The New York State Legislature finished passing the $237 billion Fiscal Year 2025 budget on Saturday, April 20.  The final budget was about $4 billion over what the Governor proposed in January.
Highlights include:

• $36 billion in school aid, which is $1.3 billion more than the Governor had proposed, and an additional year of the school district “hold harmless” for lower student enrollment.

• $825 million in temporary reimbursement increases for hospitals, nursing homes, and assisted living programs.
• $400 million+ in capital and rate increases for SUNY Downstate hospital to remain open.

• More than $600 million in capital funding to support housing statewide as a piece of what the Governor is calling a “Landmark Housing Deal” to create more affordable housing and includes new tenant protections and tax incentives for developers.
• $20 billion in reserves, which is five times the level of five years ago.
• $2.4 billion to assist with the migrant crisis – this is considered on time spending.
• $7.5 billion (over three years) for the new 1115 Medicaid waiver.

The Governor’s press release can be found here.

We will provide additional details as we uncover them.  Highlights of interest to CP State Affiliates include:

OPWDD

2.84% COLA – with 1.5% of that unrestricted and the stipulation that the remaining funding be used to provide a 1.7% wage increase to all non-executive staff for all voluntary operated OPWDD (not including CCOs), OMH, OASAS, Office of Children and Family Services (OCFS), Office of Temporary and Disability Assistance (OTDA), and the State Office for the Aging (SOFA) providers effective April 1, 2024.

Housing – an additional $15 million to “expand independent living opportunities for individuals with intellectual and developmental disabilities.”

New Opportunities – an additional $30 million in FY 2025 ($60 million annualized/$120 million with federal share) to fund OPWDD priority program reforms and new service opportunities for people new to the OPWDD system or who’s needs have changed/graduates aging out of residential schools/to-from transportation costs.

Minimum wage – an additional $45.1 million for OPWDD and $57 million for OPWDD, OMH, and OASAS in State funds to support minimum wage increases, including indexing minimum wage to inflation, for staff at programs licensed, certified, or otherwise authorized.

Olmstead Plan – $250,000 for New York’s Most Integrated Setting Coordinating Council (MISCC) to issue an Olmstead Plan to ensure that people with disabilities receive services in the most integrated setting appropriate to their needs – under the new Olmstead Director in the Chief Disability Office.

“Employment First” State – $6.7 million to support New York’s commitment to become an Employment First State for all people with disabilities through a multi-agency collaboration led by OPWDD.

Representative payee – Extends to July 30, 2027, the authority of mental hygiene facility directors, acting as federally appointed representative payees, to use funds for the cost of care and treatment of persons receiving services.

Special Olympics NY – includes a $1 million annual funding increase.

Rebasing – $380 million all shares for the rebasing initiative effective 7/1/24. $79 million state share/$270 million all shares for the 2024-2025 fiscal year.

Home enabling supports – $3 million for home enabling supports/assistive tech not covered by Medicaid.

Intensive Treatment – $16 million for hiring additional OPWDD staff to support the Intensive Treatment Opportunity expansion plus $12 million in capital funding to go live in 2026.

NOT INCLUDED:

Direct Support Wage Enhancement (DSWE) – Although included in the Senate’s One-House Budget bill, the final budget did not include any DSWE.

DSP Nursing Tasks in Non-Certified Settings – The legislature rejected the Governor’s proposal to authorize Direct Support Professionals (DSPs) in certain OPWDD community-based settings, such as a person’s private home or apartment, to perform certain nursing tasks, increasing the availability of nursing task services outside of certified residential settings. This would have allowed more people with developmental disabilities to live more independently and would have provided an estimated annual savings of $700,000.

DOH

I/DD Healthcare – $10.4 million fully annualized and $5.2 million in the 2024-2025 budget (effective 10/1/24) to “increases reimbursement rates to 50% above the base rate (currently at 20% above the base rate) for providers who treat people with physical, intellectual, or developmental disabilities” as proposed by the Governor.

Early Intervention (EI) – The final budget includes the Governor’s proposal of $13.9 million for a 5% EI rate increase for in-person services, as well as a 4% rate modifier for rural areas and underserved communities. Modifies EI telehealth and group Billing. The Budget makes various administrative changes to align billing requirements with federal regulations resulting in savings.

School Psychologists in EI Services – Extends the authorization of School Psychologists to practice as EI providers until April 1, 2025, and extends the authorization of School Psychologists to practice in preschool special education programs/4410 until June 30, 2026.

