Tag Archives: budget results

April 2, 2019

Final New York State 2019-2020 Budget Update

In the early morning hours of March 31, 2019 Governor Cuomo and Legislative Leaders announced an agreement on a final SFY 2019-20 State Budget, just before the April 1st deadline. Legislators worked throughout the day and night passing bills with the Senate adjourning at 3am this morning and the Assembly finishing just before 8am today. The final budget totals $175.5 billion and keeps state spending growth under 2%. The final budget also:

Makes the 2% state property tax cap permanent;
Enacts first-in-the-nation congestion pricing in Manhattan (streets south of 60th) to leverage $15 billion to support the MTA;
Increases education aid by $1 billion;
Creates a commission to study and make recommendations on enacting a public campaign finance system;
Includes a series of criminal justice reforms including eliminating cash bail requirements for misdemeanors and Class E felonies;
Bans the use of plastic bags and allows counties/cities to opt in to a 5cent fee on paper bags;
Adds $500 million for clean drinking water infrastructure needs; and
Expands eligibility for the Excelsior Scholarship Free Tuition Program to households under $125,000.

The Senate returned to Session on the afternoon of April 1^st and the Assembly on the morning of April 2^nd before going home to their districts after a long budget week. The Legislature will be in Session on April 8, 9 and 10^th and will then take a two-week Easter/Passover break beginning on April 11^th. They will return to Session on April 29, 2019 for the remainder of the 2019 Session.

Following is an overview of the final New York State 2019-2020 Budget:

OPWDD

Human Services COLA – $0 We are extremely disappointed that the final budget did not include the COLA (2.9% this year) and defers it to 3/31/21.
#bFair2DirectCare – the final budget included funding for a 2% increase, including salary and salary related fringe benefits, effective 1-1-20, for 100 and 200 codes and another 2% increase, effective 4-1-20, for 100, 200 and 300 codes. $8.4 million state share. Increases provided from 4-1-19 can be counted towards the 1-1-20 2% increase for 100 & 200.
Development – ACCEPTS the Governor’s proposal for an additional $30 million state share this year for a fully annualized all shares $120 million (state and Federal funding) in additional funding available for “Program Priorities,” including; certified housing supports in the community; more independent living; more day program and employment options and increased respite.
Housing – ACCEPTS the Governor’s proposal for an additional $15 million in capital funds to develop affordable housing.
Managed care readiness – ACCEPTS the Governor’s proposal for $5 million for the NY Alliance for Inclusion and Innovation “to improve provider readiness for managed care through the development of best practices, performance measurement and outcome monitoring tools.”
“More efficient use of state resources” – ACCEPTS the Governor’s proposal for OPWDD to continue to work with DOH and CMS on efficiencies including to “reconcile” room and board financial support against actual room and board costs and a proposal to modify rate methodology to reduce admin reimbursement to 15% in accordance with the cap in Executive Order 38 presumably on a program by program basis
Integrated outpatient services – ACCEPTS the Governor’s proposal to add Article 16s to the list of clinics that do not need an additional license to provide those services. Last year, Article 28, 31 and 32 clinics were granted joint licensure to provide any of those clinic services under their current license. Article 16 clinics are now included this year.
Minimum wage funding – ACCEPTS the Governor’s proposal for $47.4 million state funding (for a total of approximately $94.8 with the federal funds included).

SED

The final budget increases public school aid by $1 billion or 3.8% but there are no recommended increases for 4410 or 853 schools. COPA has sent out an Alert asking everyone to contact their Regents to advocate that SED’s 853 and 4410 rate setting letter include:
- $15 million in increased teacher recruitment and retention funding
- A 3.8% tuition increase comparable with the general school aid increase.
Mental Health Education in Schools – ACCEPTS the Governor’s proposal for $1.5 million to prevent bullying, trauma, suicide etc.in schools.
School Waivers – REJECTS the Governor’s proposal that the Commissioner of SED to grant a waiver for any requirement imposed on a local school district, approved private school, or BOCES upon a finding that the waiver will result in implementation of an innovative special education program that is consistent with applicable federal requirements, and will enhance student achievement and/or opportunities for placement in regular classes and programs.

DOH

Early Intervention – ACCEPTS the Governor’s proposal to provide a 5% rate increase for Early Intervention PTs, OTs and SLPs. The Legislature did not expand the 5% increase to all EI providers as COPA had advocated. Additionally, the “covered lives pool” language did not make it into the final budget.
Consumer Directed Personal Assistance Program (CDPAP) Program/ Fiscal Intermediary (FI) Changes – MODIFIES the Governor’s language to require FIs to submit a contract application to DOH within 90 days of it’s posting on the DOH website. Eligible applicants include, but are not limited to, FIs established prior to 2012 and continually providing services, and independent living centers. “The selection of contractors shall be based on criteria reasonably related to the contractors’ ability to provide fiscal intermediary services including but not limited to: ability to appropriately serve individuals participating in the program, geographic distribution that would ensure access in rural and underserved areas, demonstrated cultural and language competencies specific to the population of consumers and those of the available workforce, ability to provide timely consumer assistance, experience serving individuals with disabilities, the availability of consumer peer support, and demonstrated compliance with all applicable federal and state laws and regulations, including but not limited to those relating to wages and labor.” FIs shall report annually to DOH in a form prescribed by the Department. Additionally, the DOH Commissioner shall establish a stakeholder workgroup, no later than May 15, 2019, to address fiscal intermediary services, the needs of consumers including transition plans and criteria for selecting FIs. FI reimbursement would move to a per member/per month methodology with three corridors but we have not yet seen the final parameters or reimbursement amount for those corridors.

Health Facility Transformation Fund Phase IV– ACCEPTS the Governor’s proposal to use $300 million, of the $525 million in new Phase III funding, that was included in the 2018-2019 budget, to fund Phase II applicants that did not receive a grant. These Phase II applicants will be rescored and those who will be awarded a grant, from the $300 million, will be notified by May 1, 2019. There will be a new RFP for the remaining $225 million from phase III with no new funding in the 2019-2020 budget proposal for Phase IV.
Elimination of spousal or parental refusal – REJECTS the Governor’s proposal for a spouse or parent to cover the cost of long-term care services in order to qualify for Medicaid – ($5.9 million) state savings.
Electronic Visit Verification – ACCEPTS the Governor’s proposal of $10 million for EVV costs for home care providers.
Prescriber prevails – REJECTS the Governor’s proposal to repeal prescriber prevails for both managed care and fee for service Medicaid for a savings of ($22.45).
0.8% Across the Board Medicaid Cuts for Article 28 Clinics etc. – REJECTS the original proposal but MODIFIES it to authorize that DOB and the State Health Commissioner MAY use a payment reduction plan to make across the board reductions, if necessary, to State Medicaid spending by $190. 2 million in SFY 2019-20 and 2020-21.
Applied Behavioral Analysis (ABA) – ACCEPTS the Governor’s proposal for Medicaid coverage of ABA for over 4,000 children with Autism Spectrum Disorders, including those who have aged out of the Early Intervention program. $6.4 million for 2019-20.
Medicare Part B Cost-Sharing – REJECTS the Governor’s proposal to amend the language that ensures that payments for individuals who are both Medicare and Medicaid eligible shall be the same if the individual did not have Medicare to ensuring that the payment not exceed the Medicaid rate. The savings is $23.3 million which would result from not paying the Medicare crossover amount to providers. There was concern that this would further limit the number of health practitioners who will to take Medicaid patients.

TBI – ACCEPTS the Governor’s proposal to move the TBI and NHTD waiver program under the Medicaid Global Cap.
Health Home Rate Reduction – INCREASES the Governor’s proposed $5 million to $20 million which will be achieved by “streamlining the outreach reimbursement rate for care managers after initial contact has been established. This reform will incentivize care managers to enroll new members in programs and connect them to the services they require while disincentivizing intense care management over an extended period.” This $20 million program reduction is of concern to our field as CCOs were modeled on health homes and many people with I/DD will require ongoing intense care management.

OMH

Human Services COLA – $0 and defers the COLA (2.9% this year) to 3-31-21.

