Alliance Releases Additional Details on NYS Budget, National Initiatives
By Public Policy Director Luke Sikinyi CEO Harvey Rosenthal
April 24, 2024
While we have a state budget agreement in place, the Alliance’s work to improve policies affecting people with mental health, substance use, and trauma related challenges goes on all year. The Alliance remains focused on New York while also monitoring new developments at the federal level.
We are happy to share this second look at New York State’s enacted budget for Fiscal Year 2024-2025 as well as some national policy updates.
NYS Budget Updates
Independent Living Centers (ILC):
Even though ILCs were not included in categories of programs eligible for the 2.84% Cost-of-Living Adjustment (COLA), the budget did increase Independent Living Network funding by $750,000. Advocates for ILCs will continue to advocate for the future inclusion of these programs in the COLAs for human services agencies mandated by the state.
The Access to Home program, which provides funds so people with disabilities can adapt their homes to improve accessibility, received an increase of $1 million to bring the yearly funding to $4 million.
Consumer Directed Personal Assistance Program (CDPAP): After intense advocacy, the final budget made significant changes to the legislature and Governor’s proposal to reduce the number of fiscal intermediaries for the CDPAP program to one statewide entity. While the budget does call for one statewide intermediary, it requires this entity to subcontract with the eleven existing ILC fiscal intermediaries as well as one additional subcontractor per rate region.
“While we are happy that the ILC role was preserved, we remain seriously concerned regarding this change and the significant disruption in care it will cause.”
-New York Association on Independ Living (NYAIL)
Corrections on Enacted Commercial Rate Mandate:
The mandate to require commercial insurance companies to provide at least the Medicaid rate for mental health and substance use services has been enacted through this year’s budget but will not take effect until January of 2025. This gives the Department of Financial Services time to implement this requirement in regulations.
Additionally, the state has proposed a maximum waiting period of 10 days between request for an appointment and actually seeing a provider. This proposal is still a draft and not enacted, as we stated in an earlier budget analysis. We’ll have more information about this once the comment period for commercial insurance providers has closed and the state is able to give updates.
More Details on Increased Medicaid Rates:
The budget allows up to $825 million to be used to increase Medicaid payments. This is a temporary increase, meaning these rate increases are only allowed for this year. The state will determine whether they offer lower rates, but they can increase them up to these maximum amounts. Here’s how the maximum funding increases are broken down:
- $525 million for hospitals
- $285 million for Nursing Homes
- $15 Million for assisted living facilities
We are also happy to report the final budget restored the proposed $125 million cut to the Health Home Program!
At the same time, we are very disappointed that the budget does not include provisions to reform the Office of the Medicaid Inspector General’s audit process that has exacted unnecessarily punitive action for agencies acting in good faith. While we support the office’s work to curb fraud and low-quality services, we must change audit practices which punish agencies for minor mistakes which do not affect the quality of their services, such as clerical errors.
Other NYS budget details we reported yesterday:
- 2.84% COLA, with agencies required to provide at least a 1.7% increase in wages for non-executive staff
- Up to $1.5 million available for crisis response which can be used for a Daniel’s Law pilot
- Continued funding of INSET programs at $2.8 million
- $8.2 million to provide court based mental health navigators to help people get through the criminal justice system
- $43 million to increase stipends for over 17,000 OMH Supported Housing units to keep pace with rising property costs
- $119.5 million for an array of existing and new community service programs (includes crisis and respite beds, supported housing, peer-operated recovery centers, and others)
- $250,000 to revise and release a new Olmstead Plan in 2024
- $5 million to support existing recovery community centers, which are currently funded by Federal grants that are expiring in October.
- $7.5 billion from the Medicaid 1115 Waiver
- The Alliance will have two comprehensive presentations on the waiver at this week’s Executive Seminar and one on how peer support organizations and community providers can set themselves up for successful relationships with regional Social Care Networks (SCNs). See more program and registration details here.
==============
National Policy Updates
New Medicaid Regulations Announced
The Centers for Medicare and Medicaid Services (CMS) enacted a number of new Medicaid regulations intended to improve access to care, increase transparency, and improve the experiences of people who use Medicaid funded services. The New regulations include:
- Requiring Medicaid Managed Care Organizations to report how they spend state-directed payments
- Home Care Agencies will have to spend 80% of Medicaid payments on wages for aides and nurses
- National standards for wait times for many services, including primary care and outpatient mental health appointments
- Learn more here: Medicaid managed care rules aim to increase transparency | Modern Healthcare
Grants Pass v. Johnson Case
The US Supreme Court began hearing arguments in the Grants Pass v. Johnson case which is determining whether cities such as Grants Pass Oregon can make acts such as sleeping on public property illegal. The lower court decision said it was unlawful to do so under the 8th amendment, because the law essential makes being homeless illegal. The ruling in this case will have wide reaching ramifications for how cities address the growing issue of homelessness and housing affordability. Learn more about the case using the links below: