Application for OPWDD Services

People who have developmental disabilities can apply for supports and services from the Office for People with Developmental Disabilities (OPWDD). The application and review process for OPWDD services is called the Eligibility Determination Process. Only OPWDD decides whether a person meets all the conditions of eligibility.

Eligibility

To receive services from OPWDD, your child must meet four requirements:

• Have a diagnosis of a developmental disability, which includes, but is not limited to, intellectual disability, cerebral palsy, epilepsy, neurological impairment, autism, familial dysautonomia, and Prader-Willi Syndrome.
• Must have had this disability diagnosed before age 22.
• The disability is expected to be permanent.
• The disability must be so serious that it affects your child’s ability to live everyday life independently.

How to Apply

Gather the Required Documentation

• A psychological evaluation report that is less than three years old. It should include a full-scale IQ score and results from adaptive behavior testing.
• A social history or psychosocial evaluation report that is less than one year old.
• A general medical report, such as the one from the annual physical conducted for your child’s school, that is less than 1 year old.

Watch the OPWDD Front Door Information Videos to learn more about the eligibility process and services offered (available in English, Spanish, and Chinese) https://opwdd.ny.gov/access-supports/front-door-videos

• OPWDD will provide translation services for anyone who needs a different language. Contact language.access.requests@opwdd.ny.gov to submit a request.  

Connect to a Care Coordination Organization (CCO)

OPWDD works in partnership with Care Coordination Organizations (CCOs) to support people in developing and maintaining service plans. You will need to enroll with a CCO and get assigned a Care Coordinator who will:

• guide you through the OPWDD eligibility determination process,
• help you through the Level of Care Eligibility Determination process, and
• assist you in enrolling in Medicaid and applying for the Home and Community-Based Services (HCBS) Medicaid Waiver. 

There are three Care Coordination Organizations (CCOs) providing services in NYC:

• Advanced Care Alliance (ACA)
• Care Design NY
• Tri-County Care

You have the option to choose from one of the three CCOs. For more information: https://opwdd.ny.gov/find-care-manager 

Submit the Application and Required Documentation

Your Care Manager will assist you in applying and all required documents to the eligibility department at the Developmental Disabilities Regional Office (DDRO) in your borough. After the DDRO reviews your documents, they will mail you an eligibility determination letter to let you know whether your child is eligible. If you don’t receive an eligibility determination letter after three weeks, contact your local DDRO to follow up.

After sending the eligibility determination letter that informs you whether your child is eligible for services, the DDRO will call you to schedule the Developmental Disabilities Profile (DDP-2) interview and Child and Adolescent Needs and Strengths (CANS) Assessment interview for those 17 and younger or the Coordinated Assessment System (CAS) for those ages 18 and over. These are comprehensive assessments that OPWDD uses to identify the young persons’ strengths, needs, and interests which provides information used in person-centered planning for the person’s care. You can get more information about the assessments here: https://opwdd.ny.gov/getting-started/assessments. Call to schedule and complete the assessments if you have not heard from the DDRO within two weeks of receiving the eligibility determination letter. You will need your child’s TABS ID number, which can be found on the eligibility determination letter.

Submit Additional Evaluations (if applicable)

If your child has autism, you may be asked to submit the evaluation report that includes your child’s autism diagnosis, such as the Autism Diagnostic Observation Schedule (ADOS) or Childhood Autism Rating Scale (CARS, as a part of the eligibility determination process.

If your child does not have the evaluations you need to apply to OPWDD, you can often get them for free at an Article 16 Clinic. Article 16 Clinics offer evaluations, medical, and therapeutic services for people with developmental disabilities. To find an Article 16 Clinic or another clinic to conduct the evaluations, speak to your school staff, call your DDRO,  or visit your borough’s Developmental Disabilities Council website and check out their service guides for clinics that provide evaluations for individuals with or without Medicaid.

Denial of Eligibility and Appeals

If OPWDD decides that your child is not eligible for services, you can appeal through what is called a 2nd Step Review. During the 2nd Step Review, you may submit additional documents and ask OPWDD to review all the documents again. If OPWDD finds your child not eligible a second time, you can complete a 3rd Step Review and request a Medicaid Fair Hearing. Be aware of the deadlines for requesting these appeals.

For more information on the steps and accepted evaluation tools: https://opwdd.ny.gov/eligibility

Eligibility for Children Under 8

The eligibility requirements for OPWDD are the same for people of all ages. However, OPWDD sometimes gives “provisional eligibility” to children ages 8 and under. Provisional eligibility means your child will receive full OPWDD services until their 8th birthday. You must submit updated evaluations to the DDRO before your child’s 8th birthday so that “standard eligibility” can be established. It is best practice to schedule these evaluations when your child turns 7.

Disclaimer: INCLUDEnyc does not determine or impact your application process, but if you have related questions, call our Help Line at 212-677-4660 (English) or 212-677-4668 (Spanish).

For more information, review the OPWDD Front Door: Access to Services Guide (available in multiple languages): https://opwdd.ny.gov/get-started/access-services-guide 

Resources for Information and Help Navigating OPWDD Services

Your school staff

The Development Disabilities Council (DDC) in your borough:

– Manhattan DDC: www.manhattanddcouncil.org

– Bronx DDC: www.bronxddcouncil.org

– Brooklyn DDC: https://bkddcouncil.org

– Queens DDC: www.qcddny.org

– Staten Island DDC: www.siddc.org

A Care Coordination Organization (CCO)

An Independent Living Center (ILC) in your borough

The DDRO in your borough

Developmental Disabilities Regional Offices (DDROs)

All of New York City is located in OPWDD’s Region 4: