Click HERE for a web version of the 2/8/18 CP News.
Volume #24 – Issue #1
STATE BUDGET PROCESS IS IN FULL SWING
The Governor presented his budget proposal on January 16, and the 30 day amendments are due by February 15. One-house budgets will then be proposed and the 2018-19 State Budget is expected to be approved by April 1st. This year, due to Easter and Passover holidays coming during the last few days of March, the goal is to have the budget bills done before they leave for the holidays on March 29th.
With a projected $4.4 billion deficit, $2B in federal cuts mostly to healthcare and a 25% increase in income and property taxes via the limitations on state and local tax deductions (SALT), Governor Cuomo has said that New York State will sue the federal government over the tax plan, support a bill to reverse it and restructure New York State’s tax code.
His budget proposal contains a 3% increase in school spending, a 3.25% increase in health spending, flat spending for other state agencies, a 6.5% increase for Direct Support Professionals and other workers’ salaries, including the 1-1-18 and 4-1-18 payment for 100, 200 and 300 CFR codes, and $26 million to combat the opioid crisis. Changes may be made to any or all of the above in the 30-day amendments.
Below are some details within the sections of the budget that apply to our field:
- $145.8 million to support the 2nd year of our multi-year #bFair2DirectCare funding request for a living wage for our low wage workers (3.25 percent in January 2018 for 100 & 200 CFR codes and 3.25 percent in April 2018 for 100, 200 & 300 CFR code salaries)
- $44 million to support the minimum wage and related fringe benefits increases
- Defers the Medicaid Trend/COLA in order to partially fund the #bFair2DirectCare wage increases
- $120 million (State and federal funding when fully annualized) available for all new services
- $15 million in capital funds to develop independent affordable housing
- $39 million in fiscal year 2019 to support the transition from OPWDD’s Medicaid Service Coordination program to a comprehensive care coordination model operated through Care Coordination Organization/Health Homes (CCO/HHs), the first step in the transition to managed care. CCO’s will be operational July 1, 2018
- Discontinues the State supplement in ICF/IRA conversions
- Includes language defining which services require psychology, social work or mental health practitioner licensure for employees of OPWDD operated, regulated, funded or approved services so that the exemption, which has been extended many times over the years, will be unnecessary in the future
- Requires that OPWDD promulgate regulations to expand Medicaid covered telehealth services to residential settings to allow for greater access to remote patient monitoring and alternative health care delivery models
State Education Department
- Recommends a $769 million (3.0%) school aid increase and a 3% increase for charter schools
- An additional $15 million investment in pre-kindergarten to expand half-day and full-day pre-kindergarten for 3,000 three and four year old children in high-need school districts with preference given to providers which run integrated classes
- ACCES-VR funding remains flat at $54 million for case services
- $17.2 million for Minimum Wage costs
- Allows all schools to apply to SED for waivers from certain special education requirements provided that federal compliance is maintained and the waiver will enhance student achievement and opportunities. Schools may request waivers for class size and other current requirements that they feel are important to maintain
Department of Health
- Early Intervention “reforms” to reduce costs and increase insurance company participation in payment for services:
- provide for screening and partial evaluations to reduce the time between referral and service delivery (at a savings)
- establish that providers will receive a 2% rate increase upon enactment of the requirement that they appeal insurer payment denials
- requires insurers to cover services that are included in the child’s insurance policy
- requires insurance companies to consider the IFSP as documentation of medical necessity
- Eliminates “prescriber prevails” for nearly all medications including mental health medications
- Expands Medicaid covered telehealth services and includes Article 16 and Article 28 clinics in the $425 million Health Care Facilities transformation fund
- Includes Medicaid crossover payments for Article 28 clinics serving people with TBI, allowing clinics to bill up to the full Medicaid rate
- An additional $425 million capital investment for healthcare providers to “transition into fiscally sustainable systems” and to support capital projects, debt retirement, working capital and other non-capital needs; includes $60 million reserved for community based providers (i.e., clinics, home care, assisted living programs (ALPs), primary care providers)
Some Important Dates:
Joint Legislative Schedule for Adopting This Year’s State Budget:
- 28 (on or before): Economic/Revenue Report Released (Senate and Assembly)
- 28 (tentative): Joint Revenue Forecasting Conference
- March 1 (on or before): Revenue Consensus Report
- March 14: Senate and Assembly One-House Budget Actions
- March 14: Joint Budget Conference Committees Commence
- March 22: Joint Budget Conference Committees End
- March 27-29: Joint Legislative Budget Bill Taken Up
- Education – 1/31/18
- Health – 2/12/18
- Mental Hygiene – 2/13/18
COPA Lobby Days
- NYC Briefing – 2/23 @10:00 am
- Conference Call briefing – 2/23 at 9:30 am
- Albany Briefing – 2/27 @7:00 pm
- Main Lobby Day – 2/28
- Leadership Day – 3/1
DOH SAYS ARTICLE 16 CLINICS ELIGIBLE TO APPLY FOR STATEWIDE HEALTH CARE FACILITY TRANSFORMATION PROGRAM II FUNDING
Due to the advocacy of CP of NYS, the NYS Department of Health (DOH) has confirmed that in addition to our Article 28 clinics, Article 16 clinics are eligible to apply for the latest Statewide Health Care Facility Transformation Program II (Phase 2) funding. The RFA along with a Q&A from the first round of funding confirming that Article 16 clinics are “Eligible Applicants” can be found HERE. Letters of interest are due to DOH by February 23.
The funding can be used ”to provide grants in support of capital projects, debt retirement, working capital or other non-capital projects directly related to a capital project that facilitates health care transformation activities including, but not limited to, merger, consolidation, acquisition or other activities intended to create financially sustainable systems of care or preserve or expand essential health care services. To receive funding, the Eligible Applicant must demonstrate how the proposed use of the grant will strengthen and protect continued access to health care services in communities.”
DOH is particularly interested in applications to fund telemedicine equipment in our OPWDD residences, clinics, etc. They agree with, and are impressed by, the CP of NYS PPS telemedicine project data which showed an 86% avoidable emergency room visit rate. DOH understands that telemedicine can provide a significant savings to Medicaid, a savings to OPWDD not-for-profit providers and, most importantly, significantly better quality care and outcomes for people with developmental disabilities, all of which meet and exceed the intention of the Health Care Facility Transformation Program.
An informational Applicant Webinar was held on Wednesday, January 31, 2018; it will be posted to the DOH website shortly.
Questions regarding the Statewide Health Care Facility Transformation Program II (RFA #17648) are due by February 9, 2018, and can be e-mailed to Statewide2@health.ny.gov.
HOUSE AND SENATE EACH REACH BUDGET DEALS
Both the House and Senate have agreements to extend government funding past the February 8th midnight deadline and avoid another Government shutdown.
The House of Representatives passed another short-term budget plan on Tuesday that would keep the government running through March 23rd, fund expired Medicare programs and community health centers for two years, delay the Medicaid disproportionate share hospital (DSH) payment cuts for 2018 and 2019 and bundle other healthcare reforms.
CP of NYS has joined with other healthcare providers and associations to urge Congress to preserve Medicaid, fund CHIP, FQHCs, DSH, etc., and we are very pleased to see these addressed in the bill that passed the House. HERE is the latest letter that was sent.
Late yesterday, Senate Minority Leader Charles E. Schumer announced a budget deal which must now pass the House. Speaker Paul Ryan (R-Wisc.) said he would urge House members to support it. But the House Freedom Caucus condemned the deal and House Minority Leader Nancy Pelosi (D-Calif.) held the House floor for a record seven-hours-plus to demand that Ryan commit to open debate and voting on a measure to aid the Dreamers/DACA. The Senate does not mention either the border wall and border security sought by President Trump, or help for the young immigrants who benefited from DACA. However, the Senate deal does include an agreement on open debate and vote series in the Senate next week ahead of the March 5th DACA deadline. As the vast majority of Americans and Congress support DACA, most pundits feel that a deal will be crafted prior to the deadline.
The Senate deal includes long term issues including:
- Removes the caps imposed by the 2011 sequestration law that forced automatic spending cuts across the board if Congress could not agree to them independently
- $165 billion increase in military spending by over two years
- $131 billion domestic spending increase over two years
- $6 billion to fight opioid abuse and aid mental health
- $5.8 billion for childcare
- $4 billion for rebuilding veterans hospitals and clinics
- $2 billion for research at the National Institutes of Health
- $20 billion for infrastructure, including rural wastewater, drinking water, and rural broadband
The deal also reportedly includes a one-year extension of the debt ceiling and will provide for a full year federal budget.
