILD THE SUPPORTS AND SERVICES AROUND WHAT A PERSON WANTS AND IT'S IMPORTANT THAT THE PEOPLE THAT WE SUPPORT ARE TRULY A PART OF THEIR COMMUNITY.

>> AND WE DO A LOT OF ACTIVITY STUFF LIKE DRAW, HANG OUT, WATCH TV HERE.

AND GET ALONG WITH THE STAFF AND STUFF.

WE DO PAINTING AND STUFF.

AND WE MAKE COOKIES AND WE BAKE PIZZAS OR WE GO TO THE PARK SOMETIMES.

ON TUESDAY WE GO TO DAIRIES.

>> AND MEALS ON WHEELS.

>> ANYTHING WE WANT TO DO, WE LET THE STAFF KNOW AND THEY'LL PLAN IT.

WE ARE GOING TO BE DOING PUMPKIN PICKING.

THEY JUST STARTED COOKING CLASS AND WE ARE MAKING COOKIES.

WE WATCH MOVIES, COLOR, ANYTHING WE WANT TO DO.

IT'S A FUN PROGRAM TO LEARN AND WE GO OUT TO THE COMMUNITY AND WE LEARN WORK SKILLS AS WELL.

I LOVE MEALS ON WHEELS, I LOVE HELPING OUT AND SEEING THE SMILES ON PEOPLE'S FACES.

>> THE BIGGEST CHALLENGE WE FACE RIGHT NOW IS SIMILAR TO MANY BUSINESSES AND THAT'S WORKFORCE.

PRIOR TO THE PANDEMIC, WE FACED STAFFING STRUGGLES IN THIS FIELD.

SINCE THE ONSET OF THE PANDEMIC AND REALLY RIGHT THROUGH TODAY, WE ARE FACING A WORKFORCE CRISIS IT'S FUELED BY YEARS OF INSUFFICIENT INVESTMENT IN THIS FIELD.

THE WORK REQUIRES EXTENSIVE TRAINING.

IT INVOLVES PROVIDING PERSONAL CARE.

IT INVOLVES ADMINISTERING MEDICATIONS.

IT INVOLVES ASSISTING AND SUPPORTING PEOPLE IN THE COMMUNITY.

AND IT INVOLVES WORKING SOME REALLY LONG HOURS.

THE STAFF THAT WE HAVE ARE DEDICATED.

THEY ARE CONNECTED TO THE PEOPLE THAT WE SUPPORT.

AND THAT CONNECTION IS REALLY CRITICAL TO THE SUCCESS FOR THE PEOPLE THAT WE SUPPORT AND THIS IS A TOUGH JOB.

AND IT'S A CHALLENGE TO FIND THE RIGHT NUMBERS OF QUALIFIED AND DEDICATED STAFF RIGHT NOW.

>> DSP IS DIRECT SUPPORT FOR PEOPLE WITH DISABILITIES.

AND SO WE HELP WITH THEIR DAILY CARE, THEIR DAILY GOALS.

WE TAKE THEM OUT ON OUTINGS.

WE MAKE SURE THAT THEY, YOU KNOW, GET THE HEALTHCARE THAT THEY NEED.

I SPECIFICALLY DO ON MED STAFF.

I SPECIFICALLY TAKE THEM ON THEIR APPOINTMENTS, MAKE SURE THAT THEIR MEDS-- THAT THEY HAVE THE MEDS AND THEY DON'T RUN OUT OF MEDS.

MAKE SURE WHEN THEY'RE SICK, I'M THERE FOR THEM AND MAKE SURE I'M GIVING THEM THE RIGHT CARE.

>> OUR STAFF LOVE THIS WORK BUT THEY CAN'T ALWAYS AFFORD TO DO THIS.

MANY OF THEM HOLD SECOND JOBS.

MAKING APPROPRIATE INVESTMENTS IN THIS FIELD ON A STATE FUNDING LEVEL WOULD HELP US BE ABLE TO BETTER RECRUIT AND RETAIN OUR STAFF.

>> PEOPLE DON'T UNDERSTAND IT'S NOT ALWAYS ABOUT MONEY.

IT'S WHAT YOU HAVE WITHIN YOUR HEART TO BE ABLE TO TAKE CARE OF PEOPLE WITH DISABILITIES.

AND YOU HAVE TO REALLY UNDERSTAND THEM THEY JUST BRIGHTEN UP MY DAY.

THEY REALLY DO.

I LOVE WORKING WITH THE INDIVIDUALS.

>> ARC IS MY SECOND HOME.

IT'S SUPPORTS ME.

LIKE MY FAMILY, THEY GET ME, THEY UNDERSTAND ME, THEY SEE PAST THE DISABILITY.

THEY JUST MAKE US FEEL LOVED.

I COME HERE AND AN INDIVIDUAL WILL BE IN A BAD MOOD AND THEY LEAVE WITH A SMILE.

>> A LOT OF SIMILAR PROVIDERS IN ONONDAGA COUNTY AND THROUGHOUT THE STATE.

THE ARC NEW YORK OPERATES PROGRAMS AND SERVICES IN EVERY COUNTY STATEWIDE.

HOWEVER, THERE CONTINUE TO BE PEOPLE ON WAITING LISTS FOR SERVICES, PARTICULARLY FOR RESIDENTIAL SUPPORTS.

THE STAFFING CRISIS THAT ALL OF US ARE FACING RIGHT NOW ALSO IS MAKING IT MORE DIFFICULT.

WE MAY NOT HAVE THE STAFF TO PROVIDE ALL OF THE SERVICES THAT A SPECIFIC PERSON WANTS AND IS ENTITLED TO.

>> WITHOUT ARC, I PROBABLY, IF I WASN'T HERE, I WOULD PROBABLY BE SOMEWHERE ELSE OR I AIN'T GON' SAY THAT WORD, YOU KNOW WHAT I MEAN... >> IT HAS BEEN A REALLY GOOD IMPORTANT LIFE FOR US AND IT IS A BIG PART OF MY ROLE TO BE HERE.

IT'S PART OF WHO I AM AND I FEEL COMFORTABLE BEING MYSELF.

ALWAYS JOKING, LAUGHING, AND YOU KNOW, IF I HAVE A BAD DAY, STAFF IS THERE 24/7 AND I JUST AM FREE.

I CAN BE ALICIA HERE.

THAT'S WHAT I LOVE ABOUT ARC.

>> AND NOW FOR A STATEWIDE PERSPECTIVE, WE'RE JOINED IN THE STUDIO BY STATE SENATOR JOHN MANNION, A SYRACUSE-AREA DEMOCRAT, WHO CHAIRS THE SENATE'S COMMITTEE ON DISABILITIES, MICHAEL KENNEDY, A SELF-ADVOCATE WITH THE SELF-ADVOCACY ASSOCIATION OF NEW YORK STATE, BILL GETTMAN, CEO OF THE HUMAN SERVICES ORGANIZATION, NORTHERN RIVERS, AND JOINING US REMOTELY IS KERRI NEIFELD, COMMISSIONER FOR THE STATE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES.

AND COMMISSIONER, I WANT TO START WITH YOU, SINCE - WHEN WE TALK ABOUT NEW YORKERS WITH SPECIAL NEEDS - THE BULK OF THE STATE'S VULNERABLE POPULATION ARE UNDER THE PURVIEW OF YOUR OFFICE, SO CAN YOU WALK US THROUGH THE RANGE OF SERVICES THAT THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES PROVIDES OR CONTACTS OUT FOR NEW YORKERS?

I KNOW IT'S A LAUNDRY LIST, BUT WHAT CAN IT BE?

>> SURE.

IT IS A LAUNDRY LIST.

START OFF BY SAY THAGHT WE SERVE APPROXIMATELY 120,000 NEW YORKERS ACROSS THE STATE EITHER THROUGH OUR OWN STATE OPERATED SERVICES OR THROUGH APPROXIMATELY 600 NOT-FOR-PROFIT AGENCIES ACROSS THE STATE THAT ARE CONTRACTED WITH OPWDD OR PROVIDE SERVICES UNDER OPWDD'S JURISDICTION.

AND WE DO.

WE PROVIDE A RANGE OF SERVICES.

WE PROVIDE, YOU KNOW, VERY MINIMAL SERVICES FOR FOLKS WHO ONLY NEED A LITTLE BIT OF SUPPORT; ALL THE WAY UP TO A FULL CONTINUUM OF CARE INCLUDING RESIDENTIAL SERVICES, EMPLOYMENT SERVICES, DAY PROGRAM, WE HAVE CRISIS INTERVENTION FOR FOLKS WHO NEED THAT WHO HAVE BEHAVIORAL HEALTH CHALLENGES AS WELL AS DEVELOPMENTAL DISABILITIES.

WE HAVE A VERY POPULAR SELF-DIRECTION PROGRAM THAT ALLOWS PEOPLE SOME AUTONOMY IN DIRECTING THEIR SERVICES, ALLOWS THEM TO SELF DIRECT THEIR SERVICES, CHOOSE THEIR STAFF AND MAKE, YOU KNOW, DETERMINATIONS ABOUT HOW THEY SPEND THEIR DAY.

WE HAVE FAMILY CARE, WHICH ALLOWS FAMILIES IN THE COMMUNITY TO WORK WITH PEOPLE WHO HAVE DEVELOPMENTAL DISABILITIES.

WE PROVIDE RESPITE FOR FAMILIES WHEN THEY HAVE THEIR LOVED ONE LIVING WITH THEM AT HOME.

WE PROVIDE RESPITE TO ENABLE FAMILIES TO CONTINUE THOSE ARRANGEMENTS.

IT'S THE FULL GAMUT.

ANYTHING THAT A PERSON NEEDS TO HAVE A FULFILLING LIFE, OPWDD PROVIDES.

>> SO BILL, AS THE MOST SENIOR MEMBER OF THIS TABLE, CAN YOU TALK ABOUT HOW THE ATTITUDES AND APPROACH TO PROVIDING SERVICES HAVE CHANGED IN RECENT DECADES?

IN PARTICULARLY, IN THE WAKE OF SOME SCANDALS WE SAW 50 YEARS AGO.

>> SURE.

I'M BOTH A PROVIDER.

I HAVE A SON SERVED BY KERRI'S SYSTEM AND PROVIDER OF HUMAN SERVICESES IN THE CAPITAL REGION.

A LOT OF THINGS HAVE HAPPENED IN THE LAST COUPLE OF YEARS.

EVERYONE WHO IS A RECIPIENT OF SERVICE IS AT THE TABLE AND I THINK THERE IS A COMMITMENT BY THE STATE TO ENGAGE PEOPLE IN PLANNING AND IMPLEMENTING THEIR CARE AS MICHAEL WILL TELL US LATER.

BUT I THINK THE OTHER THING THAT'S GONE ON, TO BE BLUNT, WE HAVE A WORKFORCE CRISIS AND WE HAVE A SYSTEMS CRISIS.

OUR SYSTEMS HAVE NOT BEEN FULLY SUPPORTED FINANCIALLY OVER THE LAST DECADE.

AND I THINK WE NEED TO REBUILD IN THE NEXT YEAR BOTH OUR WORKFORCE AND WE HAVE TO HAVE A MULTI-YEAR PLAN THAT BRINGS TOGETHER THE VARIOUS SILOS OF HUMAN SERVICESES.

WE HAVE A CRISIS.

I APPRECIATE THE EFFORTS OF THE STATE AGENCIES BUT WE HAVE TO DO SOMETHING NOW AND OVER THE NEXT SEVERAL YEARS.

>> I WANT TO GET TO THE WORKFORCE ISSUE BUT I'M THINKING MORE ABOUT THE ISSUE OF HOW PEOPLE HAVE BEEN TREATED IN TERMS OF, YOU KNOW, LARGE FACILITIES AND TRYING TO SCALE BACK SOME OF THAT.

CAN YOU TALK ABOUT THAT?

>> I THINK THE PENDULUM HAS MOVED FROM RESIDENTIAL CARE AND INSTITUTIONAL CARE TO COMMUNITY-BASED CARE AS WELL AS SELF DIRECTED CARE AND THAT'S REALLY, REALLY IMPORTANT FOR BOTH FAMILIES AND INDIVIDUALS BEING SERVED.

HOWEVER, I KEEP GOING BACK TO WE HAVE TO HAVE AN INFRASTRUCTURE TO DO THAT.

MOVING PEOPLE OUT OF INSTITUTIONS IS THE RIGHT THING DO.

LOCKING THEM UP IN THE OLD WILLOWBROOK WAYS IS AWFUL AND WAS A CRIME AND A SIN.

HOWEVER I DON'T THINK WE HAVE FULLY INVESTED IN 9 CONTINUUM OF SERVICE IS WE NEED IN THE COMMUNITY AND THAT'S THE CHALLENGE FOR ALL OF US.

POLICY MAKERS AND ELECTED FS AND BUDGET FOLKS.

>> SENATOR MANNION, AS SOMEONE WATCHING THESE ISSUES IN RECENT YEARS FROM ALBANY CHAIR OF THE DISABILITIES COMMITTEE, WHAT HAVE YOU SEEN FROM YOUR PURVIEW.

>> I'M VERY PROUD OF THE WORK THAT I'VE DONE IN PARTNERSHIP WITH THE COMMISSIONER AND OUR VOLUNTARY PROVIDERS AND OUR ADVOCATES.

IF YOU WORK IN THIS CAPACITY OR YOU ARE AN INDIVIDUAL THAT RECEIVES SERVICES OR A FAMILY MEMBER, YOU KNOW HOW STARK THE CONDITIONS ARE RIGHT NOW AND BY CONDITIONS, I MEAN THE LACK OF FINANCIAL SUPPORT OVER THE COURSE OF A PERIOD OF A DECADE.

IN MY THREE YEARS AS CHAIR, WE DID SECURE, IN THE LAST THREE BUDGETS, COST OF LIVING ADJUSTMENTS THAT ARE ESSENTIAL FOR OUR VOLUNTARY PROVIDERS, AND ADDITIONALLY OUR STATE WORKFORCE ON THE OTHER SIDE, WHICH DOES SERVE DIRECTLY ABOUT 15% OF THE POPULATION, TO DO WHAT THEY NEED TO DO.

BUT THEY NEED THE FLEXIBILITY TO BE ABLE TO PROPERLY INTEGRATE THESE COMMUNITIES AND MAKE SURE THAT PEOPLE ARE GETTING THE SERVICES THAT THEY DO HAVE INDIVIDUALIZED SERVICES, WHAT WORKS FOR THEM.

THE INVESTMENT IS A BIG PIECE OF THAT.

BUT THE WORKFORCE CHALLENGES OUTSIDE OF THAT INVESTMENT ARE REALLY LIMITING THE ABILITY TO BE FULLY INTEGRATED AND FULLY INDIVIDUALIZED.

>> WELL, MICHAEL, WHEN YOU THINK ABOUT QUALITY OF CARE, WHAT DO YOU THINK ARE THE HALLMARKS OF HIGH QUALITY CARE?

WHAT ARE THE TENETS OR PRINCIPLES THAT NEED TO BE BEHIND ANY WELL MEANING AND WELL EXECUTED CARE?

>> WELL, FIRST OF ALL, YOU NEED TO LISTEN TO THE PEOPLE THAT YOU ARE WORKING WITH, YOU KNOW, AND MY STAFF THAT I HAVE WORKING FOR ME NOW, WE WORK TOGETHER AS A VERY GOOD TEAM BECAUSE YOU KNOW, THEY ASK ME THINGS LIKE WELL, WHAT WOULD YOU LIKE US TO DO?

AND WHAT KINDS OF THINGS DO YOU NEED DONE?

AND WE TALK ABOUT THAT ON A DAILY BASIS, YOU KNOW, BECAUSE I HAVE LIKE THREE MAIN PEOPLE THAT WORK FOR ME.

AND I'M GLAD TO SAY THAT THEY WORK FOR ME FOR A VERY LONG TIME.

I DO NOT HAVE A LOT OF TURNOVER.

AND IT'S BECAUSE I ALWAYS, WHEN I ADVOCATE FOR MY STAFF, I ADVOCATE THAT THEY GET FAIR WAGES AND THEY GET, YOU KNOW,HEALTH INSURANCE BECAUSE HOW CAN PEOPLE HELP YOU IF THEY DON'T HAVE, YOU KNOW, GOOD WAGES AND STUFF BECAUSE I NEED TO MY SERVICES SEVEN DAYS A WEEK AND IF I DON'T HAVE IT SEVEN DAYS A WEEK, THEN I CAN'T GET OUT AND DO MY ADVOCACY WORK THE WAY I FEED TO.

SO IT'S VERY IMPORTANT THAT I GET QUALITY PEOPLE IN MY HOME.

AND I THINK PEOPLE WHO I WORK FOR SANDY'S FOR A NUMBER OF YEARS, AS A MATTER OF FACT, I WAS ONE OF THE CO-FOUNDERS WITH A FRIEND OF MINE NAMED BERNARD CARABELLO AND WE SAY THAT IN ORDER FOR US TO ADVOCATE FOR PEOPLE AND TEACH PEOPLE HOW TO ADVOCATE FOR THEMSELVES, WE NEED TO HAVE YOU KNOW, THE FAIR WAGES ACROSS THE BOARD.

AND WE HAVE TO BE ABLE TO LEARN ABOUT WHAT SELF-ADVOCACY IS SO THAT THEY CAN ADVOCATE FOR THEMSELVES.

THAT'S WHAT I'VE DONE FOR MY WHOLE CAREER.

>> DAVID, CAN I JUMP IN ON THAT?

>> SURE.

I.

>> I THINK FAIR WAGES IS A BIG THING AND THE CENTER HAS BEEN GREAT ABOUT ADVOCATING FOR THE COLA BUT WE HAVE TO REBUILD A CAREER FOR THE INDIVIDUALS PROVIDING SERVICES, WHETHER IT'S IN THE OPW SYSTEM, OMH, CHILD WELFARE, WE NEED TO TREAT THEM WITH RESPECT, GIVE THEM A CAREER LADDER, WHICH INCLUDES WAGES, RETIREMENT AND SOME KIND OF OTHER PROMOTIONAL CAPACITY.

OTHERWISE THEY'RE GOING TO GO SOMEWHERE ELSE.

>> KERRI, CAN YOU TALK ABOUT THIS MICROCREDENTIALING PROGRAM THAT THE STATE IS PARTNERING WITH, SUNY COMMUNITY COLLEGES AS WELL AS WORKFORCE GROUPS, IN ORDER TO TRY TO CREATE THAT CAREER LADDER AND THIS ATTRACTIVE CAREER PATH?

>> YEAH, ABSOLUTELY.

IT'S SOMETHING THAT WE ARE VERY EXCITED ABOUT AND I THINK BILL IS ABSOLUTELY RIGHT.

WAGES ARE VERY IMPORTANT BUT IT'S ALSO ABOUT THE PROFESSIONALIZATION OF THE WORK, RECOGNIZING IT FOR THE PROFESSIONAL JOB THAT IT IS AND FOR THE DEMANDING JOB THAT IT IS AND SO WE HAVE PARTNERED WITH THE NATIONAL ASSOCIATION FOR DIRECT SUPPORT PROFESSIONALS, NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS, AND SUNY, AND WE ARE BRINGING MICRO CREDENTIALING TO CURRENT DSP AND WORKING IN THE FIELD RIGHT NOW AND IT'S ALSO BEEN ATTRACTING TO NEW PEOPLE WHO MIGHT WANT TO ENTER THE FIELD TO SEE THAT WE ARE INVESTING IN THEIR PROFESSIONALIZATION, THE MICROCREDENTIAL, THE ABILITY FOR THEM TO REALLY DEVELOP THE SKILLS THAT THEY LEARN THROUGH THEIR TRAINING, YOU KNOW, AND TO DEMONSTRATE HOW THEY CAN AFFECT THEIR ABILITY TO DO THEIR JOB.

AND IT'S EXACTLY THAT.

IT'S ABOUT PROVIDING A GREAT JOB FOR A DSP BUT ALSO BY ALSO PROVIDING THAT CAREER PATHWAY SO PEOPLE CAN MOVE UP, THEY CAN BE MANAGERS, THEY CAN MORE EFFECTIVELY MANAGE THEIR PEERS AND LITTLE ENTER INTO OTHER SPACES, RIGHT?

WE HAVE PEOPLE THAT ENTER INTO DSP WHO GO INTO NURSING.

ALL STAYING IN THE SAME FIELD, RIGHT, BUT ABLE TO EXPLORE THEIR OWN NATURAL DESIRES AND THEIR NATURAL, YOU KNOW, WHAT THEY WANT TO DO WITH THEIR CAREER ALL WITHIN OUR FIELD.

>> SO I THANK THE COMMISSIONER FOR HER, YOU KNOW, PROACTIVE STEPS HERE TO MAKE SURE THAT WE HAVE A CREDENTIALING PROGRAM.

I WAS PROUD TO HAVE SUPPORTED IN THE BUDGET A PILOT PROGRAM THAT O.C.C.

TO DO JUST THAT.

AND OTHER MENTORING PROGRAMS.