#bFair2DirectCare – the final budget included funding for a 2% increase, effective 1-1-20, for 100 and 200 codes and another 2% increase, effective 4-1-20, for 100, 200 and 300 codes. $1.2 million state share.

Mental Health Education in Schools – ACCEPTS $1.5 million in the SED budget to prevent bullying, trauma, suicide etc.
Supportive housing and SROs rate increase– ACCEPTS the Governor’s $10 million increase.
Supports for high-need individuals – ACCEPTS the Governor’s $10 million for those residing in adult homes with specialized supports such as peer support and in-reach.
Community Reinvestment- ACCEPTS funding for community services expansion derived from the closure of additional state hospital beds of $5.5 million/$11 million fully annualized.
Capital Funds for Community Based Nonprofit Housing Providers – ACCEPTS $60 million
Behavioral Health Parity – budget includes several million dollars to enhance staff at the Department of Financial Services and the Department of Health to help assure health plans have adequate provider networks and are in compliance with parity requirements. dedicated to network adequacy and reviewing existing health plans to help ensure compliance with parity. Some of the specifics are:
- assures 28 days of SUD services and 14 days of inpatient psychiatric services for youth without the barriers associated with prior or concurrent insurer and health plan approval
- assures access to prescribed medications for treatment of substance use related conditions without prior insurer and health plan approval
- assures that the clinical review criteria used by utilization review agents must be approved by OMH and OASAS
- requires insurers and health plans to post additional information regarding their in-network providers of MH/SU services

Contact us with any questions.

Barbara, JR & Wini

Barbara Crosier

Vice President, Government Relations

Cerebral Palsy Associations of NYS

3 Cedar Street Extension, Suite 2

Cohoes, NY 12047

Phone: (518) 436-0178, Ext. 104

Cell: (518) 424-3198

E-mail: bcrosier@cpstate.org

John R Drexelius, Jr.

Government Relations Counsel,

DDAWNY
Law Office of John R. Drexelius, Jr.

PO Box 141
Buffalo, NY 14223
(716) 316- 7552
E-mail: jrdrexelius@gmail.com

Winifred Schiff

Associate Executive Director for Legislative Affairs

InterAgency Council of Developmental Disabilities Agencies, Inc.

150 West 30th Street 15th floor

New York, NY 10001

Office – 212-645-6360

Cell – 917-750-1497

E-mail: wini@iacny.org

GOVERNOR CUOMO – LETS HAVE REAL ECONOMIC JUSTICE

February 19, 2016Action Alerts, Advocacy, Bronx, Brooklyn, Manhattan, nyc fair, Queens, Staten Islandaction alert, advocacy, budget results, developmental disabilities, opwddelly.rufer@gmail.com

SWAN of NYS Statewide Advocacy Network– NY

Governor Cuomo Let’s Have Real Economic Justice

We are members of the Statewide Advocacy Network of New York SWAN-NY; family members and guardians of people with Intellectual and Developmental Disabilities. We would like to add our support to the many voices calling for funding the proposed minimum wage increases in the 2016-2017 NYS Budget for the dedicated Direct Support Professionals who work with people with IDD.

As family members we know first hand what Direct Support Professionals are required to do and how important their role is. We also know what happens when they are not there. We are seeing gaps in support now, and we worry for the future. As the movement toward having people with IDD ‘out in the community’ there is a need for more staff, with better training especially for those with more intensive needs. All these factors have led to vacancies with more and more people with no services at all.

We ask an enormous amount from DSPs ranging from accompanying individuals in the community, administering medication at the right times and in the right doses, following eating protocols, assisting in activities of daily living for many different people day after day after day. We also ask that they understand and are responsive to their emotional needs. Direct Support Professionals are trained to deal with challenging behaviors and non-verbal people. Everything they do must be recorded and checked. DSPs are there when we can’t be and they are family when family members are not around. This is not a job for just anyone, it takes dedication and caring.

OPWDD has an understanding that the voluntary agencies will be responsible to hire, train and supervise the support staff. Being a DSP is a job with enormous responsibility and pitiful compensation. We endorse raising the minimum wage but without funding from the state not-for-profit agencies cannot afford this raise. Agencies have few options to meet this requirement, some may have to close certain programs and some may have to go out of business, leaving our family members stranded.

