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 for OPWDD–funded services.

Eligibility

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

• Have a diagnosis of a developmental disability, such as an intellectual disability, autism, neurological impairments (such as the result of an injury or illness), cerebral palsy, Down syndrome, or other disabilities with specific testing scores on IQ, which measure intellectual functioning, and adaptive behavior scales, which measure personal and social skills.
• 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

OPWDD Transmittal Form for Determination of Developmental Disability: https://opwdd.ny.gov/eligibility

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

Sign up for and attend a Front Door information session. You must attend a Front Door information session. Sessions are being held remotely until further notice. Call the Developmental Disabilities Regional Office (DDRO) to register for a Front Door session or visit the website link https://on.ny.gov/2VscZi8 to register. OPWDD will take a note of your attendance for their records.

Submit 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 a letter within one to two weeks 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. The DDP-2 interview is a conversation to gather information about a person’s strengths, needs, and interests. You can get more information about the questions asked during the DDP-2 interview here: https://opwdd.ny.gov/getting-started/assessments. If you have not heard from the DDRO within two weeks of receiving the eligibility determination letter, call to schedule and complete the DDP-2 interview. You will need to have your child’s TABS ID number, which can be found on the eligibility determination letter.

Once your child is determined eligible for OPWDD services, you will need to select a Care Coordination Organization (CCO), if you do not already have one, in order to receive care coordination services and a care manager. If your child does not have Medicaid, then the CCO can  help you to apply. Medicaid pays for most OPWDD services and supports. Please note that you can also contact a CCO and work with their intake team to complete the eligibility determination process from the beginning.

Evaluations

Scores on the evaluation report that typically qualify individuals for OPWDD services are IQ scores below 60 and/or adaptive behavior scores in the “Low” range.

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).

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.

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 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 that your child will receive full OPWDD services until their 8th birthday. You will need to submit updated evaluations to the DDRO before your child’s 8th birthday, so that “standard eligibility” can be established. It is best practice to start scheduling 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.

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: www.brooklynddcouncil.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: