Organizations participating:

The Alliance, Cerebral Palsy of New York State, DDAWNY, IAC, NYSARC, SANYS

12-4-14 MEETING WITH GOVERNOR CUOMO’S STAFF

Click HERE for PDF: 12-4-14 Associations Meeting with Governor’s staff

Attendees:

Rose Duhan, Assistant Secretary for Health; Nadine Fontaine, Counsel;  Lou Raffaele, Chief Budget Examiner; Marshall Vitale, Principal Budget Examiner; and Roger Bearden, OPWDD General Counsel.

Margaret Raustiala, ALIA; Barbara Crosier, CP of NYS;  JR Drexelius, DDAWNY; Wini Schiff, IAC; Ben Golden, NYSARC; and Steve Holmes, SANYS.

On Thursday, December 4^th, ALIA, CP of NYS, DDAWNY, IAC, NYSARC and SANYS met with members of Governor Cuomo’s program, counsel and fiscal staff to convey the profound disappointment, anger and desperation of families in the wake of the Governor’s vetoes of legislation that they had believed would begin to address the problems, of access and sufficiency of services, to meet the needs of their family members with developmental disabilities.  The tone of the meeting was serious, even somber, as we conveyed the frustration and desperation of families and the heart-wrenching stories, which they told at the recent OPWDD 5.07 plan hearings, of their inability to access crucial services for their family member.  The point was made that family after family spoke movingly of their frustration with and lack of trust in OPWDD because the rhetoric of choice, person centered services and self-determination were belied by reality.

DOB responded that these egregious situations are unacceptable.  The Governor’s staff repeatedly made the point that a needs-assessment, that can be depended on to accurately reflect an individual’s needs is required so that those needs can then be funded.  Additionally, they stressed that the goal of the Administration is to provide services to meet the individual’s needs—not more and not less–and to increase services as the needs increase.  While this is a reasonable goal, we pointed out that it requires families to trust the system and right now trust is simply not there.
The association representatives argued that, even without a reliable needs assessment, (which clearly will not be available for the proposed 2015-16 Executive Budget) there is a critical need for additional resources in Governor Cuomo’s, soon to be released, Executive Budget.

Furthermore, we suggested that the resources could be found in the reinvestment of savings from the closure of developmental centers and from the $5 billion surplus.   DOB responded that they are “acquiescing to fundamental changes that improve the process” even if they cost money.  As an example, they stated that they recognized that some of the problems plaguing the Front Door process were due to state staff shortages, so they provided $25 million for 500 additional staff people to improve the Front Door process.

The general stance of the Governor’s staff was collaborative, stating repeatedly that they share our goals and will be providing adequate funding to meet the needs of individuals with developmental disabilities.  According to DOB, while they were not at liberty to discuss the upcoming Executive Budget, they were looking at:

• Using federal Balancing Incentives Program (BIP) funding for ongoing, and not just for non-reoccurring, expenses. It was unclear where the funding would come from to support reoccurring expenses once BIP funding is no longer available.
• “Template funds” for individuals who leave the Developmental Centers.
• New dollars to fund needed services

In addition to our emphasis on the mood of the families and the need for additional resources, we:

• Thanked them for the COLA and requested that information on implementation be released quickly.
• Discussed the problems with the plan to close Work Centers (aka Sheltered Workshops) in 6 years as opposed to the far more reasonable plan adopted by Rhode Island, with its longer time frame and recognition of individual choice.
• Expressed concern of the timing and sufficiency of soon to be released SEMP rates;
• Discussed the need for information on OPWDD’s plans for the START Program after the pilots have ended.
• Requested an update on the OPWDD’s housing strategy.
• Were assured that funding will not be taken from supports and services, for people with developmental disabilities and their families, to develop or support a new managed care infrastructure.

In summary, the Governor’s staff said that they agreed with us, that they shared our desire to work cooperatively, and they pledged to administratively implement actions to address the issues that the vetoed legislation was designed to address.  Most importantly, they repeatedly stated that resources would be in the, soon to be released, Executive Budget to address the lack of services. In a few weeks, Governor Cuomo will release his 2015-2016 Executive Budget and we will all learn whether the positive statements made by his staff are allowed to materialize in the budget or instead, become more rhetoric unsupported by reality.

The Associations also met with the Assembly program & fiscal Staff and CP of NYS will be setting up an OPWDD rate-setting and fiscal tutorial with Jim Moran. Senate staff were unavailable but we will be having similar meetings with them in the beginning of January.

From a NYSARC Memo”

GOVERNOR VETOES ALL FOUR BILLS

A couple of weeks ago, in anticipation of the Governor’s actions on the bills below, we asked you urge him to sign the measures.  We were reasonably sure the Governor  would veto at least one of the bills, namely S6641 which reforms the Front Door process.  In fact he vetoed all four bills.

No doubt anticipating a negative reaction to such sweeping vetoes, the Governor waited until after elections to have the bills delivered to his desk.  Prior to elections the Governor signed one key bill, S.7232 requiring the Justice Center to follow safety protocols when interviewing a consumer.

All the bills below represent important concerns for people with developmental disabilities and their families.  The sweeping nature of his vetoes is troubling especially given a continuing lack of engagement and transparency by the Administration with the entire field regarding these bills and other issues, an indifference which appears to extend beyond the field of developmental disabilities to other human services areas.

Here are the bills along with the veto messages (see links) released by the Governor:

1) The S.6641 by Carlucci reforming the Front Door process. The Governor’s veto message sites cost and duplication of reform efforts already underway as the reason for his veto.  Reports however indicate that the Front Door process is still broken and that the crisis of people in need of out of home care – an important part of this bill – is getting worse, not better.

2)  S.7400 by Carlucci requiring that providers of service contracting with Managed Care Organization’s continue to consist of the trusted system of nonprofit and public providers.  The Governor’s veto message claims that the bill violates the Commerce clause of the US Constitution by limiting entities that can provide services under managed care.  This was wasn’t mentioned in extensive negotiations during the Spring.  That the Commerce Clause came out of the blue makes us skeptical that it is a valid excuse.  Furthermore, this veto raises disturbing questions about what the Administration intends the managed care system for people with developmental disabilities to ultimately look like.  Does it intend to replace the current system, at least in part, by inviting out-of-state for-profit provider into New York State?  Does the Administration currently have no such plans but wants the flexibility that this bill would eliminate?  Or is the reason for this veto in fact legitimate?

We don’t know the answer but this particular veto greatly increases the existing uncertainty around managed care; further underscores concerns about a lack of transparency; and, adds even more confusion to the entire managed care initiative.

3) Task Force bill S.6659 establishes a Task Force to assess and plan for the needs of Adults with developmental disabilities.  The veto message states that this “legislation simply duplicates efforts the Administration has undertaken” as well as the efforts of the Governor’s Olmstead Cabinet.

4) People First bill S.1109 requires identification of gaps in the existing developmental disabilities service system.  The veto message states that this “legislation simply duplicates efforts the Administration has undertaken”

Summaries of vetoed bills:

1)      “Front Door” S6641-C (Carlucci)/A8846 C (Weisenberg)-This bill would amend the Mental Hygiene Law to require the Commissioner of the OPWDD to develop a plan to overhaul and improve the front door process. The Front Door is intended to allocate services to people with developmental disabilities efficiently, based on person-centered planning.  S. 6641 requires that the Plan provide for a clear, rational and transparent Front Door process.  It requires expedited care for persons in critical need and for OPWDD to regularly submit an updated waiting list of people in critical need of out-of-home care.  The current Front Door process is making the issue of sufficient development for people in out of home care worse, not better.  This bill would hopefully improve that.  The plan must be submitted to the Speaker of the Assembly and the Senate Majority Leader no later than January 1, 2015 with implementation beginning no later than April 1, 2015.

2)      OPWDD Services Under Managed Care –  S.7400-B (Carlucci)/A.9766-A (Gunther) -This bill clarifies that those entities that provide supports and services for individuals with developmental disabilities, such as residential, day and employment services, must be public or non-profit entities with experience providing those services under OPWDD regardless of the type of managed care entity: Developmental Disabilities Individual Support and Care Coordination Organization (DISCO); Managed Care Organization (MCO); or Managed Long Term Care (MLTC) program.

3)      Task Force on Adults with Developmental Disabilities S6659-A (Carlucci)/A.8835-A (Gunther)-  This bill would create a task force on adults with developmental disabilities to study, evaluate and develop recommendations relating to measures to support and meet the needs of adults with developmental disabilities, including their vocational, residential and social needs. The task force will also study the long-term needs of adults with developmental disabilities who reside with caregivers. The recommendations of the task force would lead to the creation of a comprehensive plan for meeting the needs of adults with developmental disabilities which is to be submitted to the Governor and the Legislature by January 1, 2016.

4)      People First Act of 2014 – S.1109-D (Maziarz)/A.8452 (Gunther) – This bill requires the Commissioner of OPWDD to conduct a geographic analysis of the supports and services available in a community setting to individuals with developmental disabilities and to identify gaps in supports and services by regions of the state. The Commissioner is also directed to develop a web-based data base which will permit the prioritization of urgency of needs for those facing emergency or immediate need, those facing critical need, defined as additional services and supports within one year and planned need for those who will need additional services and supports within five years or where the individual’s caregiver is over sixty years old. Annual reporting requirements will allow the Legislature and the Executive to make informed policy decisions in the delivery of services and supports to individuals with developmental disabilities.