ANOTHER CHALLENGE THAT'S HERE AND ALL THESE THINGS ARE SO IMPORTANT TO TALK ABOUT AND I APPRECIATE THE PLATFORM, BECAUSE THIS IS A CAREER.

IT'S BASED ON TRUST.

IT'S SOMETHING THAT WE NEED INDIVIDUALS TO GO INTO IT, BUT THEY'RE REALLY CALLED INTO IT.

IT IS A VOCATION.

SOMETHING AT THE FEDERAL LEVEL THAT'S NECESSARY IS TO HAVE A SPECIFIC JOB TITLE FOR DSPs, A JOB CODE, AND WE LACK THAT RIGHT NOW SO WHEN WE WERE IN THE MIDST OF THE PANDEMIC, AND WE HAD TO DETERMINE WHO WAS PART OF THE ESSENTIAL WORKFORCE, THERE WAS SOME GRAY AREA THERE.

SO THERE IS MULTIPLE FRONTS THAT I THINK WE ARE WORKING TOWARDS AND ADVOCATING TOWARDS AND WE ARE GOING TO GET THERE.

BUT WE NEED TO REALLY VALUE OUR WORKFORCE AND MICHAEL COULDN'T HAVE ARTICULATED THAT BETTER.

>> SO I WANT TO THANK THE COMMISSIONER FOR TAKING ON THE CREDENTIALING PROGRAM.

WE HAVE TO TAKE IT TO SCALE THOUGH.

WE HAVE TO TAKE IT BEYOND OPW AND INCLUDE OMH, CHILDREN SERVICES, THE CHILD WELFARE PROGRAMS, BECAUSE OTHERWISE WE ARE GOING TO HAVE A PING PONG, PEOPLE ARE GOING TO JUMP FROM AGENCY TO AGENCY.

THEY'RE GOING TO FOLLOW THE CREDENTIAL OR FOLLOW THE MONEY.

SO, AGAIN, I WOULD CHALLENGE EVERYONE TO SEE HOW WE CAN, IN THE NEXT YEAR'S BUDGET, TAKE TO IT SCALE FOR THE ENTIRE HUMAN SERVICES SECTOR.

>> COMMISSIONER, I WANT TO COME BACK TO YOU TO COMMENT ON SOMETHING THAT MICHAEL SAID ABOUT THE SCOPE OF CARE.

SEVEN DAYS A WEEK.

I THINK SOME PEOPLE MIGHT NOT UNDERSTAND HOW EXTENSIVE THE CARE THAT OPWDD AND SOME OF THE NON-PROFIT PROVIDERS THAT YOU CONTRACT OUT WITH.

SO CAN YOU ELABORATE WITH THAT?

I KNOW WE TALK ABOUT THE RANGE OF SERVICES BUT HOW INVOLVED CAN CARE CONSIST OF?

>> IT RUNS THE FULL CONTINUUM.

WE TALK ABOUT THIS A LOT.

IT'S JUST ANOTHER REASON WHY OUR DSPs NEED TO BE, NEED TO HAVE THOSE MICROCREDENTIALING AND RESPECTED FOR THE PROFESSIONAL THAT THEY ARE, ESPECIALLY OUR DSP WORKING IN THE RESIDENTIAL PROGRAMS OR DAY HABS.

DEPENDING ON WHO IT IS THAT THEY'RE SUPPORTING AT THE MOMENT, THEY COULD BE SUPPORTING SOMEONE WHO NEEDS ASSISTANCE WITH TOTAL CARE, YOU KNOW, ASSISTANCE WITH DRESSING, GOING TO THE BATHROOM, WITH, YOU KNOW, ANY KIND OF PERSONAL HYGIENE, EATING.

ALL THE WAY, YOU KNOW, UP TO SOMEONE EMPLOYED IN THE COMMUNITY AND NEEDS MINIMAL ASSISTANCE AND MINIMAL SUPPORT.

OUR DIRECT SUPPORT PROFESSIONALS NEED TO BE PREPARED AND KNOW HOW TO PROVIDE ALL OF THOSE LEVELS OF CARE BASED ON THE PERSON THEY'RE WORKING WITH AT THE MOMENT AND BASED ON THE PERSON THEY'RE SUPPORTING AND THE NEED.

WE HAVE PEOPLE OUT IN THE FIELD ADJUSTING TO PEOPLE'S NEEDS, MAKING IN THE MOMENT DECISIONS ABOUT WHAT IS BEST.

OBVIOUSLY, THROUGH CONVERSATION WITH THE PERSON THAT THEY'RE SUPPORTING AND OBVIOUSLY ALWAYS WITH, YOU KNOW, UTMOST RESPECT FOR THEIR AUTONOMY, BUT, YOU KNOW, IT'S REALLY A PROFESSIONAL JOB THAT A PERSON NEEDS TO HAVE A REALLY HIGH RANGE OF PRETTY TEM SKILLS.

EVEN BORDERING ON, YOU KNOW, NURSING SKILLS AT TIMES.

NOT GOING INTO NURSING SKILLS BUT GETTING VERY CLOSE TO, YOU KNOW, SOME OF THE PERSONAL CARE, THINGS LIKE THAT CAN GET PRETTY CLOSE TO SOME OF THE STUFF THAT NURSES ARE ASKED TO DO AS WITH EL.

>> MICHAEL, CAN YOU TALK A LITTLE BIT ABOUT THE DIFFERENCE BETWEEN CARE THAT'S NOT JUST ABOUT HELPING SOMEONE SURVIVE, BUT HELPING SOMEONE THRIVE, INDIVIDUALIZED CARE THAT REALLY HELPS A PERSON EXCEL AND ENJOY LIFE?

>> WELL, THE INDIVIDUAL CARE IS A LOT OF STUFF BECAUSE, YOU KNOW,PEOPLE NEED TO GET USED TO PEOPLE BEING IN YOUR HOMES AND STUFF, SO-- AND YOU KNOW, YOU BUILD A RELATIONSHIP WITH THE PEOPLE THAT ARE WORKING WITH YOU AND THAT'S VERY VITAL BECAUSE I WOULDN'T WANT JUST SOMEBODY COMING IN MY HOUSE AND NOT BE ABLE TO CARRY ON CONVERSATION.

IT'S VERY IMPORTANT THAT YOU BUILD NOT ONLY A FRIEND RELATIONSHIP BUT IT'S MORE LIKE A WORKING RELATIONSHIP, TOO.

BECAUSE YOU HAVE TO TELL-- BECAUSE I HAVE TO HAVE EVERYTHING DONE FOR ME.

YOU KNOW, I CAN'T DO ANY OF IT MYSELF BECAUSE, YOU KNOW, I RELY ON MY DSPS A LOT, A REAL LOT.

AND, YOU KNOW, THEY'RE VERY CARING AND THEY WANT ME TO LIVE MY LIFE TO THE FULLEST BECAUSE WE SAID-- THEY SAID WE COULD BE IN YOUR POSITION, TOO.

WE COULD BE JUST LIKE YOU.

AND WE WOULDN'T WANT TO LIVE OUR LIVES-- AND WE WOULD WANT TO LIVE OUR LIVES TO THE FULLEST, TOO.

AND YOU ARE NO DIFFERENT THAN US.

>> BILL, HOW DO YOU GO ABOUT THAT?

>> MICHAEL NAILED IT.

IT'S ABOUT RELATIONSHIPS, REGARDLESS IF WE ARE IN THE OPWDD SYSTEM, THE OMH SYSTEM, RESIDENTIAL SETTING, TO ALLOW THE INDIVIDUALS TO LEARN NEW SKILLS, TO SAFELY BE ENGAGED WITH THEIR PEERS IN THE COMMUNITY.

WE NEED THESE RELATIONAL ARRANGE MANIES WITH OUR EMPLOYEES AND PEOPLE TAKING CARE OF US.

>> AND MY COSTS, AND MY-- I HAVE TO RELY ON MORE MONEY IN SOME WAYS.

IT JUST DEPENDS... >> I DON'T THINK IT'S A QUESTION OF MONEY.

I THINK IT DEFINITELY COSTS MORE MONEY.

>> WELL, RIGHTED, BUT IT'S...

I WEIGH OUT THE MONEY VERSUS THE PERSON'S HAPPINESS.

I ALWAYS SAY IF I COULD HAVE ADVOCATE AND TEACH SOMEBODY HOW TO ADVOCATE FOR THEMSELVES AND DO IT WELL, AND EVEN I'D LIKE TO SEE A BUNCH OF PEOPLE ADVOCATE FOR THEMSELVES, BUT I ALWAYS SAY, IF I COULD TEACH ONE PERSON HOW TO ADVOCATE FOR THEMSELVES, AND DO IT WELL, WITH THE HELP OF SOMEBODY LIKE ME, THEN I'VE DONE MY JOB, YOU KNOW.

I'VE DONE MY JOB.

I FEEL I'VE DONE MY JOB.

>> WELL, SENATOR MANNION, BILL MENTIONED THIS IDEA OF IN THE COMMUNITY AND SINCE WILLOWBROOK, THERE HAS BEEN AN EMPHASIS ON GETTING PEOPLE BACK OUT IN THE COMMUNITY.

THAT'S A CHALLENGE THOUGH.

IT IS EXPENSIVE.

IT IS HANDS O.

IT DOES REQUIRE RELATIONSHIPS.

SO FROM WHAT YOU'VE HEARD FROM CONSTITUENTS AND ADVOCACY GROUPS BECAUSE OF YOUR FOCUS ON THE COMMITTEE ON DISABILITIES, WHAT DO YOU THINK OF THAT EFFORT?

IS THE STATE, BROADLY SPEAKING, DOING A GOOD ENOUGH JOB IN GETTING PEOPLE OUT INTO THE COMMUNITY, GOING THAT EXTRA MILE?

>> WELL, FIRST OF ALL IT'S THE RIGHT THING TO DO AND WE HAVE COME A LONG WAY SINCE WILLOWBROOK.

MY AUNT HAD DOWN SYNDROME AND SHE DID LIVE IN A RESIDENTIAL FACILITY THAT WE WOULD PUT INTO THAT INSTITUTION SPACE.

BUT THEN LATER IN HER LIFE, SHE DID NOT.

SHE WAS REALLY INTEGRATED INTO THE COMMUNITY.

SHE WORKED.

WE HAVE MADE ADVANCEMENTS IN THE STATE THROUGH LEGISLATION WITH THE PREFERRED SOURCE PROGRAM AND OTHERS, TO, FOR PEOPLE THAT WANT TO WORK, TO FIND AN APPROPRIATE PLACE FOR THEM TO DO THAT.

SO WE ARE MOVING IN THE RIGHT DIRECTION, WHETHER IT IS INDIVIDUALS WITH DISABILITIES ENTERING THE WORKFORCE, ENTREPRENEURSHIP PROGRAMS, WHICH WE-- I WAS PROUD TO SUPPORT AT SYRACUSE UNIVERSITY AND ALSO AN EMPLOYMENT PROGRAM THERE.

BUT WE KEEP COMING BACK TO THIS, AND IT IS GOING TO-- WE ALL ARE ADVOCATES FOR THIS, INCLUDING THE COMMISSIONER.

BECAUSE WE ARE LACKING DSPs BECAUSE OF THE CHALLENGES WITH THE RISING MINIMUM WAGE AND ALSO THE DEMAND OF THE WORK, THERE IS HIGH TURNOVER.

RECRUITMENT AND RETENTION ARE EVERY VOLUNTARY PROVIDER OUT THERE IS DOING WHATEVER THEY CAN TO MAKE SURE THAT THEY'RE DOING THAT.

BUT IT IS A CHALLENGE.

SO THAT INTEGRATION IS NOT NECESSARILY WHERE IT IS.

BUT WE'VE GOT TO HAVE SOME FLEX IBILITY WHEN IT COMES TO HOUSING, WHEN IT COMES TO EMPLOYMENT, WHEN IT COMES TO SERVICES THAT ARE OUT THERE IN THE COMMUNITY AND WE ARE DOING THAT.

AND BUT WE HAVE TO DO IT IN A SMART WAY AND IN A TRANSPARENT WAY AND ALSO IN A WAY THAT ASSURES EVERYONE'S SAFETY.

>> AND THE OTHER THING, TOO, IS THAT PEEP NEED TO REMEMBER, I THINK WE ALL ARE AROUND THIS TABLE AND WE DO OUR BEST.

EVERYTHING HAS TO BE ACCESSIBLE.

FROM THE HOUSING TO THE, YOU KNOW, TO THE AFFORDABILITY OF STUFF, TOO.

I MEAN EVERYTHING HAS TO BE ACCESSIBLE.

>> I WANT TO PIVOT TO ANOTHER SIDE OF THIS CONVERSATION.

OVERSIGHT OF THE CARE OF VULNERABLE NEW YORKERS 679 BEFORE WE HEAR FROM THE PANEL, WE'RE GOING TO CHECK IN WITH DENISE MIRANDA, EXECUTIVE DIRECTOR OF THE JUSTICE CENTER FOR THE PROTECTION OF PEOPLE WITH SPECIAL NEEDS, WHICH - FOR THE LAST DECADE - HAS BEEN REPSONSIBLE FOR FIELDING ALLEGATIONS OF ABUSE AND NEGLECT.

WE TALKED WITH DENISE MIRANDA IN HER CAPITAL REGION HEADQUARTERS, IN EARLY OCTOBER.

>> THANK YOU FOR BEING HERE.

>> A PLEASURE.

>> BEFORE SOMEONE CAN WORK DIRECTLY WITH A VULNERABLE PERSON IN SOME SORT OF SETTING OUT AND ABOUT IN THE STATE, WHAT SORT OF VETTING DOES YOUR OFFICE PUT THEM THROUGH.

>> WE HAVE A UNIT KNOWN AS CRIMINAL BACKGROUND CHECK AND ON AVERAGE WE PROCESS ABOUT 100,000 FINGERPRINTS.

THAT PROCESS, RATHER EXTENSIVE PROCESS STARTS WITH OUR STAFF EXCLUSION LIST.

IT'S A LIST OF APPROXIMATELY 900 INDIVIDUALS RIGHT NOW WHO HAVE BEEN SUBSTANTIATED FOR CATEGORY 1 OFFENSES.

OUR CATEGORY 1 OFFENSES ARE THE MOST SERIOUS EGREGIOUS INCIDENTS OF ABUSE AND NEGLECT.

AND THAT STAFF EXCLUSION LIST PROVIDE THES, A BAR FROM ANY OF THESE INDIVIDUALS RETURNING TO EMPLOYMENT UNDER OUR JURISDICTION.

SO THAT'S THE INITIAL PROCESS.

MAKING SURE THAT SOMEONE IS NOT ON THE STAFF EXCLUSION LIST.

THAT'S ONE OF THE BIGGEST PREVENTION TOOLS.

IT'S A GREAT ASSET HERE FOR US ENSURE THAT THE PEOPLE STAY OUT OF THE SYSTEM.

WE HAVE HAD ABOUT 250 INSTANCES WHERE PEOPLE ARE TRYING TO SEEK EMPLOYMENT.

ASSUMING YOU PASS THE STAFF EXCLUSION LIST CHECK THERE IS A CRIMINAL BACKGROUND CHECK AND WE DO AN EXTENSIVE REVIEW.

CRIMINAL BACKGROUND HISTORIES, CERTAIN QUALIFYING CONSIDERATIONS WE HAVE TO LOOK AT WITH EXECUTIVE LAW AND THOSE RESULTS ARE TRANSMITTED BACK TO THE EMPLOYER.

>> SO WHEN ALLEGATIONS OF ABUSE AND NEGLECT ARE MADE, HOW DO THEY REACH YOUR OFFICE?

AND HOW MANY OF THESE REPORTS DO YOU RECEIVE ANNUALLY?

>> SO WE OPERATE A 24/7 CALL CENTER HERE IN DEL MAR WHERE WE RECEIVE ALL OF OUR CALLS.

IT IS THE FIRST STEP IN THE PROCESS OF REPORTING, AS YOU KNOW THERE IS MANDATORY REPORTING FOR CUSTODIANS WORKING IN THE SETTINGS UNDER OUR JURISDICTION.

THOSE CALLS COME IN.

WE HAVE AN AGENT HERE THAT WILL ANSWER THAT PHONE CALL.

THOSE PEOPLE ARE WELL TRAINED.

THEY'RE CREDENTIALED.

THEY OFTEN HAVE AN EXTENSIVE HISTORY AND EXPERIENCE WORKING IN THE HUMAN SERVICES FIELD AS WELL AS PROFESSIONAL POST HIGH SCHOOL GRADUATE EDUCATION.

AND SO THEY'LL TAKE THE INFORMATION AND A DETERMINATION WILL BE MADE AS TO A CLASSIFICATION.

IF WE NEED ADDITIONAL INFORMATION, WE HAVE A PROCESS IN PLACE WHERE WE CAN HOLD THAT CASE, THAT ALES.

THAT'S IMPORTANT, DAVE BECAUSE THE CLASSIFICATION SETS THE TRAJECTORY FOR THE MATTER YOU CANS RIGHT.

IF IT IS AN ABUSE AND NEGLECT CASE, WE ARE GOING TO TAKE IT STATUTORILY.

WE ARE REQUIRED TO INVESTIGATE THAT CASE TO ITS COMPLETION.

AND PERHAPS THERE IS A NON-J.C.

EVENT SO THOSE CALLS COME IN HE, THE INITIAL STEP IN TERMS OF A REPORT BEING MADE TO THE JUSTICE CENTER.

>> AND HOW MANY CALLS ARE WE TALKING ABOUT ON A GIVEN YEAR AND IS THERE FLUCTUATION IN CALLS HAVE YOU SEEN OVER THE PAST DECADE.

>> VERY CONSISTENT, ABOUT 90,000 CALLS COME IN A YEAR.

NOW OBVIOUSLY THERE ARE NOT 90 HOW INCIDENTS OF ABUSE AND NEGLECT.

THAT'S A GOOD THING.

WE GET A LOT OF PHONE CALLS NOT RELATED TO THE J.C., WE DO HAVE AN OBLIGATION STATUTORILY TO PROVIDE REFERRALS TO THESE PEOPLE.

SHOULD SOMEONE CALL RELAYING AN INCIDENT ABOUT A SCHOOL SETTING, PUBLIC SCHOOL OR NURSING HOME, WE WILL MAKE THE APPROPRIATE REFERRAL TO THE CORRESPONDING AGENCY, DEPARTMENT OF HEALTH OR EDUCATION.

BUT IN TERMS OF INCIDENTS OF ABUSE AND NEGLECT, WE ARE LOOKING AT APPROXIMATELY 13,000 A YEAR AND THAT NUMBER HAS BEEN EXTREMELY CONSISTENT IN THE 10 YEARS THAT WE HAVE BEEN HERE.

>> IS THE CONSISTENCY A GOOD THING OR WOULD YOU WANT TO SEE THE NUMBERS MOVING IN SOME SORT OF DIRECTION?

WHAT DOES CONSISTENCY MEAN TO YOU?

>> WE DON'T WANT TO SEE THE NUMBERS GOING UP, RIGHT?

THAT WOULD BE PROBLEMATIC AND THAT WOULD BE VERY CONCERNING.

BUT I THINK THE CHALLENGE HERE WHEN WE ARE TALKING ABOUT THE NUMBERS ARE CONSISTENT, RIGHT AND PEOPLE ASK, WHAT DOES THAT SAY TO YOUR EFFECTIVENESS?

WE HAVE TO REMEMBER THAT THIS IS NOT A STATIC POPULATION, RIGHT?

THERE ARE PEOPLE COMING INTO THE WORKFORCE EVERY SINGLE DAY.

THERE ARE PEOPLE WHO ARE GOING IN AND OUT OF SERVICE, RIGHT, WHO ARE RECEIVING SERVICES EVERY SINGLE DAY.

SO THE POPULATIONS ARE CHANGING ON BOTH FRONTS.

SO THERE IS A LEVEL OF CONSISTENCY THERE.

THAT SAID, EVERY ONE OF THESE CASES IS INVESTIGATED FROM BEGINNING TO END, DETERMINATIONS ARE MADE.

OVERWHELMING MAJORITY OF THE INVESTIGATIONS THAT COME IN ARE CATEGORY 3 OFFENSES.

THOSE CATEGORY 3 OFFENSES ARE LEAST SERIOUS OFFENSES.

ABUSE AND NEGLECT.

THAT'S THE OVERWHELMING MAJORITY OF WHAT WE ARE SEEING.

SO ABOUT 57% OF THE CASES THAT COME IN FALL INTO THE CATEGORY 3 BUCKET.

YOU KNOW, THE NUMBERS ARE WHAT THEY ARE.

IT IS ALWAYS A CHALLENGE TO PROVE A NEGATIVE, RIGHT?

BUT WE DO BELIEVE THAT THE WORLD IS SAFER WITH RESPECT TO THESE SETTINGS TODAY THAN IT WAS 10 YEARS AGO WHETHER WE DIDN'T EXIST.

>> AND THOSE CATEGORY 3 OFFENSES, DO YOU FIND THAT THEY ARE PREDOMINANTLY THE RESULT OF INSTITUTIONAL AND SYSTEMIC ISSUES OR ARE THEY THE RESULT OF INDIVIDUAL CHOICES, SO TO SAY?

>> I THINK IT'S A COMBINATION OF A LOT OF THINGS, RIGHT?

AND I THINK WHEN WE TALK ABOUT CATEGORY 3, IT'S IMPORTANT TO REMEMBER WHERE THAT FALLS ON THE SCALE OF CATEGORIES.

WE HAVE CATEGORY 1 I MENTIONED BEFORE, WHICH ARE THE MOST SERIOUS INCIDENTS OF ABUSE AND NEGLECT.

SERIOUS PHYSICAL INJURY, SEXUAL ASSAULT, ET CETERA.

>> INGS THIS THAT CAN END UP IN CRIMINAL CHARGES POTENTIALLY.

>> OFTEN END UP IN CRIMINAL CHARGES AND WILL DEFINITE PLACE YOU ON THE STAFF EXCLUSION LIST, THE LIFETIME BAR CATEGORY 3 IS THE LEAST SERIOUS.

WHEN WE LOOK AT CATEGORY 3 INSTANCES WE ARE LOOKING FOR OPPORTUNITIES FOR RETAINING AND EDUCATION.

SYSTEMIC ISSUES EXIST WITH LACK OF STAFFING, INSUFFICIENT TRAINING THAT CAN LEAD TO A CATEGORY 3, RIGHT?

THERE IS NEGLECT.

PERSON MAY NOT BE AWARE THAT THEY HAD A DUTY TO DO X, Y OR Z IN A PARTICULAR SITUATION.

WHEN WE ASK THESE QUESTIONS, WELL WHY WERE YOU UNAWARE?

I DIDN'T RECEIVE TRAINING.

THAT WAS NOT PART OF MY ONBOARDING EXPERIENCE.

THAT'S A SYSTEMIC ISSUE AND WE ARE ABLE TO ADDRESS THAT AND A LOT OF OUR CASES HAVE CORRECTIVE ACTION PLANS.

SO IF WE SEE THERE IS A SYSTEMIC ISSUE, THERE IS A MECHANISM HERE IN PLACE FOR US TO WORK WITH THE PROVIDER TO ENSURE THAT A CORRECTIVE ACTION PLAN IS PUT TOGETHER SO THAT WE CAN ADDRESS IT.

THE MAJORITY OF THOSE CASES ARE NEGLECT.

SO THEY'RE NOT INTENTIONAL CASES WHERE WE ARE SEEING PEOPLE WHO ARE HITTING OR KICKING AN INDIVIDUAL WHO IS RECEIVING SERVICES.

>> CAN YOU EXPAND A LITTLE BIT ON THE PROACTIVE NATURE OF THIS WORK AND THIS IDEA THAT YOU ARE NOT JUST RESPONSIBLE FOR CLEANING UP AFTER THERE IS AN ALLEGATION OF ABUSE AND NEGLECT BUT HOW YOU ARE TRYING TO PREVENT FUTURE INSTANCES OF NEGLECT IN PARTICULAR.

>> SURE, SO 10 YEARS, RIGHT, WE ARE CELEBRATING OUR 10 YEAR VFS THIS YEAR.

THAT 10 YEARS OF DATA WE HAVE BEEN ABLE TO COLLECT BECAUSE WE HAVE THE CENTRAL REPOSITORY.

SO WE ARE ABLE TO IDENTIFY TRENDS.

WHAT ARE THE MOST PREVALENT INCIDENTS OF ABUSE AND NEGLECT, RIGHT?

WHERE ARE WE SEEING THAT THERE IS A POTENTIAL SPIKE?

WHERE ARE WE SEEING THAT CERTAIN INSTANCES CAN RESULT IN MORE SERIOUS INJURIES.

SO WHEN WE LOOK AT THE DATA, WE ARE ABLE TO IDENTIFY AREAS FOR EDUCATION AND PREVENTION MATERIALS.

WE CREATE THESE TOOLKITS THAT ARE RESOURCES FOR STAFF AND FOR PROVIDERS SO THAT THEY HAVE ALL THE TOOLS NECESSARY TO MAKE SURE THAT THEY'RE APPROPRIATELY EDUCATED.

WE HAVE TOOLKITS WITH RESPECT TO WHEELCHAIR SECUREMENT.

WE DID SEE THERE ARE SERIOUS INCIDENTS THAT RESULT IN WHEELCHAIRS BEING IMPROPERLY SECURED ON A VEHICLE.

SO WE ACTUALLY CREATED A TOOLKIT FOR ASSESSMENT AND OTHER TRAINING.

WE HAVE ISSUES WITH RESTRAINTS.

WE HAVE DONE TRAINING TO MAKE SURE PEOPLE ARE AWARE OF RESTRAINTS AND THE PROPER WAY IN WHICH THEY'RE SUPPOSED TO BE DONE.

CAREGIVER FATIGUE.

THERE ARE A HOST OF THEM.

ABOUT 10 OR 11 DIFFERENT TOOLKITS THAT ARE THERE.

BUT THAT'S BASED ON WHAT WE ARE SEEING ON THE GROUND.

WE HAD A VERY SERIOUS INCIDENT WHERE WE HAD AN INDIVIDUAL WHO IS RECEIVING SERVICES WHO PASSED AWAY THAT RESULTED IN US DOING A TOOLKIT WITH RESPECT TO INTESTINAL BLOCKAGES, RIGHT, AND MAKING SURE THAT WE NEVER SEE A SITUATION LIKE THAT.

WE WANT TO MAKE SURE THAT WE ARE CONTRIBUTING TO THE PREVENTION AS WELL AS THE INVESTIGATION OF INCIDENTS OF ABUSE AND NEGLECT AND THAT'S VERY IMPORTANT.

WE HAVE AN ENTIRE UNIT HERE DEDICATED TO EDUCATION AND PREVENTION AND THEY REALLY DO A SOLID JOB OF MAKING SURE THAT THEY ARE STAYING ON TOP OF THE INCIDENTS AND THE FREQUENCY AND TURNING THOSE DATA POINTS INTO OPPORTUNITIES FOR EDUCATION.

>> SO THINKING PROACTIVELY, DO YOU HAVE THE CAPACITY TO SET UP SAY AN EARLY WARNING SYSTEM MONITORING STAFFING RATIOS IN FACILITIES BECAUSE NOT HAVING ENOUGH STAFF COULD LEAD TO NEGLECT.

IS THAT SOMETHING THAT YOU ARE ABLE TO USE TO RAISE AN LARGE BEFORE SOMETHING MIGHT HAPPEN?

>> SO, WE DON'T HAVE A SYSTEM IN PLACE WHERE WE ARE ABLE TO PROACTIVELY, AS YOU MENTIONED, GO INTO A SETTING, RIGHT, AND LOOK AT STAFFING LEVELS.

WE DO HAVE THE ABILITY THOUGH TO AUDIT AND WE HAVE THE ABILITY TO ACTUALLY GO TO SETTINGS AND LOOK FOR THIS INFORMATION.

BUT THAT IS OFTEN THE RESULT OF SOME SORT OF INITIATING ACT, RIGHT, A CALL, AN ALLEGATION OR PERHAPS A FINDING THAT IS UNRELATED TO THE INITIAL CASE; FOR EXAMPLE, WE'LL HAVE SOMEONE GO INTO A SETTING.

THERE IS AN INCIDENT OF ABUSE AND NEGLECT THAT IS REPORTED THAT JOHN WORKER HIT SUSIE WHO IS RECEIVING SERVICES.

WE GO TO THE SETTING.

WE ARE DOING INTERVIEWS.

WE ARE SPEAKING TO PEOPLE.

WE ARE NOTICING A RATHER CHAOTIC ENVIRONMENT.

NOTICING THAT THINGS ARE NOT CLEAR.

WE ARE NOTICING THAT PEOPLE DON'T SEEM TO BE ATTENDED TO IN THE MANNER IN WHICH THEY SHOULD.

WE ARE ABLE TO ADDRESS EVERYTHING THAT WE ARE OBSERVING PROACTIVELY.

WE DON'T NEED TO WAIT FOR THERE TO BE AN INCIDENT OF ABUSE AND NEGLECT EVEN THOUGH THAT HAS NOTHING TO DO WITH THE REASON WHY WE ARE INITIALLY THERE.

SO IN THAT SENSE, RIGHT, OUR FOLKS WHO ARE ON THE GROUND EVERY SINGLE DAY WHO ARE GOING TO SETTINGS, WHO ARE GOING TO PROVIDERS, THEY'RE THE EYES AND EARS SO THEY'RE ABLE TO CATCH THINGS PROACTIVELY BUT IN TERMS OF LOOKING AT A PROVIDER HOW THEY'RE SPENDING THEIR MONEY, LOOK AT A PROVIDER, ASKING THEM FOR THEIR SHIFT DETAILS, NO, WE DON'T DO THAT UNLESS, OF COURSE, IT'S PART OF AN OBSERVATION OR ALLEGATION.

>> SO THE JUSTICE CENTER WAS SET UP IN RESPONSE TO A SERIES OF HIGH PROFILE CASES OF ABUSE AND NEGLECT ACROSS NEW YORK STATE AND THERE SEEMED, IN ITS INITIAL INCARNATION TO BE A VERY LAW ENFORCEMENT EMPHASIS FOR THE AGENCY AND THERE WAS A LOT OF TUMULT AND QUESTIONS ABOUT ITS OPERATIONS IN THE FIRST FEW YEARS.

YOU TOOK OVER AFTER THAT.

HOW, IF AT ALL, HAVE YOU TRIED TO RESPOND TO THE EARLY YEARS OF THE JUSTICE CENTER?

>> WELL, I THINK WE HAVE A REALLY GOOD IDEA OF WHAT WORKS NOW, RIGHT, 10 YEARS LOOKING BACK ON WHAT DOESN'T WORK.

THE AGENCY WAS CREATED OUT OF A SERIOUS SET OF CIRCUMSTANCES, RIGHT, AND ALESES AND INVESTIGATIVE REPORT THAT POINTED OUT LOTS OF ABUSE AND NEGLECT AND A SYSTEM THAT WAS FUNDAMENTALLY BROKEN.

I CAN CERTAINLY APPRECIATE WHEN THE JUSTICE CENTER WAS CREATED THAT THERE WAS A REAL EFFORT AND COMMITMENT TO MAKING SURE THAT WE WERE ADDRESSING INCIDENTS OF ABUSE AND NEGLECT.

THAT SAID, THE MANNER IN WHICH WE APPROACHED THAT WORK, I THINK REALLY NEEDED SOME REFINEMENT.

