Authorizes the use of a trend factor in determining payments to certain care facilities

Summary of provisions

Section 1 of the bill amends Article 43.02 of the mental hygiene law to direct the OPWOD Commissioner to add a 3% trend factor for the current fiscal year for all rates of payment for under 31-bed intermediate care facilities for the developmentally disabled and all rates of payment for home and community based waiver services.

Section 2 of the bill states that additional appropriations shall be necessary to effectuate the purpose of this act and shall be made pursuant to a chapter amendment.

Section 3 of the bill provides for an immediate effective date retroactive to January 12, 2012.

Existing law

The budget for OPWDD has included a trend factor for each of the last approximately 30 years.

Justification

New York State has long recognized that a trend factor is essential to provide critical resources necessary to safeguard the health, safety and even lives of our State's most vulnerable citizens. Thus, for three decades the budget for the Office of People with Developmental Disabilities (OPWDD) included a trend factor for its major Medicaid programs. This year the trend factor was discontinued.

This action is of extreme concern to the parents, family members and advocates whose loved ones depend on services funded through OPWDD's budget. Many receive 24 hour care. They are often non-ambulatory, have severe and/or multiple disabilities, are medically frail and/or have behavioral issues that pose a risk to themselves or others. As events, including recent events, have shown they are uniquely at risk, sometimes mortal risk. Their safety depends on the care of adequate, trained and capable staff. (Note: Questions have been raised about the adequacy of staffing at a state operated group home that recently resulted in the deaths of four individuals in a fire in Wells, New York.)

However, these staff face an extremely challenging occupation. Recruiting and retaining them depends on providing wages and benefits which are at least minimally acceptable. The Medicaid trend factor is central to providing such wages and benefits. Further, unlike other health care providers, Medicaid is the sole source of funding for these programs which are also faced with ever rising costs of

pharmaceuticals, food, utilities, workers compensation, liability insurance, health care, technology, compliance, record retention and reporting paperwork and other unfunded mandates. All of these factors force these providers to operate on the margin in the best of times with reserves which, on average, compare poorly to hospitals, nursing homes, school districts and other major human services employers.

It should be noted that while nursing homes and home care programs did receive a trend factor for the first calendar quarter, hospitals, home care, nursing homes and personal care programs received more than $265 million in recruitment and retention funding. This funding fulfills the same purpose as a trend factor. On the other hand, OPWDD programs received no recruitment and retention funding.

The vast majority of OPWDD's consumers are served by community based non-profit providers. Since 1996, the OPWDD service system has grown from about 65,000 consumers to over 135,000. The health, safety and even lives of all the individuals served by this vast mainly nonprofit infrastructure is highly dependent on a stable funding system. That stability rests on the presence of the Medicaid trend factor. This year the Governor has chosen to discontinue the trend factor. This bill would reinstate it.

Legislative history

New bill.

Fiscal implications

To be determined.

Effective date

Immediately and shall be retroactive to January 1, 2012.