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NYS Budget Update

NYS Budget Update

Here is the NY Alliance Preliminary Analysis of Governor Cuomo's 2020/2021 NYS Budget Proposal.  More details are expected over the next few weeks.

NY Alliance Preliminary Analysis

Yesterday, Governor Andrew Cuomo delivered his Executive Budget Proposal in the Hart Theater at The Egg in Albany. Following his ambitious state of the state address, his budget proposal reflects many of the same priorities. The result is an interesting mix of budget and policy initiatives that would, among other things: 

  • Legalize adult-use cannabis
  • Invest in renewable energy and climate change resiliency projects
  • Invest in airport and rail station rebuilds
  • Reformulate how education “foundation aid” is distributed to schools
  • Create a new domestic terrorism law with investments toward enforcement and education
  • Continue Regional Economic Development Council funding
  • Raise the family income level threshold for college scholarship programs
  • Increase community-based residential opportunities for people with mental health needs with $20M in this year’s budget
  • Create a new paid sick leave requirement

 
Medicaid
With the State facing a $6 billion deficit and citing the Medicaid program’s responsibility for $2 billion of that amount, the Governor proposed some changes to the existing Medicaid program. Specifically, he limits the amount of Medicaid takeover growth by the State to counties to 2% for counties that opt out of the 2% property tax cap. And, he limits growth in the local share of Medicaid growth to 3% annually and requires local districts to assume all growth above 3% in a given fiscal year. However, in his speech, the Governor provided incentive to localities, offering them 25% of the savings when they remain under the 3% growth target. Importantly, OPWDD, OMH and OASAS Medicaid funded services will remain outside of this initiative as proposed by the Governor.
Harkening back to his first year in office, the Governor also proposes reinstituting the Medicaid Redesign Team for a second round of work. He has charged the group with identifying $2.5B in savings initiatives associated with efficiencies and identifying fraud, waste and abuse, and reporting back with recommendations by April 1st. Again, it appears that OPWDD, OMH and OASAS Medicaid funding will not be subject to the MRT II work.  
 
Lastly, as in previous years, the Governor has proposed language that would allow him “superpower” authority to make across the board reductions to the Medicaid program of up to $2.5B – like the 1% that was promulgated in rule making on New Year’s Eve. Yet again, OPWDD, OMH and OASAS are not included in this proposed language.
 
I/DD Services
More specific to services and support for people with I/DD, the FY 2021 Executive Budget largely maintains commitments from prior years and expands the authority of OPWDD with regard to issuing/revoking operating certificates for those providing supports. Some highlights of the budget pertaining to OPWDD include:

Increasing the OPWDD operating budget by $201.7 million (5.4%) in FY 2021.  

Maintaining commitments to the bFair2DirectCare wage commitments from last year (2% effective 1/1/20 and 2% effective 4/1/20) as well as funding associated with the increase in the minimum wage.  

Continued commitment to transitioning OPWDD services to managed care, with an anticipated release of the Specialized I/DD Plan – Provider Led (SIP-PL) documents shortly. Notable is the absence of language from previous years stating that the Medicaid Global Cap (non-OPWDD funding) would support the initial costs of transitioning to managed care. 

Maintains $120 million investment fund for unspecified OPWDD priorities, but which is discussed as earmarked for system reforms, supporting individuals new to the system, and individuals already receiving services whose needs have changed. 

Invests an additional $15 million to support the expansion of residential opportunities for those with I/DD.

Creates direct OPWDD authority and oversight of certain State Plan Medicaid services, which we understand include Care Coordination Organizations/Health Home services.  

OPWDD will prioritize additional investments in self-directed services, which has now reached 16,000 enrollees statewide.

Re-appropriates $5 million associated with the managed care community of practice grant to ensure provider readiness for managed care.
 
Justice Center

Discontinues the requirement that every Justice Center investigation of abuse and neglect must also include a Statewide Central Register of child abuse and maltreatment check. This provision was included to reduce an administrative burden that had previously extended the amount of time required to complete Justice Center investigations. 
 
As in previous years, this is our preliminary analysis, with plenty of additional analysis needed to provide a more complete picture of this complex budget proposal. As we learn more about the various components of the Governor’s executive budget proposal, we will provide additional updates. Stay tuned!