Applying for supports and services through the Office for People With Developmental Disabilities (OPWDD) can feel overwhelming for families. This guide explains the Eligibility Determination Process and what steps you need to take to get started.
Who Can Apply?
People with developmental disabilities can apply for OPWDD services. To be eligible, your child must meet all four requirements:
Step 1. Gather the Required Documentations
Adaptive Behavior Testing (such as the Vineland II or ABAS) – This is an interview or form completed by someone familiar with the person, in order to provide information about their daily living skills and functioning. As with IQ testing, the report should include all scale and summary scores and a narrative report written by the clinician. Computer generated reports alone are not acceptable.
submitted for school-aged people. Also include any psycho educational reports referenced in the plan. For those who
are no longer in school (e.g., no longer school aged, they have graduated), you must submit any school records available.
Early Intervention (EI): If the person has an EI plan, they must submit it. This includes the Core
Evaluation and progress notes, including a level of deficit for each domain.
💡 If you don’t have the required evaluations, you may be able to get them at an Article 16 Clinic, which offers evaluations and therapeutic services for people with developmental disabilities.
P.S. Additional information may be requested by OPWDD as needed.
Step 2. Watch the OPWDD Front Door Information Videos
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.
Step 3. Contact A Care Coordination Agency
OPWDD works in partnership with Care Coordination Organizations (CCOs) to support individuals in developing and maintaining service plans. Once you signs contests with a CCO, The Enrollment Specialist/Care Connection Specialist sends documents to OPWDD. OPWDD makes the determination in 30 – 90 days. OPWDD may request for more documents; this does extend the timeframe to determine eligibility. Specialist will notify you of next steps in either situation. In NYC (5 Boroughs & Long Island), the three CCOs are:
Step 4. Complete Required Assessments
After receiving the OPWDD 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.
* Eventually, the CAS/CANS will replace the DDP-2. Until that time, both will continue to be used.
Step 5. Level of Care Determination (LCED)
After permanent OPWDD eligibility approval, the Enrollment Specialist/Care Connection Specialist will conduct LCED – this is required for CCO enrollment, Waiver Services and Medicaid Waiver, if applicable.
Step 6. Apply for Medicaid
For CCO enrollment, you must have Medicaid approval. The Enrollment Specialist/Care Connection Specialist can assist with Medicaid applications. Medicaid approval can take a minimum of 3 months.
Step 7. Enrollment in a CCO
Enrollment into the CCO is effective the first of the following month after OPWDD Eligibility has been established and Medicaid is active. Once enrollment occurs, a Care Manager is assigned. The Care Manager assists you with exploring various services and link you to requested supports and services.
Step 8. Apply for HCBS Waiver
The Home and Community Based Services (HCBS) Waiver provides opportunities for Medicaid beneficiaries to receive services in their own home or community. Requirements are OPWDD eligibility, Medicaid, and approval of the HCBS Waiver application. A Care Manager can assist with the Waiver application. To receive HCBS Waiver Services, enrollment
in a CCO is required.
Step 9. Apply for Self-direction (optional)
Self-Direction may be right for you if you can make your own decisions (or have someone to help you do so) and want more responsibility, flexibility, and control over your supports and services. Anyone who is eligible for OPWDD services and enrolled in the Home and Community Based Services (HCBS) Waiver can choose to self-direct their services.
To enroll in Self-Direction, you should inform your Care Manager that you would like to participate. Before enrollment, you are required to attend a 2-hour virtual Self-Direction Information Session.
2026 Schedule of Self-Direction Information Sessions:
After attending the Information Session, you will receive a confirmation email that serves as proof of attendance. Please share this email with your Care Manager and keep a copy for your records, as it will be needed for enrollment with a Fiscal Intermediary (FI).
Denial of Eligibility and Appeals
If OPWDD determines that your child is not eligible for services, you have the right to appeal that decision. 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.
Provisional Eligibility for Children Under 8
The eligibility requirements for OPWDD are the same for individuals ages 3 and older (children under age 3 should access services through the Early Intervention Program). However, children age 8 and under may be granted provisional eligibility. This means your child can be found eligible for OPWDD services, but the eligibility is considered temporary until their 8th birthday.
In practice, many young children are approved for OPWDD eligibility but are not enrolled in the HCBS Waiver right away, particularly those under age 8. OPWDD may expect families to first utilize available supports such as Family Support Services (FSS), CDPAP/HHA, ABA therapy, and OT/PT/ST.
After exploring these services with the support of a Care Manager, families may demonstrate that these supports are not sufficient to meet the child’s needs and then pursue enrollment in the HCBS Waiver.
👉 If your child was approved for OPWDD eligibility but denied the HCBS Waiver, you can read more in my article: “My Child Was Found Eligible for OPWDD — But Denied the Waiver. What Can I Do?”
Who Can Apply?
People with developmental disabilities can apply for OPWDD services. To be eligible, your child must meet all four requirements:
- Have a diagnosis of a developmental disability (such as intellectual disability, cerebral palsy, epilepsy, neurological impairment, autism, familial dysautonomia, Prader-Willi syndrome, etc.)
- The disability was diagnosed before age 22
- The disability is expected to be permanent
- The disability significantly affects your child’s ability to function independently in daily life
Step 1. Gather the Required Documentations
- Psychological Evaluation (less than 3 years old). It should include:
Adaptive Behavior Testing (such as the Vineland II or ABAS) – This is an interview or form completed by someone familiar with the person, in order to provide information about their daily living skills and functioning. As with IQ testing, the report should include all scale and summary scores and a narrative report written by the clinician. Computer generated reports alone are not acceptable.
- Social history/psychosocial Evaluation (less than 1 year old)
- Educational Records
submitted for school-aged people. Also include any psycho educational reports referenced in the plan. For those who
are no longer in school (e.g., no longer school aged, they have graduated), you must submit any school records available.
Early Intervention (EI): If the person has an EI plan, they must submit it. This includes the Core
Evaluation and progress notes, including a level of deficit for each domain.
- Medical Report (less than 1 year old)
💡 If you don’t have the required evaluations, you may be able to get them at an Article 16 Clinic, which offers evaluations and therapeutic services for people with developmental disabilities.
P.S. Additional information may be requested by OPWDD as needed.
Step 2. Watch the OPWDD Front Door Information Videos
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.
Step 3. Contact A Care Coordination Agency
OPWDD works in partnership with Care Coordination Organizations (CCOs) to support individuals in developing and maintaining service plans. Once you signs contests with a CCO, The Enrollment Specialist/Care Connection Specialist sends documents to OPWDD. OPWDD makes the determination in 30 – 90 days. OPWDD may request for more documents; this does extend the timeframe to determine eligibility. Specialist will notify you of next steps in either situation. In NYC (5 Boroughs & Long Island), the three CCOs are:
- Advanced Care Alliance (ACA)
- Care Design NY
- Tri-County Care (currently not accepting new participants)
Step 4. Complete Required Assessments
After receiving the OPWDD 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.
* Eventually, the CAS/CANS will replace the DDP-2. Until that time, both will continue to be used.
Step 5. Level of Care Determination (LCED)
After permanent OPWDD eligibility approval, the Enrollment Specialist/Care Connection Specialist will conduct LCED – this is required for CCO enrollment, Waiver Services and Medicaid Waiver, if applicable.
Step 6. Apply for Medicaid
For CCO enrollment, you must have Medicaid approval. The Enrollment Specialist/Care Connection Specialist can assist with Medicaid applications. Medicaid approval can take a minimum of 3 months.
Step 7. Enrollment in a CCO
Enrollment into the CCO is effective the first of the following month after OPWDD Eligibility has been established and Medicaid is active. Once enrollment occurs, a Care Manager is assigned. The Care Manager assists you with exploring various services and link you to requested supports and services.
Step 8. Apply for HCBS Waiver
The Home and Community Based Services (HCBS) Waiver provides opportunities for Medicaid beneficiaries to receive services in their own home or community. Requirements are OPWDD eligibility, Medicaid, and approval of the HCBS Waiver application. A Care Manager can assist with the Waiver application. To receive HCBS Waiver Services, enrollment
in a CCO is required.
Step 9. Apply for Self-direction (optional)
Self-Direction may be right for you if you can make your own decisions (or have someone to help you do so) and want more responsibility, flexibility, and control over your supports and services. Anyone who is eligible for OPWDD services and enrolled in the Home and Community Based Services (HCBS) Waiver can choose to self-direct their services.
To enroll in Self-Direction, you should inform your Care Manager that you would like to participate. Before enrollment, you are required to attend a 2-hour virtual Self-Direction Information Session.
2026 Schedule of Self-Direction Information Sessions:
After attending the Information Session, you will receive a confirmation email that serves as proof of attendance. Please share this email with your Care Manager and keep a copy for your records, as it will be needed for enrollment with a Fiscal Intermediary (FI).
Denial of Eligibility and Appeals
If OPWDD determines that your child is not eligible for services, you have the right to appeal that decision. 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.
Provisional Eligibility for Children Under 8
The eligibility requirements for OPWDD are the same for individuals ages 3 and older (children under age 3 should access services through the Early Intervention Program). However, children age 8 and under may be granted provisional eligibility. This means your child can be found eligible for OPWDD services, but the eligibility is considered temporary until their 8th birthday.
In practice, many young children are approved for OPWDD eligibility but are not enrolled in the HCBS Waiver right away, particularly those under age 8. OPWDD may expect families to first utilize available supports such as Family Support Services (FSS), CDPAP/HHA, ABA therapy, and OT/PT/ST.
After exploring these services with the support of a Care Manager, families may demonstrate that these supports are not sufficient to meet the child’s needs and then pursue enrollment in the HCBS Waiver.
👉 If your child was approved for OPWDD eligibility but denied the HCBS Waiver, you can read more in my article: “My Child Was Found Eligible for OPWDD — But Denied the Waiver. What Can I Do?”
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