Special Projects Fund

Grantee Name

Center for Independence of the Disabled in New York, Inc.

Funding Area

Special Projects Fund

Publication Date

September 2016

Grant Amount


Grant Date:

February 2014 – February 2016

Approximately one-third of New York’s 700,000 dual eligibles—individuals who qualify for both Medicare and Medicaid—are under the age of 65. Many of these individuals have physical and cognitive disabilities that create significant barriers to accessing health care.

As New York State moved to implement the Fully Integrated Duals Advantage (FIDA) program, dual eligibles would receive a comprehensive package of physical health care, behavioral health care, and long-term services through both Medicare and Medicaid.

Because FIDA plans will be created by managed long-term care plans that currently serve elderly and disabled Medicaid beneficiaries, these plans must increase their capacity to serve a wider disabled population. Furthermore, federal and State laws, including the Americans with Disabilities Act (ADA), require that affirmative steps be taken to ensure that people with disabilities are treated in a nondiscriminatory manner and have access to health plans with providers in their networks.

NYHealth awarded the Center for Independence of the Disabled in New York (CIDNY) a grant to work with six plans and the New York State Department of Health to support the implementation of FIDA, improve ADA compliance, and enhance access and outcomes for people with disabilities.

Outcomes and Lessons Learned

  • Reviewed policies, procedures, and key documents with four of the six proposed health plans  and suggested modifications that provide patients with notice of rights and procedures for accessing assistance and obtaining reasonable accommodations;
  • Trained management-level personnel at the participating health plans and ADA compliance personnel at the New York State Department of Health on legal obligations and best practices for working with people with disabilities;
  • Made recommendations and identified best practices for the New York State Department of Health to ensure sufficient physical access to buildings, equipment, and services; and
  • Presented findings to a national audience of consumer advocates for dual-eligible programs.



The project faced difficulties in compelling FIDA plans and care providers to improve their ADA compliance on a voluntary basis, which led two plans of the original six to drop out of the project. The remaining plans only provided training to their case managers and supervisors, not to the rest of the staff who directly interacts with the plan members. In addition, CIDNY identified several gaps and challenges in enforcing ADA compliance.

FIDA plans received numerous templates on ADA policies and procedures from the New York State Department of Health that do not adequately capture or identify ADA requirements. Furthermore, many health plans felt overwhelmed by the changes to the State and Centers for Medicare & Medicaid Services requirements related to FIDA implementation and provider accessibility.

Although FIDA case managers and nurse evaluators are mostly responsible for enforcing ADA compliance, enhancing accommodations, and modifying policy, CIDNY learned that these particular workforce members do not have such authority within the current model.