FROM WINI SCHIFF @ IAC: By email
The New York State Senate, Assembly and the Governor came to a final 2014- 2015 state budget agreement on late Friday night. The Budget bills went to print and the Legislature is expected to pass the final budget on Monday, March 31, 2014, the day before the beginning of the new state fiscal year.
Attached is the Governor’s press release on the final budget agreement with what he views as highlights of the 2014-2015 budget agreement – Tax cuts, job creation, education reforms and investment.
Gov press release on 2014-15 budget
The following summary was prepared by CP of NYS, DDAWNY, IAC, NYSARC and The Alliance regarding issues which we worked on collaboratively. We want to thank our respective members, Affiliates, Chapters, agencies and especially the families they represent around New York State for their participation. This appears to have been a very successful effort during a challenging period in the history of developmental disabilities services in New York State.
We would also like to thank the Senate, Assembly and the Governor for a number of important budget initiatives. We would like to thank Senator Carlucci and Assemblymember Gunther for their leadership in a number of areas and we would particularly like to thank Assemblyman Harvey Weisenberg for his relentless championing of salary increases for direct service professionals.
OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES (OPWDD)
DSP and Clinical Salary and Wage Increase
The final budget includes a targeted 2% wage and fringe benefit increase for Direct Support Professionals beginning on January 1, 2015. The Division of the Budget and legislative staff have confirmed that the intent is to include an additional 2% increase beginning on April 1, 2015, which would also include clinicians. If this holds, that would amount to a total of a 4% increase for Direct Support Professionals after April 1, 2015.
The increase applies to eligible employees of not-for-profit providers under the jurisdiction of the 6 State agencies, including OPWDD, authorized to receive the Human Services Cost of Living Adjustment (COLA).
The increase is intended to include both Medicaid and non-Medicaid funded staff. Budget language suggests that this commitment will last at least through the duration of FY 15-16.
Accountability provisions require providers to be held accountable for using funds for their intended purposes by developing “a plan of implementation” and by submitting “a resolution ….. attesting that funding received will be used solely” for direct support and clinical staff. Commissioners can recoup funding not used as required. This initiative is subject to complex budget language and there remain some key unanswered questions which we hope to provide definitive answers to in the days ahead.
We extend our deepest thanks for the success of this critical budget initiative to the Assembly, Senate and the Governor and, in particular, to Assemblyman Harvey Weisenberg who continues to be the foremost advocate for people with developmental disabilities in the New York State Legislature.
DISCO Language
The DISCO language included in Governor Cuomo’s 30 day amendments was NOT included in the final budget. The Governor’s 30 day language would have redefined a DISCO to also include large for-profit and not-for-profit HMOs and MLTCs with experience serving persons with developmental disabilities or, lacking that experience, has an affiliation agreement with an entity or entities with such experience. Under current law a DISCO only means an entity controlled by one or more non-profit organizations with a history of providing long term care to persons with development disabilities. The language fell off the table due to a controversy as to whether or not to require that the MCO be a non-profit.
Integrated Employment Plan
Final budget language requires the Commissioner of OPWDD to develop an “Integrated employment plan” in consultation with the Developmental Disabilities Advisory Council. The plan would outline a comprehensive array of individualized integrated employment options to increase employment opportunities for people with developmental disabilities. It would also require collection of critical data on employment for people with developmental disabilities; identify models of integrated employment including partnerships with business; and, identify the best means to transition people with behavioral and medical needs to integrated employment. The plan also calls for identification of technical assistance to aid providers to transition to integrated employment and assessment of funding requirements to implement the provisions of the plan.
The plan is to be developed with input from stakeholders including individuals with developmental disabilities, advocates, parents, guardians and providers. The plan is subject to the approval of CMS and shall be submitted to the Legislature within 180 days following such approval.
Tax Credit for Hiring Individuals with Developmental Disabilities
There is a new tax credit that allows employers to get a credit of 15% of a person’s salary for at least 30 hours per week and 10% of a person’s salary for as little as 8 hours per week. There are two credit points, the first one after 6 months of employment and the second one after a year of employment.
Employers will have to choose between this new tax credit and a previous tax credit which gives employers a tax credit of 30% of the first $6000.00 that was paid to an employee. The new tax credit will be better for a number of reasons, including that it is available to employers who hire someone for only 8 hours per week, the upper limit on the credit is $5,000, whereas the old one had a cap of $2,100, and this credit is only for employers who hire workers with intellectual/developmental disabilities (the previous one covered other disability groups as well).
Career Ladder
Provides that no later than January 1, 2016 OPWDD will issue report to the Governor, Senate and the Assembly making recommendations for the establishment of a Direct Support Professional (DSP) credentialing pilot program. The recommendations will be based on a study conducted by OPWDD and will consider: National and international models of DSP credentialing; Career ladders for both DSPs and supervisors; Current DSP salaries and training; Classroom and on-the-job requirements for current programs; Impact on operation of services, Ongoing and continuing professional education requirements; Fiscal impact of a credentialing pilot and Financial incentives for DSPs who complete the program.