Agencies are already having a problem filling vacancies when other jobs that are so much easier and less stressful pay the same. The vacancy rate is high and program staffing reflects this. There is a danger that safety will become a serious issue especially for those with more complex needs or challenging behaviors. Constant turnover is unsettling and threatens our family members sense of stability.

Direct Support Professionals deserve much more than they are paid now, and raising the minimum wage is the first step to equitable compensation for the important work they do. We wholeheartedly support this BUT without funding this raise there is a real possibility that both the agencies who employ DSPs and families who use Self Direction will find themselves unable to function at all and our loved ones will be deprived of needed services.

SWAN NY

Western New York: DDAWNY Family Committee, Barb Delong
www.ddawnyfamilycommittee.org ddawnyfamilycommittee@gmail.com

Capital Region: ENYDDA, Patrick Curran,
ENYDDA@gmail.com

Hudson Valley Region: GROW, Will Mayerik
www.grow-ny.org, info@grow-ny.org

New York City: NYC FAIR, Elly Rufer
www.nycfair.org, nycfair@gmail.com

IAC’s: Another On Time NYS Budget

April 14, 2015Advocacy, NYS Legislative Informationbudget results, EI, nys budget, opwdd, SEITelly.rufer@gmail.com

Download PDF: IAC Budget Recap 2015

IAC’s: Another On Time New York State Budget

By Wini Williams

Late on March 31st (actually 1:30 am on the 1st), the legislature passed the final budget bills which were still being printed on the last day. The Governor “postponed” many of the reforms he previously insisted on, including minimum wage, ethics and education, to have an on-time budget for the 5th consecutive year. As for programs and services for people with intellectual/developmental disabilities…..here’s what happened:
 State Education Department (SED)
IAC is very hopeful that SED will request an increase for both 4410 and 853 programs, in the 3-3.5% range, through the usual process that exists outside of the budget. The Assembly had called for a 2.4% increase in the budget. However, we felt a more significant increase was necessary and therefore, they removed their request for a specific percentage. We will continue to support these increases through the next few months. The Assembly also included a delay in the implementation of regional Special Education Itinerant Teacher (SEIT) rates till July 2016 which we were concerned would derail the 4410 increase mentioned above. The final agreement contains welcome language which enables regional SEIT rates to be implemented as soon as SED is ready, but no later than July 2016. As always, the blanket waiver of NYS requirements for special education, proposed by the Governor every year, was defeated in the final version.
 OPWDD
The Governor proposed $30 million for new services ($120M all shares fully annualized) and we had lobbied for modest increases for specific needs including $11.25M for residential development for people in desperate need, living at home with families and $3M for the expansion of Supported Employment, which is a State priority. In the end, only $2M ($8M all shares fully annualized) was added for new opportunities for families who can no longer care safely for their loved ones with developmental disabilities at home and an additional $1M to be used to facilitate the collection of information on peoples’ needs (so that good planning for the future can be accomplished). It is also intended to help advance the work of the transformation panel, charged with examining and making recommendations on the future of our service system (which our own Peter Pierri sits on). Language was included which ensures choice for people currently attending sheltered employment programs, the collection and dissemination of information on regional need for planning purposes (to be financed by the additional $1M), as well as reporting on the efficacy of the Front Door, and other provisions from bills that were vetoed by the Governor last legislative session. We will provide details on these provisions in the near future.
 DOH
Early Intervention:
Again this year, EI was ignored. According to the Department of Health, there was a decrease in spending for the program of $4.8M last year even though the number of children and the utilization
intensity per child stayed relatively the same and many new providers entered the system. We will get additional information on these claims so that we can develop a strategy for next year since we know that our providers have been discontinuing services for the last few years with no increases for virtually 20 years for this life-changing program.
 Article 16 Clinics:
Two years ago, a 2% across the board cut was made to clinics and other Medicaid services, but for Article 16 clinics, the cut was taken based on utilization thresholds. Clinics which managed to reduce the number of therapies per person below the threshold received no cut. Others which were unable to reduce the number of services based on the individual needs of patients received as much as a 5% cut. Last year that cut was restored except for the Article 16 clinics. Despite support from the Legislature to add language which would direct the DOH to restore the Article 16 cut, the Department’s opposition to the restoration prevailed. We will continue to address this issue through the rest of the legislative session. Staff contact: wini@iacny.org