GOVERNOR CUOMO’S 2018 STATE OF THE STATE ADDRESS
Governor Andrew Cuomo delivered his annual State of the State address on January 3rd in the Convention Center at the Empire State Plaza in Albany. The Governor spoke of “a three front war” that New York is facing including the challenges of sexism, discrimination and homelessness, terrorism and opioid addiction and federal and economic challenges, which he also called a federal assault on New York State, which includes a $2 billion federal cut and a $4 billion deficit. The Governor outlined his Administration’s 2018 priorities, many of which are recurring themes and were unveiled in the 22 press releases he issued leading up to the State of the State address.
Prior to the Governor’s State of the State, COPA team members joined #bFair2DirectCare colleagues to hand out #bFair2DirectCare buttons to every Senator and Assemblymember. Capital District #bFair2DirectCare advocates held signs and thanked legislators as they entered the Convention Center for the Governor’s speech.
Unfortunately there was no mention of any of the COPA priorities or an inclusion of Early Intervention or programs for children with special needs in the education or First 1,000 Days sections of the Governor’s State of the State. We expect to learn more details of the Governor’s proposals in his 2018-19 Executive Budget which was released January 16th.
SEATS ARE STILL AVAILABLE FOR SUPERVISORY TRAINING PROGRAM – DON’T MISS OUT!
A key to improving retention is qualified supervisors – with our workforce at all-time highs in vacancy and turnover, this training provides you an opportunity to take a proactive step to address your staffing problems.
CP of NYS has partnered with the New York City-based Training Collaborative to offer their nationally accredited supervisory training program to Affiliates across the State. The training series, developed by Peg Gould and the partners in the NYC collaborative, will be offered over 5 months in 2018 (February – June) and is an important component of the field’s broader efforts to stabilize a qualified workforce. This series also can be used for you to train staff who might then be able to provide this training locally at a future date in conjunction with the training collaborative and CP of NYS.
The sessions starts February 16th so register now! Click here to REGISTER.
FEDS APPROVE OPWDD REFORMS
The Office for People With Developmental Disabilities (OPWDD) recently announced that New York State has received approval from the federal Centers for Medicare and Medicaid Services (CMS) for a package of reforms. The approval includes a new rate methodology focused on serving people with higher needs; modified reimbursement tiers for respite services; and a funding mechanism for Intermediate Care Facilities (ICFs) transitioning to Individualized Residential Alternatives (IRAs). These changes are contained in “Amendment 02” to the 1915(c) OPWDD Comprehensive Home and Community-Based Services (HCBS) Waiver. The approval of “Amendment 02” has a retroactive effective date of July 1, 2017.
The approved “higher needs” funding methodology will help ensure that those with more significant disabilities are supported comprehensively, and replaces what was formerly known as “template” funding. While the enhanced supports have the potential to be available until a full year of costs for serving the individual are reflected in a provider’s base year Consolidated Fiscal Report (CFR), agencies must attest semi-annually that the added supports continue to be necessary. Contact your local Developmental Disabilities Regional Office (DDRO) for more information regarding the application for higher needs funding. Contact information for each DDRO is available HERE.
“Amendment 02” also includes formal approval for the respite tiers that were implemented on July 1. Respite services are now reimbursed via an hourly fee schedule across the four DOH Regions, and are divided into five categories: in-home, camp, site-based, recreational and intensive. Additional information regarding the respite service changes can be reached through the following links:
A new mechanism for the conversion of ICF programs will establish funding for services delivered to individuals who are transitioning from an ICF to an IRA, after a review of direct care and clinical support hours. This funding will become a component of a provider’s Residential Habilitation reimbursement rate. For more information or to apply for ICF to IRA conversion funding, providers should contact their Regional Office.
Your Regional Office will be able to provide further details on accessing these funding streams. You can also contact the People First Waiver Unit at firstname.lastname@example.org with questions you may have regarding this announcement.
COPA ARGUES FOR EXEMPTION FROM PROPOSED RULE ON CALL-IN PAY FOR DISABILITY FIELD
Comments were submitted on behalf of COPA to the NYS Department of Labor on the Proposed Rule for Employee Scheduling – Call-In Pay. Copies were also submitted to OPWDD Acting Commissioner Kerry Delaney and Louis Raffaele, DOB’s Chief Budget Examiner. Read the full text of the comments HERE.
