Learn about the updated Certified Residential Opportunity Process
Before referring a person to a Certified Residential Opportunity (CRO), the Care Manager must fully explore with a Member, their family, and their circle of support the possibility of remaining in the current home or a different non-certified setting in the community and document all attempts. The Member and family with the Circle of Support should consider adding additional support and services to accommodate needs and address concerns with the current home or another potential non-certified setting in the community.
Once all options of remaining in the current home have been explored and the Member and family agree to move forward with seeking residential opportunities, the Care Manager, residential providers, and OPWDD will work together to ensure that the Member is offered the most integrated and least restrictive housing options available.
Documenting the referral
The Care Manager will complete the Residential Referral Form H005 and submit all required supporting documents as one complete Residential Referral Packet to the Certified Housing Team (CHT) at the Regional Field Office (RFO). Supporting documents include:
- Current Life Plan
- Current DDP-2,
- Current CAS/CANs
- Assessments (psychological, psychosocial, medical, OT/PT/speech, etc.)
- SAP, Behavior Support Plans, IEP, etc.
The submission of the Residential Referral Packet grants permission to the CHT to share necessary information as appropriate with the CCO and residential providers.
After the CHT reviews the complete referral packet and determines the need for a certified residential setting, they will issue a Notice of Decision (NOD.15) to the Care Manager and the Member and family to inform that the person is either authorized or not authorized for residential services. If it is determined that the person is not authorized, the issued NOD.15 will state one or more of the three reasons why the need was not demonstrated. A dispute resolution is available if a person objects to the Notice of Decision.
If the person is authorized to be added to the CRO list, the CHT will issue a Notification of Residential Support Category form H004. When determining the support category, the CHT considers many factors, such as the level of care required due to disability, availability, and adequacy of natural supports, and risk of harm associated with the current living situation. The OPWDD Statewide Residential Support Categories are:
- Emergency need
- Substantial need
- Current need
Once the NOD.15 and H004 forms are issued, the person is added to the CRO list, which is shared with residential providers. OPWDD updates and maintains the CRO list. OPWDD manages housing and residential support access and does not share the CRO list with Care Managers or CCOs.
OPWDD requires residential provider agencies to notify them of any vacancies in their residential programs. When reviewing the CRO list, residential providers must first prioritize screening people on the “Emergency Needs” list to determine if needs can be met in existing vacancies before moving on to the “Substantial” and “Current Needs” lists. The residential provider will receive the CRO packet with attachments from the DDRO either upon request from the residential provider or through targeted referrals made by OPWDD’s CRO team. After reviewing the packet, the residential provider will contact the Care Manager if they want to set up a screening. Care Managers can present information to residential provider agencies and state operations of a person on the Emergency Needs list at the Access to Residential Opportunities Committee (AROC).
The following are changes to OPWDD CRO effective September 1, 2023.
- A Referral packet will be required for every submitted referral.
- An NOD.15 will be issued to notify of the decision of determination
- A H004 form will be issued to identify designated support categories: Emergency, Substantial, Current
- The opening of a Residential Needs is no longer necessary in TABS.
- Dispute resolution requests must be made within 30 days.
- Care Managers are required to update referrals annually and whenever significant changes occur:
- Care Managers are responsible for keeping the CRO referral current, including sending updated Life Plan reviews, clinical reviews, DDP2s, CAS, IEPs, and annual physicals to CHT.
- If annual updated information is not received, CHT will send a reminder requesting the updated CRO packet within 30 days.
- If the Care Manager does not send the updates within 30 days, CHT will send out second and third requests with an additional 30-day deadline.
- If the third request for an update is unanswered, CHT will deactivate and close the CRO record.
- Any change in Care Manager, Care Management Supervisor, or provider of Care Management services must be reported.
- If changing CCOs, the Care Management Supervisor from the outgoing CCO is responsible for notifying the CHT and providing information for the new CCO.
- Care Managers must notify the CHT as soon as they become aware of any changes in circumstance that impact the person’s level of need.
- Care Managers must submit an amended Life Plan with a signature and documents that support the change.
- Care Managers must notify the CHT if a member wishes to withdraw their CRO referral.
Read OPWDD’s complete CRO updates, effective September 1, 2023.