AND SO WE DO HAVE LAW ENFORCEMENT CAPACITY.

WE DO HAVE POLICE OFFICERS HERE.

WE STILL HAVE THEM HERE.

BUT HOW WE APPROACH OUR WORK IS REALLY IMPORTANT BECAUSE WE CANNOT AFFORD TO ALIENATE THE PEOPLE WHO WE ARE WORKING WITH.

TODAY YOU ARE A SUBJECT, TOMORROW YOU ARE A WITNESS, TOMORROW YOU ARE A WITNESS, TODAY YOU ARE A SUBJECT.

WE NEED TO WORK WITH THESE INDIVIDUALS EVERY SINGLE DAY.

TO HAVE AN ANTAGONISTIC RELATIONSHIP WHERE PEOPLE ARE FEARFUL OF THE JUSTICE CENTER, WHERE THEY THINK THAT THEIR LIVELIHOOD IS GOING TO BE TAKEN AWAY BY VIRTUE OF TALKING TO US, THAT'S NOT HELPFUL.

THERE ISN'T A PERSON I'VE EVER MET THAT THINK ABUSE OF PEOPLE RECEIVING SERVICES IS OKAY.

HOW WE APPROACH THE WORK IS VERY DIFFERENT.

BUT THE WORK AND THE COMMITMENT IS STILL THE SAME.

I JUST DON'T THINK WE NEED TO BE AS HEAVY HANDED AS WE WERE BEFORE.

YOU KNOW, LANGUAGE MATTERS.

WE'VE HAD THIS CONVERSATION BEFORE.

WHEN I ARRIVED HERE, THE USE OF THE WORD SUSPECT WAS USED ACROSS THE BOARD WHETHER IT WAS AN ADMINISTRATIVE CASE OR A CRIMINAL CASE.

THAT'S NOT APPROPRIATE LANGUAGE.

SUSPECT IS A TERM USED IN THE CRIMINAL CONTEXT WORLD.

THAT SHOULD BE FOR CRIMINAL CASES.

IF WE ARE TALKING ABOUT A PERSON WHO IS INVOLVED IN AN ADMINISTRATIVE MATTER, SUBJECT IS MUCH MORE APPROPRIATE RATHER THAN SUSPECT.

WE ARE NOT LOOKING TO USE LANGUAGE THAT FURTHER CONTRIBUTES, RIGHT, TO THAT CULTURE OF FEE AND LAW ENFORCEMENT AND, YOU KNOW, BEING RATHER HEAVY HANDED IN OUR APPROACH.

>> THANK YOU SO MUCH FOR MAKING THE TIME, DIRECTOR MIRANDA.

>> A PLEASURE TO BE HERE.

THANK YOU, DAVE.

>> SO COMMISSIONER, I WANT TO START WITH YOU AND FOCUS ON SOMETHING THAT EXECUTIVE DIRECTOR MIRANDA SAID WITH REGARDS TO THE PROACTIVE NATURE OF THEIR WORK AND THIS IDEA THAT THEY CAN IDENTIFY SYSTEMIC ISSUES.

HOW, IF AT ALL, HAS THAT BEEN ADDRESSED AT OPWDD?

ARE THERE INSTANCES THAT COME TO MIND WERE THE JUSTICE CENTER MAKING RECOMMENDATIONS FOR OPWDD OR NON-PROFIT PROVIDERS THAT YOU WORK WITH THAT HAVE POTENTIALLY HELPED PREVENTING ABUSE OR NEGLECT IN THE SYSTEM?

>> SURE, YEAH AND WE DO WORK VERY CLOSELY WITH THE JUSTICE CENTER AND CERTAINLY THE WORK THAT THEY'RE DOING ON THE PREVENTIVE SIDE IS-- HAS BEEN SOMETHING THAT WE HAVE PARTICIPATED WITH THEM.

WE HAVE OUR OWN DIVISION OF QUALITY IMPROVEMENT AND WE HAVE OUR OWN INTERNAL INVESTIGATIONS TEAM.

THEY BOTH WORK COLLABORATIVELY WITH THE JUSTICE CENTER.

SO WHEN WE NOTICE EITHER AN UPTICK IN A TYPE OF INCIDENCE, YOU KNOW, INCIDENTS THAT DEMONSTRATE THE NEED FOR NEW TRAINING, RIGHT, OR SIMPLIFIED TRAINING OR WE CAN SEE THAT, YOU KNOW, THERE IS HAPPENING ACROSS THE BOARD, YOU CAN RECOGNIZE SYSTEMIC ISSUES THERE AND WE HAVE PARTNERED WITH THEM ON THE WHEELCHAIR SECUREMENT, YOU KNOW, WORK THAT THEY DID.

THE WORK THAT THEY DID RELATED TO RESTRAINTS.

WE'VE DONE OUR OWN WORK OUTSIDE OF THE JUSTICE CENTER BASED ON OUR OWN INVESTIGATIONS AND BASED ON OUR OWN ANNUAL CERTIFICATION SURVEYS, THINGS LIKE CHOKING PREVENTION.

WE ARE CONSTANTLY LOOKING AT THAT AND CONSTANTLY UPDATING IN AN EFFORT TO PREVENT THINGS.

, ESPECIALLY WHEN THEY'RE RELATED TO NEGLECT OR RELATED TO THINGS THAT HAPPEN BY ACCIDENT.

THEY'RE NOT INTENTIONAL BY STAFF.

THOSE ARE AREAS WHERE WE CAN REALLY DIG IN, TRY TO INCREASE THOSE TRAINING OPPORTUNITIES, TRY TO INCREASE THE MATERIAL THAT WE ARE PUTTING OUT THERE, MAKING IT MORE ACCEPTABLE FOR ACCESSIBLE FOR OUR STAFF AND PREVENT BAD THINGS FROM HAPPENING.

>> AND JUST TO FOLLOW UP ON THAT, COMMISSIONER, DO YOU FEEL LIKE THE JUSTICE CENTER, WHEN THEY DO MAKE RECOMMENDATIONS, THEY'RE GROUNDED IN REALITY; THAT THEY REFLECT SOME UNDERSTANDING OF THE POPULATION THAT YOU ARE TRYING TO SERVE?

OR DO YOU FEEL LIKE IT'S POSSIBLE THAT THEY DON'T NECESSARILY REFLECT WHAT IS ACTUALLY HAPPENING ON THE GROUND BECAUSE THEY'RE NOT THE ONES PROVIDING THE SERVICE.

THEY MIGHT BE JUMPING IN FOR A DAY OR BRIEF PERIOD OF TIME AND NOT HAVE THAT LIVED EXPERIENCE THAT YOUR OFFICE AS WELL AS THE NON-PROFIT PROVIDERS MIGHT HAVE?

>> SURE, THAT'S A GREAT QUESTION.

AND I THINK YOU HEARD DENISE TALKING ABOUT IT.

THEY HAVE SPENT A LOT OF TIME MAKING SURE THAT THEIR STAFF REALLY UNDERSTAND THE SYSTEMS THEY'RE WORKING IN.

THEY'RE REALLY WELL TRAINED, PEOPLE WHO COME TO THE JOB WITH A BACKGROUND AND OFTEN TIMES IN THE CITIES SYSTEMS THEY'RE INVESTIGATING OVERALL IN HUMAN SERVICES SOCIAL WORK, THE PROGRAMS THAT, YOU KNOW, THAT WE ARE WORKING IN.

SO I THINK THAT THE JUSTICE CENTER STAFF REALLY DO DIG IN AND WORK TO UNDERSTAND AND SEEK TO UNDERSTAND THE CIRCUMSTANCES, ARE NOT COMING IN FROM AN AUDIT PERSPECTIVE LOOKING TO FIND FAULT.

THIS REALLY ARE THERE AS PARTNERS.

LOOKING TO IMPROVE THE SYSTEMS THAT THEY WORK IN.

>> WELL, BILL, NO TO THE DATE YOU, BUT YOU'VE SEEN VARIATIONS OF THE OVERSIGHT DONE IN NEW YORK.

DENISE MIRANDA SAID THE WORLD IS SAFER NOW WITH THE JUSTICE CENTER.

IS THAT ACCURATE?

ARE THE VULNERABLE PEOPLE UNDER THE STATE'S CARE HOT JUSTICE CENTER HAS THE RESPONSIBILITY TO POLICE, ARE THEY SAFER NOW?

>> I BELIEVE THEY ARE SAFER AND THE PROCESS FOR SAFEGUARDING THOSE PROTECTIONS IS MORE TRANSPARENT.

AND IT'S MORE OBJECTIVE.

I THINK WE HAVE COMMON DEFINITIONS OF NEGLECT AND ABUSE ACROSS ALL THE STATE AGENCIES.

I THINK THAT'S VERY, HAVE ARE IMPORTANT.

I THINK ALSO THE PIVOT FROM THE LAW ENFORCEMENT FOCUS AND INITIAL PARTS OF THE JUSTICE CENTER TO A PREVENTION FOCUS IS MADE A BIG DIFFERENCE TO THE WORKFORCE BECAUSE AS WE TRY TO PREVENT PROBLEMS THAT HAPPEN OR BAD DAY THAT HAPPENS, JUSTICE CENTER UNDERSTANDS THAT THE WORK IS DIFFICULT AND CONDITIONING.

SO THE SHORT ANSWER IS YES.

I THINK IT'S BETTER.

THERE IS LESS BAD ACTORS IN THE FIELD RIGHT NOW AND AGAIN, I THINK WE HAVE TO PROMOTE PREVENTION AND THE WORKFORCE.

>> THE PREDECESSOR TO THE JUSTICE CENTER WAS A COMMISSION ON QUALITY CARE FOUNDED IN THE 70s, EVERYBODY WAS EXCITED WHEN IT WAS LAUNCHED AND EVERYONE LOVED THE HEAD OF IT AT THE TIME, CLARENCE SUNDRUM BUT AS AT AGENCY CONTINUED TO OPERATE OVER THE DECADES, CLARENCE LEFT, DISINVESTMENT, A LACK OF EMPHASIS AND PROBLEMS EMERGED ACROSS THE SYSTEM, PROBLEMS THAT LED TO AN OVERALL.

SO HOW DO YOU ENSURE THAT THERE ISN'T A FUTURE LACK OF FOCUS.

WHAT IS THE LEGISLATURE'S ROLE IN THAT?

IS IT JUST ABOUT HOLDING HEARINGS?

ABOUT MABELING INVESTMENTS?

HOW DO YOU ENSURE PEOPLE ARE STAYING ON TOP OF THIS?

>> I THINK THAT'S ALL PART OF IT.