CP of NYS, as part of COPA, asserted that the disability provider sector should be exempt from this regulation given the significant negative impact it will have on the services and supports available to people with disabilities and their families across New York. The disability provider community has a legal and moral obligation to maintain required staffing levels at all times – obligations never imposed on or assumed by most other businesses. This critical distinction is the main reason that our field requires an exemption.
CP of NYS OFFERS COMMENTS ON OPWDD TRANSITION PLAN
CP of NYS recently offered comments to a draft transition plan offered by OPWDD. A key concern in our advocacy over the years has been the responsiveness of a system established for a large population to meet the need of those with the most significant physical and behavioral needs. CP of NYS providers and others have always made the decision to ensure services and supports would be in place for people with the highest needs, this new system holds the potential for the median and means language and policy-setting principles of managed care companies to severely compromise access to services needed by those who fall outside the bell curve and truly require more needs. In general, the State’s embracement of a system that forces a regression to the mean is problematic for those whose disabilities define them as high need or high cost members of the disability community. While there are comments and assurances by OPWDD that needs will be met in this plan, we believe clearer processes and stronger safeguards are needed to ensure that all people with disabilities’ needs will be met.
Also, in regard to the development of CCO’s and the move to managed care, CP of NYS expressed concerns about the timelines established for enrollment in CCOs and ultimately the oversight of the managed care plans and CCOs from state agency personnel who are familiar with disability services and issues. The timelines for CCO enrollment in particular seem to present obstacles that will only forestall the smooth transition, initial billing, and general start-up of the CCOs.
Read the full text of our comments HERE
CP of NYS, GATES CAPITAL PARTNER TO OFFER INVESTMENT BANKING AND FINANCIAL ADVISORY SERVICES
CP of NYS has entered into a partnership with Gates Capital and is pleased to offer a Composite Bond Financing Program. Many Affiliates and other agencies across the State have found the expertise of the Gates Team and their insights into our field, invaluable in putting together financing that works for their specific needs. We hope that you will consider reaching out to any of the Gates team listed below to see how they might help you. Financing through this method will also support the CP of NYS Affiliate Services Office. Program highlights include:
- Low fixed interest rates;
- All project types included (program NOT limited to PPA or specific revenue streams);
- Both new money and refunding bonds included;
- Separate series of bonds for each Participant (no cross-default, no cross-collateralization);
- No onerous covenants or additional indebtedness tests included;
- 100% of Project and issuance costs included (no out-of-pocket expenses); and
- Additional and/or replacement working capital lines of credit arranged.
If you have questions about the CP of NYS Composite Financing Program please contact Mike Alvaro at 518-436-0178 or email@example.com.
Underwriter / Placement Agent
Gregory M. LiCalzi
David W. Barr
Greg LiCalzi, Jr
NEW YORK STATE AUTISM SPECTRUM DISORDERS ADVISORY BOARD ANNOUNCES UPSTATE AND DOWNSTATE PUBLIC FORUMS
In November of 2016, Governor Andrew M. Cuomo signed into law Chapter 469 of 2016 which created the Autism Spectrum Disorders Advisory Board (the Board) to help provide guidance and information to New York policymakers, individuals with an autism spectrum disorder diagnosis, and families seeking reliable information regarding available services and supports.
The Advisory Board consists of appointed members, including Mary Boatfield (CP Rochester & Happiness House) and Robert Myers (Kelberman Center). The Members of the Board are tasked with several important duties including:
- Studying and reviewing the effectiveness of supports and services currently being provided to people diagnosed with autism spectrum disorders;
- Identifying legislative and regulatory activity which may be required to improve existing service systems that support people diagnosed with autism spectrum disorders;
- Identifying methods of improving interagency coordination of services and maximizing the impact and effectiveness of services and agency functions; and,
- Other matters as deemed appropriate by the Board.
The Board is developing recommendations in these areas and has announced public forums to seek input. For your convenience, two “satellite” locations (connected by video-conference) are available as well as the main “host” site for each forum.
February 13 (Tuesday) from Noon to 2:00 P.M.
Syracuse (Host Site)
Office for People With Developmental Disabilities (OPWDD) Regional Office
Regional Training Center
187 Northern Concourse, North Syracuse, NY 13212
Rochester (Connected to the Host Site by Video-conference)
OPWDD Regional Office
Room 25 Leaf
620 Westfall Road, Rochester, NY 14620
Schenectady (Connected to the Host Site by Video-conference)
OPWDD Regional Office
Room 2, Building 3
500 Balltown Road, Schenectady, NY 12304
Thiells (Connected to the Host Site by Video-conference)
OPWDD Regional Office
Building 5, Conference Room 2
5 Wilbur Road, Thiells, NY 10984
February 22 (Thursday) from Noon to 2:00 P.M.
Manhattan (Host Site)
Department of Health Office (in the Federal Office Building)
Room A/B, 4th Floor
90 Church Street, Manhattan, NY 10007
Queens (Connected to the Host Site by Videoconference)
OPWDD Regional Office
Room VC-2, Building 80
80-45 Winchester Blvd., Queens Village, NY 11427
Long Island (Connected to the Host Site by Videoconference)
OPWDD Regional Office
415-A Oser Avenue, Hauppauge, NY 11788
Each forum will be hosted by Chairperson Courtney Burke and members of the Board.
If you wish to speak at the forum, you are asked to reflect on one or more of the following questions:
- What is working in terms of services for people with autism spectrum disorders (ASD), and what models would you like to see more of?
- What can be improved in terms of government interagency coordination?
- How can people with ASD be more accepted in their communities and in the workplace?
- What is one legislative or regulatory change that you think could make a great, positive impact for people with ASD?
You do not have to speak at the forum to provide input—written remarks are accepted as well. Both written and spoken comments will be given equal consideration.
Written comments may be sent by email to: ASDadvisoryboard@opwdd.ny.gov
Or by mail to: OPWDD
Attn: N. Mitchell, ASD Board
44 Holland Ave, 3rd Floor
Albany, NY 12229
If you wish to attend and/or speak at the forum nearest you or to learn more about the board, please click here to register at the Board’s webpage.
ITHACA AFFILIATE HAS A NEW NAME
Franziska Racker Centers, an Affiliate headquartered in Ithaca, has a new name and logo. Franziska Racker Centers is now Racker. Racker is the last name of former beloved medical director, Dr. Franziska Racker. Dr. Racker served the agency from 1971-1999 and was a compassionate leader and a champion of human rights. Her holistic and strength-based approach to serving people with disabilities became the agency’s guiding philosophy.
“As the community’s needs change, we have always been an organization that changes to meet those needs. Finding a name that fully describes an agency that is so vast, is a bit of a challenge,” states Dan Brown, Executive Director. “We provide services that support individuals of all ages, from preschool, to mental health programs, to residential supports, and more throughout Cortland, Tompkins and Tioga counties. So, as we looked to transform our name it felt like the perfect choice to hold onto Dr. Racker and her legacy, and shorten our name to provide for ease of use, and sharing.”
Racker began serving the Finger Lakes region in 1948 as the Cerebral Palsy Association of the Ithaca Area, offering supports and services for families who did not want to send their children off to an institutional setting. For more information visit their website at www.Racker.org.
CP of NYS BOARD MEMBER HAS NEW BOOK ON AMAZON
Perfectly Human, a new book written by Dr. Joseph Dutkowsky is available now on Amazon. To find out more and to order the book visit the website HERE.
PROACTIVE CARING PROJECT OFFERS TRAINING FOR FAMILY CAREGIVERS
The Center on Aging and Policy (CAP) at Mount Saint Mary College was recently selected by New York State’s Developmental Disabilities Planning Council to implement a program delivering two evidence-based trainings, Mindfulness Based Stress Reduction (MBSR) and Positive Adult Development (PAD), to family caregivers of individuals with intellectual, developmental, and other disabilities throughout New York State.
The CAP plans to draw on the wisdom and experience of an Advisory Council composed of self-advocates, practitioners, and family members. The Advisory Council, which will meet quarterly either in person or by conference call, will be vital to ensuring the success of the project. Anyone interested in serving on the advisory council should contact Elaine Sproat, Director, ProActive Caring Initiative The Center on Aging and Policy, Mount Saint Mary College at firstname.lastname@example.org, or Barbara Diesem-Zimmons at email@example.com.
Learn more information on the project and the advisory council HERE.