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Cuts causing challenges for I/DD providers

Joseph Abraham - Managing editor
Posted 5/13/21

SULLIVAN COUNTY -- In addition to millions of dollars in unfunded COVID-19 expenses, cuts from the state over the span of several years, have presented providers of services to people with …

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Cuts causing challenges for I/DD providers

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SULLIVAN COUNTY -- In addition to millions of dollars in unfunded COVID-19 expenses, cuts from the state over the span of several years, have presented providers of services to people with intellectual and developmental disabilities (I/DD) with even more challenges.

Things looked especially grim early on in the state budget process with the potential one percent targeted Medicaid rate reduction and five percent withholding of non-Medicaid State-only payments, which would have cost programs serving those with I/DD $47 million and $12 million, respectively statewide.

However, an infusion in federal aid from the COVID relief bill saved those prospective cuts from happening.

I/DD providers are also receiving a one percent cost of living adjustment (COLA), which results in $90 million in new money to the Office for People With Developmental Disabilities (OPWDD) delivery system statewide.

According to Arc Greater Hudson Valley Executive Director Ric Schwartz, this was the first “real” COLA they've received since 2009. They received a .002 percent one year.

Back in February Arc NY CEO Erik Geizer described the struggle caused by the lack of COLAs.

“It's like starting a job making $10 an hour a decade ago, and you're still making $10 an hour now, yet the price of everything in the world has gone up,” he said, “and then trying to provide services using that same formula. It just doesn't work. We're falling farther and farther behind. It's been a decade of neglect from a financial perspective.”

Even though certain cuts were restored and a COLA adjustment was implemented, a separate cut outside of the executive budget, which reduces bed vacancy reimbursements, has caused new concerns for I/DD providers.

The cut, which went into effect on May 1, slashes reimbursement to voluntary providers by 50 percent whenever individuals with I/DD leave to spend time with family or are admitted to the hospital for care.

The proposal also imposes an annual “cap” of 96 days of therapeutic leave, after which reimbursement would be reduced to zero, and eliminates the occupancy adjustment resulting from vacancies.

New Hope Community CEO Debbie McGinness explained that when someone that lives in one of their homes goes away for the weekend, they don't buy less food, use less utilities or reduce their staffing patterns. The same structure and rhythm remains in place.

“Our costs don't go down but our reimbursement is reduced by 50 percent for each 24-hour period a resident is away,” she said. “This represents a major funding cut for organizations like New Hope Community. We're a large, strong residential provider but reductions like this create a service delivery environment that is increasingly and negatively impacted by shrinking support.”

Lawmakers respond to cuts

NYS Senator Mike Martucci recently wrote to the Commissioner of OPWDD to voice serious concerns about their plan to implement rate reductions to the voluntary residential program, noting that the proposed cuts will have significant impacts on individuals with intellectual/developmental disabilities (I/DD), resulting in a $238 million annualized cut to the system.

He called the reimbursement cut “the most egregious.”

“As Ranking Member of the Disabilities Committee, I strongly oppose these outrageous cuts,” said Martucci. “We successfully fought large cuts proposed in the state budget. Now, here we are a few weeks later staring down more cuts. In a year when we received a massive infusion of cash from the Federal government and also raised taxes by $4.3 billion, there is simply no excuse for cutting any service to our most vulnerable New Yorkers.”

Martucci said there is clear consensus across party lines that the proposed actions will hurt residents, families, and service providers.

In the letter to OPWDD, Senator Martucci and his colleagues urged an immediate delay of at least 90 days, allowing for additional stakeholder input and the ability to properly explore alternative solutions. However the call was not heeded by the state.

Aileen Gunther, as a former chair of the NYS Assembly's Committee on People with Disabilities, also knows about these issues all too well.

“They've been suffering for such a long time with such little money to be able to do things like rehab rooms and to be able to provide the services that they truly wanted to give to people with disabilities. I'm very disappointed,” said Assemblywoman Gunther, who noted she remains in close contact and continues to work with [NYS Assemblyman] Tom Abinanti who presently chairs the committee.

She added that they've all been advocating for increased funding for people with I/DD, and that even though the federal government has supplied some money, there's such a catch up [in funding] that has to happen.

As for the bed reimbursement cut, Gunther called it “criminal.”

“That's a terrible thing to do to people,” she said. “Families love their children, their brothers and sisters and to penalize them for going home and spending some quality time with their family, it's just so abstract to me. I can't even believe it. I think that we should support the I/DD community more, not less. We give capital money to this person and that person … I mean, schools, health care, those are the backbone of our society and cutting it is ridiculous.”

The big picture

Schwartz explained that cuts in recent years have also impacted Arc Greater Hudson Valley's staffing. Across the three counties they provide services in (Sullivan, Orange and Dutchess Counties), they have over 200 direct support professional vacancies, which is another factor that influences the services they can provide.

“We can't rely on any funding they give us because we see that it gets eroded over years through cuts or through formularies,” he explained. “At a time we probably need help the most is the time it [funding] is potentially going to get pulled, which will have a tremendous impact on our ability to hire and maintain staff.”

Geizer added that if something doesn't change soon in terms of investment in their sector, providers will start to fail, going out of business or consolidating with other providers.

“There's the financial piece of all this,” said Geizer, “but all of that has a real human toll on the back end for people that we serve across the state.”

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