I DO THINK THAT LEGISLATION CAN BE NECESSARY AND I HAVE HOPEFULLY BEEN HELPFUL IN ADVANCING SOME OF THOSE THINGS AND WE CERTAINLY NEED THE INVESTMENT.

WE, AS OFFICES IN THE SENATE AND THE ASSEMBLY, ALSO HAVE TO STAY CONTINUOUSLY ENGAGED WITH OUR CONSTITUENTS TO MAKE SURE, WHETHER YOU ARE DISABILITIES CHAIR OR NOT, THAT INDIVIDUALS THAT ARE LIVING IN YOUR COMMUNITY, SOME OF WHOM HAVE DISABILITIES, AND WHETHER THEY'RE SELF-ADVOCATES OR FAMILY ADVOCATES, THAT WE ARE ENGAGED IN WITH THEM AND CONSTANT COMMUNICATION WITH THE JUSTICE DEPARTMENT AND OPWDD AND DHS AND BEYOND.

DIRECTOR MIRANDA MENTIONED IN YOUR INTERVIEW WITH HER THE WORKFORCE, AND THAT SHE USED THE WORD WITNESS.

SO THESE ARE INDIVIDUALS THAT ARE BY AND LARGE VERY DEDICATED, AS MICHAEL ARTICULATED.

IT'S BASED ON RELATIONSHIPS.

IT'S BASED ON TRUST.

IT'S BASED ON FRIENDSHIP AND BUT IT'S VERY CHALLENGING WORK AS WE HAVE ALL SAID.

SO WE WANT TO MAKE SURE THAT THE EMPHASIS IS ON PREVENTION; THAT IT IS ON EDUCATION, THAT WE HAVE GOOD PEOPLE WORKING WITH GOOD PEOPLE, BUT WE ALSO WANT TO-- THE PROCESS TO PLAY OUT AND BE THOROUGH BUT WE DON'T WANT TO DRIVE PEOPLE AWAY AND THAT'S WHY I'M THANKFUL THAT SHE MENTIONED THAT IN YOUR CONVERSATION WITH HER.

>> WELL, MICHAEL, WHEN YOU THINK ABOUT OVERSIGHT FOR THESE SERVICES THAT WE HAVE BEEN TALKING ABOUT, WHETHER IT'S THE JUSTICE CENTER OR THE AGENCIES RESPONSIBLE FOR ADMINISTERING THE CARE, DO YOU FEEL LIKE THERE IS ADEQUATE OVERSIGHT THAT IS RESPONSIVE TO PEOPLE'S LIVES?

>> YES.

>> WHY?

>> >> BECAUSE WHEN THE OVERSIGHT FOR THE PEOPLE, THEY ALSO WORK WITH US TO SEE THAT EVERYTHING IS WORKING WELL AND IF IT'S NOT WORKING WELL, THEN THE SELF-ADVOCATES TELL THEM WHEN IT'S NOT WORKING WELL.

I MEAN MANY PEOPLE KNOW I I AM VERY VOCAL WHEN THINGS WORK WELL AND I'M VERY VOCAL WHEN THEY DON'T WORK WELL.

AND BECAUSE I HAVE BEEN A PART OF THIS SYSTEM FOR A LONG TIME.

AND PEOPLE KNOW THAT WHEN THINGS AREN'T WORKING WELL FOR ME OR ANYBODY ELSE, I'M AN ADVOCATE FOR MYSELF, BUT I'M ALSO AN ADVOCATE FOR PEOPLE WITH DISABILITIES WHO DON'T HAVE THE CAPABILITY TO SPEAK FOR THEMSELVES.

BECAUSE SOME OF THEM, YOU KNOW, THEY DON'T-- SOME OF THEM DON'T HAVE PARENTS ANYMORE THAT CAN SPEAK FOR THEM.

I TAKE THAT AS A ROLE THAT SELF-ADVOCATES NEED TO DO BECAUSE THEIR VOICE NEEDS TO BE HEARD AS WELL AS OURS.

SO THAT'S-- THAT'S WHAT I THINK OUT OF SELF-ADVOCACY AND STUFF.

>> BILL, MICHAEL MENTIONED THIS IDEA OF PEOPLE WHO CAN'T NECESSARILY ADVOCATE FOR THEMSELVES.

ARE THERE SAFEGUARDS, DO YOU THINK, THAT ARE IN PLACE FOR THOSE PEOPLE WHO CAN'T SPEAK UP ABOUT MAYBE NOT GETTING FED AT THE RIGHT TIME OR IF SOMEONE, GOD FORBID IS ACTUALLY BEING PHYSICALLY OR MENTALLY ABUSIVE TOWARD THEM?

>> I THINK THE LEGISLATION IS VERY CLEAR ABOUT WHO IS REQUIRED TO REPORT ALESES OF ABUSE AND NEGLECT.

AND I THINK AS WE PROFESSIONALIZE AND FURTHER PROFESSIONALIZE THE FIELD, THE STAFF FRONT LINE, THE STAFF THERE SATURDAY NIGHT OR ALL ALONE SOME DAYS FEEL THE RESPONSIBILITY TO REPORT.

AND WHEN THE INVESTIGATION IS EVEN HANDED AND FAIR AND STRENGTH BASED, I THINK THAT GOES A LONG WAY TO INCREASE THE APPROPRIATE REPORTING OF POTENTIAL ABUSE AND NEGLECT.

AND THE OTHER POINT I THINK DENISE MADE VERY STRONG IS NOT EVERY ALES IS SUBSTANTIATED.

>> A THIRD OF THEM.

>> ABOUT A THIRD ARE.

SO THAT MEANS PEEP MADE THE RIGHT DECISION TO CALL IT IN BUT THERE MIGHT HAVE BEEN MITIGATING CIRCUMSTANCES OR, IN FACT, THE VIDEO SHOWS IT DIDN'T HAPPEN.

BUT I THINK IF WE HAVE A MORE TRANSPARENT PROCESS AND WE SUPPORT OUR EMPLOYEES TO MAKE THE CALLS, AND THEN, AGAIN, IT ALL COMES BACK TO WORKFORCE AND PROFESSIONALIZATION.

>> COMMISSIONER, DO YOU WANT TO ADD SOMETHING?

>> THANKS, I JUST WANTED TO ADD JUST BUILDING ON WHAT BILL SAID, RIGHT, YOU FLOW I'VE SPENT A TON OF TIME IN MY TWO YEARS HERE IN THE FIELD.

I'M AT HOMES AND AT PROGRAMS AND TALKING WITH DIRECT SUPPORT PROFESSIONALS ALL THE TIME.

AND TO THE EXTENT THAT PEOPLE CAN'T ADVOCATE FOR THEMSELVES, I HAVE SEEN NO FIERCER ADVOCATES THAN THE DSPs THEMSELVES, WHEN THEY SEE SOMETHING HAPPENING THAT IS NO THE OKAY FOR THE FOLKS THAT THEY'RE THERE TO SERVE, THEY'RE THE FIRS ONES TO CALL OR TO SAY THIS IS NOT OKAY.

THIS IS NOT THE WAY WE SHOULD BE TREATING PEOPLE.

THIS IS NOT TREATING SOMEONE WITH DIGNITY.

SO AGAIN, JUST WANTED TO REALLY LIFT UP THE STAFF THAT WE HAVE IN THE FIELD.

THE VAST MAJORITY OF THEM ARE THERE BECAUSE THEY LOVE AND CARE FOR THE WORK THAT THEY'RE DOING AND THEY REALLY ARE, THEY'RE SUCH HUGE ADVOCATE IS AND CHAMPIONS FOR SAFETY AND DIGNITY FOR THE FOLKS THEY'RE SERVING.

>> WE TALKED WITH DENISE MIRANDA ABOUT AN EARLY MONITORING SYSTEM.

THEY DON'T HAVE ANYTHING LIKE THAT IN PLACE.

I'M CURIOUS, BASED ON THE INFORMATION YOU HAVE ACCESS TO AT OPWDD, ARE THERE METRICS OR TRENDS THAT YOU ARE ABLE TO UTILIZE TO POTENTIALLY IDENTIFY MAYBE NEGLECT OR ABUSE BEFORE IT HAPPENS, WHETHER IT'S STAFFING RATIOS OF PROVIDERS OR HOW AN ORGANIZATION IS SPENDING THEIR RESOURCES?

DO YOU USE DATA THAT WAY?

AND IF SO, HAS IT BEEN EFFECTIVE?

>> SURE, I WOULDN'T SAY THAT WE HAVE NECESSARILY METRICS OR ALGORITHMS THAT WE ARE USING AND I THINK IT'S REALLY IMPORTANT TO RECOGNIZE THAT YOU CAN'T REALLY APPLY THOSE TYPES OFALS TO OUR SYSTEM BECAUSE EVERYTHING WE DO IS SO PERSON CENTERED.

SO STAFFING RATIOS UNDERSTAND THE NUMBER OF STAFF THAT ARE NEEDED OR WHERE THEY'RE NEEDED ALL REALLY DEPENDS ON A PERSON'S NEED, RIGHT?

SOMETIMES WE HAVE STAFF THAT NEED TO STAY WITHIN ARM'S LENGTH OF AN INDIVIDUAL AT ALL TIMES BECAUSE THAT'S WHAT THAT PERSON NEEDS.

OTHER PEOPLE HAVE A MUCH HIGHER LEVEL OF INDEPENDENCE AND STAFFING RATIOS CAN LOOK VERY DIFFERENT.

THE TRAINING THAT A STAFF PERSON NEEDS IS VERY DIFFERENT IN THOSE CIRCUMSTANCES.

SO YOU CAN'T REALLY APPLY THAT KIND OF ACROSS THE BOARD.

BUT ONE THING WE DO AT OPWDD THAT THE JUSTICE CENTER DOESN'T DO BECAUSE IT'S NOT THEIR ROLE, RIGHT, WE ARE PROACTIVELY IN THE FIELD IN OUR HOMES ALL THE TIME.

OUR DIVISION OF QUALITY IMPROVEMENT ON AN ANNUAL BASIS IS IN HOMES, YOU KNOW, DOING THEIR ROUTINE INSPECTIONS WHETHER THEY BE ON SITE OR ADMINISTRATIVE REVIEWS OF WHAT IS HAPPENING IN THE HOME.

SO WE DO HAVE THE ABILITY, IF WE SEE SOMETHING, TO POTENTIALLY PREVENT A NEGLECTFUL SITUATION FROM OCCURRING BECAUSE WE CAN WORK WITH THE PROVIDER, WE CAN SAY WE'VE NOTICED THIS DURING OUR REVIEW.

WORK WITH THE PROVIDER TO CORRECT ANY ISSUES, POTENTIALLY BEFORE THERE ARE ANY NEGATIVE RAMIFICATIONS AS A RESULT OF THAT AND CERTAINLY WITHIN OUR OWN STATE OPERATIONS TEAMS, MONITORING STAFFING, UNDERSTANDING WHO IS LIVING IN HOMES, YOU KNOW, CONTINUOUSLY, YOU KNOW, DIVING INTO AND GETTING THAT INSIGHT OF YOU KNOW, STAFFING RATIOS IN OUR OWN HOMES AND WHERE WE NEED TO MAKE CHANGES.

THAT'S SOMETHING THAT OUR STATE OPERATIONSES TEAM IS DOING ON A DAILY BASIS.

>> I SENATOR, WHEN WE THINK ABOUT THE JUSTICE CENTER, IT'S MISSION IS ABOUT PREVENTING ABUSE AND JEG.

THAT'S A LOW THRESHOLD FOR THE QUALITY OF LIFE THAT SOMEONE MIGHT ACTUALLY BE ENJOYING UNDER THE STATE CARE OR NON-PROFIT CARE.

WHAT DO YOU THINK ABOUT THE IDEA THAT THE MANDATE FOR THE J.C.

NEEDS TO HAVE A HIGHER THRESHOLD, THAT THE JUSTICE CENTER COULD HAVE AN EXPANDED MANDATE THAT INCLUDES ACTUALLY POLICING THE QUALITY OF CARE?

IS THAT SOMETHING THAT IS WORTH CONSIDERING?

>> WELL, THIS IS WHERE I THINK THE COMMISSIONER AND OPWDD AND THE VOLUNTARY PROVIDERS AND THE STATE WORKFORCE ARE ALWAYS LOOKING FOR THAT LEVEL OF QUALITIED.

YOU KNOW, I DON'T KNOW IF IT HAS TO BE A TOP DOWN LEGISLATIVE APPROACH AND CHARGED, YOU KNOW, THE JUSTICE CENTER IS CHARGED WITH THAT MISSION BECAUSE AS BILL SAID, HE REFERENCED BAD ACTORS.

I THINK OVER THE COURSE OF TIME, WITH THE ASSISTANCE OF THE JUSTICE CENTER, WE HAVE ACKNOWLEDGED AND SEEN WHERE THE REALLY QUALITY PROGRAMS, WHERE THE REAL INTEGRATED SETTINGS, WHERE THE REAL COMMITMENT TO THE HIGHEST QUALITY OF LIFE FOR INDIVIDUALS IS ALREADY OUT THERE BEING PROVIDED BY OUR PROVIDERS.

SO I'M NOT SURE IF THAT'S NECESSARILY THE JUSTICE CENTER'S ROLE BUT IT'S SOMETHING WE ALL WANTED.

I KNOW THE COMMISSIONER WANTS IT.

I KNOW THE DIRECTOR WANTS IT.

AND YOU KNOW, I GET TO GO OUT AND SEE SOME GREAT THINGS.

MY LAST THING I WILL SAY IS I WILL COME BACK TO, YOU KNOW, WHEN WE HAVE TO CONSOLIDATE RESIDENCES AND THERE MIGHT BE UNFAMILIAR STAFF THAT HAD TO BE MOVED AROUND TO MEET THAT CONSOLIDATION, SOMETIMES IT'S THAT FAMILIARITY THAT'S NOT THERE THAT CAN LEAD TO CHALLENGES AND SOMETIMES REPORTS.

AND CERTAINLY THAT GOES ALONG THE LINES OF THE QUALITY THAT IS OF A PERSON'S EXPERIENCE IN THOSE SETTINGS.

>> DID YOU WANT TO ADD SOMETHING?

>> I AGREE WITH THE SENATOR WHOLEHEARTEDLY.

YOU CAN'T LEGISLATE QUALITY.

IT'S A PARTNERSHIP BETWEEN THE DIRECT CARE PROVIDERS, THE VOLUNTARY AGENCIES, AND THE STATE.

WITH ALL DUE RESPECT TO THE LEGISLATURE AND THEIR WISDOM, IT WON'T INCREASE THE QUALITY.

WE NEED TO PARTNERSHIP AND HONEST COMMUNICATION BETWEEN ALL THE EMPLOYERS AT THE TABLE INCLUDING RECIPIENTS.

THEY WILL TELL YOU WHAT QUALITY LOOKS LIKE AND FEELS LIKE EVERY DAY.

BACK TO THE BROKEN RECORD, IT STARTS WITH A HIGH QUALITY STAFF.

>> AND THAT STAFF AS WE TALKED ABOUT, IS SOMETHING THAT REQUIRES ANNUAL INVESTMENT.

SO COMMISSIONER, I'M CURIOUS, THIS SUMMER, THE BUDGET DIRECTOR SENT OUT A LETTER TO ALL AGENCIES, AND SORT OF HIGHLIGHTED THE FISCAL CONDITIONS THE STATE MIGHT BE IN FOR THE UPCOMING FISCAL YEAR AND SAID, YOU KNOW, PLAN ON FLAT BUDGETS.

WHAT DOES THAT PEEN FOR THE CONVERSATION WE HAVE BEEN HAVING?

DOES THAT MEAN THERE IS ROOM TO MAKE ADDITIONAL INVESTMENTS?

THE WORKFORCE OR IS THAT SOMETHING THAT MIGHT NOT BE ABLE TO HAPPEN UNTIL FUTURE YEARS GIVEN THAT BUDGET REQUEST?

>> SURE, THAT'S A GREAT QUESTION AND CERTAINLY WE ARE AT THE VERY BEGINNING OF THE PROCESS.

I THINK OPWDD IS A VERY WELL RESOURCED AGENCY.

WE HAVE A REALLY SIGNIFICANT BUDGET AND WE WORK HARD ALL THE TIME TO MAKE SURE THAT WE ARE INVESTING IN THE RIGHT AREAS.

CERTAINLY IT'S UP TO THE GOVERNOR'S OFFICE AND TO THE LEGISLATURE, RIGHT, TO DETERMINE WHERE, YOU KNOW-- AND ADDITIONAL INVESTMENTS ARE MADE.

WE WERE VERY HAPPY TO SEE, YOU KNOW, THE CALL LETTER AND UNDERSTANDING THAT WE COULD CONTINUE TO MAKE THE HISTORIC INVESTMENTS THAT THE GOVERNOR AND THE LEGISLATURE HAVE GIVEN US THE OPPORTUNITY TO MAKE IN THE LAST TWO YEARS.

>> BILL, WE HAVE ABOUT 90 SECONDS LEFT AND I'M GOING TO COME TO YOU.

AND I HAVE A FEELING IN THE UPCOMING LEGISLATIVE SESSION, YOU MIGHT BE MAKING NOISE AND PROBABLY SETTING THE TENOR OF THE DEBATE COMING FORWARD.

SO WHAT CAN WE EXPECT FROM ADVOCATES IN TERMS OF WHAT THEY WILL BE ASKING FOR AND WHAT THEY WILL BE PUSHING FOR BECAUSE I IMAGINE YOU ARE NOT GOING TO BE HAPPY WITH THE FLAT BUDGET?

>> NO.

MINIMALLY THE CPI IS UP 3.2%, THAT'S THE FIRST THING THAT HAS TO BE FUNDED.

SECONDLY, WE NEED TO REINVEST MONEY THAT WAS NEVER FUNDED OVER THE LAST DECADE BECAUSE THERE WERE BUDGET CUTS NOTWITHSTANDING LANGUAGE.

WE NEED BETWEEN 500 MILLION AND A BILLION DOLLARS TO MAKE UP FOR LOST REVENUE SO WE CAN INVEST IN STAFF, HIGH QUALITY PROGRAMS AND ELIMINATE THE WAIT LIST BECAUSE THAT'S THE OTHER THING.

WE HAVE WAIT LISTS ACROSS OUR SYSTEMS RIGHT NOW SO WE NEED TO INVEST OVER A MULTIYEAR PERIOD AND THE COMMISSIONERS INTO ED TO SIT TOGETHER AND FIGURE OUT HOW TO MAKE THOSE DOLLARS COUNT.

>> SENATOR, DID YOU TAKE NOTES ON ALL THAT.

>> 100% BILL IS RIGHT.

WOO WENT A DECADE WITHOUT INVESTMENTS WE HAVE HAD COST OF LIVING ADJUSTMENTS OF 1% 5.4%, 4.5%.

WE CAN NOT GO BACKWARDS.

WE CAN'T GO BACKWARDS.

WE MUST MOVE FORWARD.

WE ARE ALL WORKING TOGETHER WITH THE CHALLENGES THAT COME WITH A RISING MINIMUM WAGE AND REALLY VALUING THE STAFF.

THE WORKFORCE SETTINGS HAVE BECOME EVEN MORE CHALLENGING BECAUSE OF THAT.

WE HEAR STORIES WHERE PEOPLE ARE LEAVING THE SECTOR TO GO WORK IN RETAIL.

WE CAN'T HAVE THAT.

WE HAVE TO VALUE THIS AS A PROFESSION AND WE HEAR THOSE HIGH QUALITY OF LIFE STORIES AS WELL AND IT ALWAYS COMES BACK TO THE RELATIONSHIPS AND WE HAVE TO VALUE THE PEOPLE.

THE WAY WE VALUE THEM IS TO MAKE SURE WE INVEST IN THE SYSTEM.

>> UNFORTUNATELY, THAT'S ALL THE TIME WE HAVE TODAY.

I BANT TO THANK EVERYONE AROUND THE TABLE AS WELL AS THE COMMISSIONER FOR JOINING US IN A THOUGHTFUL CONVERSATION THAT I DON'T THINK HAPPENS ENOUGH WHEN IT COMES TO POLICY IN NEW YORK.

OUR GUEST SENATOR JOHN MANNION DEMOCRAT WHO CHAIRS DISABILITIES.

MY THANKS TO STATE SENATOR JOHN MANNION, SELF-ADVOCATE MICHAEL KENNEDY, NORTHERN RIVERS CEO BILL GETTMAN, AND OPWDD COMMISSIONER KERRI NEIFELDFELD.

IF YOU'D LIKE TO REVISIT THIS EPISODE - OR DIG INTO THE CONNECT NEW YORK ARCHIVES - VISIT WCNY.ORG/CONNECT NEW YORK.

AND FOR MORE STATE GOVERNMENT COVERAGE, CHECK OUT THE CAPITOL PRESSROOM AT CAPITOL PRESSROOM P.ORG.

ON BEHALF OF THE ENTIRE TEAM AT WCNY - I'M DAVID LOMBARDO - THANKS FOR WATCHING.