The legislative budget hearings have concluded and negotiations between the Governor’s office and the Legislature have begun, with the goal of adoption of the state budget by April 1 – the beginning of the new state fiscal year.
The Governor has submitted amendments that replace part of the initial budget proposal, these are known as the “30-day amendments.” Part of those amendments are to address what the Governor predicts to be a significant revenue shortfall, and as a result, his amendments have taken funds from the growth of the state’s Medicaid program
We are pleased that those cuts did NOT reduce the Governor’s commitment of $15million to office for aging programs in the budget allocation related to community-based services.
NY StateWide Senior Action Council (StateWide) raised concerns about how the distribution of the new $15m of funding would be implemented. Of major concern was budget language that would have allowed the NYS Office for Aging (NYSOFA) to redistribute funding to where they determined there was unmet need for services. We asked for an amendment to eliminate new authority proposed to allow NYSOFA to decrease spending from any funded program in the aging service budget in order to meet unmet needs.
We are pleased that the Governor revised this section of the budget bill based upon StateWide’s request for an amendment to address our major concern that funding to approved programs could be reduced. The new budget language does NOT allow NYSOFA to decrease appropriations.
We have expressed our support for the infusion of additional funds to address unmet needs, and have highlighted the need for public disclosure of needs data and transparency on the process that will be used to distribute the new NYSOFA funds. Our advocacy efforts will continue to address the core issues related to unmet needs and waiting lists – the workforce shortage.
One important program to address the home care worker shortage allows consumers to hire their own personal care assistants through the Consumer Directed Personal Assistance Program (CDPAP). This very successful program works in both Medicaid and EISEP (non-Medicaid, non-medical Office for Aging funded home care services) through businesses called Fiscal Intermediaries, that assist the consumer with bill paying and other responsibilities of their new employer-employee relationship.
However, the Governor has proposed cuts in the fees that the Fiscal Intermediaries can charge the state, reducing the administrative fees allowable by underestimating costs. The Governor also plans to reduce the number of these businesses that are allowed. We are concerned that the proposed cuts will make it more difficult for seniors and persons with disabilities to enroll or continue their enrollment in the CDPAP program, even while the office for aging and Medicaid Managed Long Term Care companies have been encouraging those in need of home care services to utilize the consumer directed model to offset the inability of traditional providers to address unmet need. Changes proposed under Medicaid budget language would not only impact Medicaid enrollees – they would further destabilize home care services being delivered under the NYSOFA EISEP model by reducing the fiscal intermediaries that are able to remain in business.
We recommend that the Legislature reject the Governor’s proposed limitations to the Consumer Directed Personal Assistance Program to ensure that there are no new barriers to accessing cultural and language competent fiscal intermediaries, and no disruption in continuity of care for the health care consumers and their chosen aides under this model.
Stay tuned for more state budget news from StateWide when the Assembly and Senate release their budget bills as an alternative to the Governor’s proposals in the coming weeks.