DEPARTMENT OF HEALTH (DOH)
Disability Clinician Advisory Group
The 2014-2015 final budget requires the Health Commissioner to establish a Disability Clinician Advisory Group, which we had strongly advocated, to provide direction, education and an understanding of the effect of policy or fiscal actions in the healthcare delivery system for individuals with disabilities. The Disability Clinician Advisory Group will be comprised of experienced clinicians and clinic administrators who have an understanding of the comprehensive needs of people with disabilities. The Disability Clinician Advisory Group will provide DOH with information and data on the effects of policies, including proposed regulations, statutes and fiscal proposals, on the delivery of supports and services, including specialty services, for individuals with disabilities.
Medicaid Managed Care for Persons with Developmental Disabilities Advocacy Program
The Health Commissioner is required to establish an independent Medicaid Managed Care for Persons with Developmental Disabilities Advocacy Program which will coordinate with the current Medicaid Managed Care Ombuds program for individuals with disabilities. This advocacy program will advise individuals with developmental disabilities of their rights and responsibilities and will assist them and ensure protection and advocacy as they enroll in Medicaid Managed care, including DISCOs, FIDAs, HMOs, MLTCs and any other Medicaid Managed care entity. The establishment of this Advocacy Program recognizes that individuals with Developmental Disabilities have unique concerns and needs that must be addressed and protected as they are placed into a managed care system that is untested and evolving.
Safe Patient Handling
The 2014-15 enacted budget establishes a Safe Patient Handling program for health care facilities. The legislation creates a facility-specific safe patient handling program in New York State. It provides for a workgroup to report by July 1, 2015 identifying safe patient handling best practices, requires the dissemination of best practices, examples of sample safe patient policies and other resources and tools by January 1, 2016 and requires the establishment of facility specific safe patient handling committees and programs. Such programs are to be operational as of January 1, 2017.
Discussions among the safe handling committee participants are to remain confidential and shall not be released except to the department of health pursuant to Section 2805-m of the Public Health Law and Section 6527 of the Education law.
In addition to residential health care facilities, diagnostic and treatment centers, and clinics licensed pursuant to article 28 of the Public Health Law, and facilities which provide health care services and are licensed or operated pursuant to article 8 of the Education Law, article 19-g of the Executive law or the Correction law, the new law applies to hospitals and schools as defined in section 1.03 of the mental hygiene law which includes a facility for the residential care treatment, training or education of individuals with developmental disabilities which are certified by OPWDD.
Early Intervention
Both the Senate and the Assembly One-House bills included language to provide reimbursement and have the fiscal agent process commercial insurance claims. Unfortunately, the final budget agreement does not include any of the fiscal agent provisions but does provide funding to reimburse for commercial insurance claims from April through June of 2013 that have not yet been paid.
Additionally, Early Intervention is included in the 2006 COLA provision which include a 2% increase for clinicians salaries and benefits effective 4-1-15. Therefore, it appears that Early Intervention providers will get a 2% increase effective 4-1-15 but as with the DSP increase above, this initiative is subject to complex budget language and there remain some key unanswered questions which we hope to provide definitive answers to in the days ahead.
STATE EDUCATION DEPARTMENT
Expansion of Nurse Practice Act Exemption
The current exemption from the Nurse Practice Act for appropriately trained and certified direct care staff is extended to such staff working in non-certified settings funded, authorized or approved by the OPWDD. The tasks must be under the supervision of a nurse and other appropriate safeguards are included in the legislation. OPWDD and SED will enter into a memorandum of understanding to effectuate the provisions of the new exemption.
Special Education
853
Both houses included an increase for 853 school-age programs; the Senate included a yearly growth index tied to the personal income growth indicator which, this year, would have been 3.9%. and the Assembly included a 3% increase on direct services (70% of the rate) for the school years 14/15 and 16/17, which would go into the base. Unfortunately, neither of these proposals made it into the final version of the budget. It is important to note however, that last year’s increase/growth for 853 schools was included by the State Education Department/Executive and there is no cost in the current state fiscal year. For this reason, the Associations will continue to work on an increase for both 853’s and 4410 preschool classroom-based services during the remainder of this legislative session.
4410
Three SEIT reforms were proposed by the Governor: regional rates, a fee-for-service payment system and competitive bidding of contracts for NYC. The only proposal accepted in the final budget was for fee-for-service payments. Unfortunately, the fee for service did not include our proposal that it be modified to reimburse for a child’s absence but not for the teacher’s absence. The budget language is not specific about how the rates would be devised and the associations will maintain their involvement to try to make sure that the new payment system doesn’t disrupt operations and harm services for children.