NYSARC’s Budget Results

April 14, 2015Advocacy, NYS Legislative Informationadvocacy, budget results, informationt, nys budge, opwddelly.rufer@gmail.com

Download .PDF :New Budget Language nysarc

From NYSARC:

New Budget Language (the full text of these language changes is below)

The Legislature and the Governor agreed to a series of provisions that will provide greater oversight, planning and transparency relating to the implementation of a number of significant policies at OPWDD, including the following:

Residential services: OPWDD is required toissue a report as a result of its statewide review of individuals with developmental disabilities currently on the residential (waiting) list, including information regarding services currently provided to such individuals, and any available regional information on priority placement approaches and housing needs for such individuals. The report will update the progress the office has made in meeting various transformational goals for people on the waiting list. Furthermore, the commissioner, of OPWDD, in consultation with stakeholders, is directed to establish a plan to increase housing alternatives for people with developmental disabilities. The report must be issued by February 15, 2016.

Employment choice: OPWDD will develop a plan to assist individuals transition to integrated work settings that will “provide choice of work settings for individuals with DD.” The plan will solicit and analyze stakeholder input, involve outreach and education, set forth “a detailed analysis of options available to meet the needs and goals of those individuals who currently cannot or choose not to transition to integrated community work settings.” The plan must be submitted by February 15, 2016.

Transformation panel: Codifies OPWDD’s existing transformation panel which will develop a transformation plan. The transformation plan will include recommendations and strategies for maintaining the fiscal viability of service and for supporting delivery systems for persons with developmental disabilities. The plan will include strategies that will enable OPWDD to comply with federal and state service delivery requirements and provide appropriate levels of care. It will also study increasing access to self-directed models of care; enhancing access to integrated housing; increasing integrated employment opportunities; and the program design and fiscal model for managed care. OPWDD must report the recommendations of the panel to the Legislature by February 15, 2016.

DC census issues: OPWDD is required to provide the Legislature with monthly updates on developmental center deinstitutionalization which will include reports on current census, census reductions, support for discharged residents, etc.

Front Door: By February 15, 2016, the commissioner OPWDD shall report on the extent to which front door policy has been implemented; has improved community education and available service options; has connected individual needs to available services; and, has enhanced opportunities for self-direction. OPWDD shall also make information available information regarding how the Front Door process determines priority placements and provides access to services.

Nurse Practice: Language is included to allow direct support employees to perform certain tasks in non-certified settings provided they are under the supervision of a nurse. Final authorization is subject to a memorandum of understanding (MOU) between OPWDD and the State Education Department. This authorization is critical for service expansion of the existing service system in order to meet unmet needs.
Transportation study: Language is included to authorize OPWDD to contract with an entity to study the transportation needs of people with disabilities and to authorize the development of a pilot project to meet those needs. Transportation, especially in rural areas, poses a critical barrier to employment and other important activities for people with developmental disabilities.

OPWDD budgetary additions in Aid To Localities (Funding for non-for-profits)

1) $2 million in additional funding for people living at home with “caregivers who are unable to care for them.” This equates to $4 million once matching federal funds are included and, it appears, $8 million worth of programming when fully annualized.

2) $1 million which appears to be aimed at facilitating the information gathering and reporting requirements contained in budget language as well as the work of the Transformation Panel, though more detail is needed to evaluate this funding addition.

Additional items

A reserve fund of $850 million proposed by the Governor was passed as part of the State budget. The fund is for possible retroactive federal claims relating to overbilling at Developmental Centers. The Legislature appeared to be on the verge of eliminating the reserve fund. Steven Kroll sent a letter to Speaker Heasty and Majority Leader Skelos urging the Legislature to pass the fund as it was proposed by the Governor. We are pleased that the Legislature did that.

Language was included in the budget to authorize reform of Special Education Itinerant Teacher rates (SEIT). Reform of SEIT rates is seen by many as a necessary first step to obtaining a growth factor for 4410 preschool programs.