Consumer Directed Personal Assistance Program – Rather than eliminating wage parity, as proposed by the Governor, the final budget implements a single Statewide Fiscal Intermediary (FI) which must meet the following minimum criteria:

• Demonstrate capability to perform statewide FI services with cultural and language competencies appropriate for consumers and CDPAS workers;
• Have experience serving individuals with disabilities; and
• As of April 1, 2024, serve as a statewide FI for another state.

This FI will subcontract to:

• Independent Living Centers, which were CDPAP FIs prior to 1/1/2024 and
• “at least one entity per region that has a proven record of delivering services to individuals with disabilities and the senior population and has been providing FI services since 1/1/2012.” Such subcontractor shall be required to provide any delegated fiscal intermediary services with cultural and linguistic competency specific to the population of consumers and those of the available workforce.

The statewide FI is responsible for payments to subcontractors and shall not require Commissioner’s certification if “reasonable.”

Implementation of the Medicaid 1115 Waiver Amendment which bundles a comprehensive series of actions to advance health equity, reduce health disparities, and strengthen access to primary and behavioral health care across the state, and will be supported through $7.5 billion in funding over the next three years.

Mandatory Dual Special Needs Plan (DSNPs) Dental Coverage – Shifts coverage of Medicaid dental benefits for dual eligibles within DSNPs to the Medicare program. Saving $3 million in FY 2025.

Medicaid Global Cap – Extends the Medicaid Global Cap through FY 2026.

Medicaid Managed Care Tax – Awaiting federal approval of a new tax on Managed Care Organizations (MCOs) to generate funding to repay the plans and generate an additional $4 billion federal funding to be used for Medicaid investments – including hospital and nursing home rate increases. Establishes a dedicated “healthcare stability fund” to hold this new revenue which could be used for Medicaid rate increases, quality incentive programs, capital projects or reimbursements of the state’s general fund for unspecified Medicaid expenditures.

NOT INCLUDED:

Discontinuation of Prescriber Prevails – The Legislature extended prescriber prevails.

Scope of Practice Expansion for Physicians Assistants and extends the Nurse Practitioner Modernization Act for two years to allow PAs and NPs to independently practice primary care in outpatient settings – were rejected by the Legislature.

Licensure Compacts – to allow New York to join the Interstate Licensure Compact and the Nurse Licensure Compact for physicians and clinicians to practice in New York were both rejected by the Legislature.

SED

School Districts – Provides $35.9 billion in total School Aid for the 2024-25 school year – a $1.3 billion increase over the Governor’s budget proposal. This investment represents a year-to-year increase of $2.125 billion and rejected the Executive proposal to eliminate the Foundation Aid Hold Harmless which would have resulted in roughly half of New York’s school districts – many in rural areas – projected to receive sharp cuts in the foundation aid from what they were allotted last year (the first year that Foundation Aid was “fully funded”), some by as much as 48%.

Special Education Rate Reform – As requested by SED and the Governor, the FY 2025 Executive Budget provides an additional $1.4 million for SED to study and design a new special education tuition rate-setting methodology to streamline and improve the timeliness of tuition rates for providers, bringing total available project funding to $3.9 million and extends the deadline for SED to present its recommendations from July 1, 2025, to July 1, 2027.

Financing Structure for Residential Placements of Children with Special Needs Outside of New York – extends to April 1, 2025, the current structure of financing Committee on Special Education (CSE) residential placements outside of New York City.

ACCES-VR: no change

• Case Services – $54 million
• Supported Employment – $15.2 million

Independent Living Centers – an addition of $750,000 for a total of $16.75 million.

OMH

2.84% COLA – with 1.5% of that unrestricted and the stipulation that the remaining funding be used to provide a 1.7% wage increase to all non-executive staff.

Commercial Insurance Minimum Reimbursement Rates – Requires commercial insurance companies to pay for State-licensed outpatient mental health and substance use services at least at the Medicaid rate.

Existing Residential Programs – $43 million for 17,000 housing supports.

988 Hotline – $100,000 to provide specialized maternal mental health training programs for providers working on 988.

Improve Mental Health Admissions and Discharge – $7 million to expand regulatory compliance activities with OMH licensed and unlicensed programs including inpatient hospitals and CPEPS.

OTHER

State’s COVID-19 Sick Leave Law Repeal – The current NYS requirement that employers provide sick leave benefits, paid family leave, and benefits due to disability for employees subject to a mandatory or precautionary order of quarantine or isolation due to COVID-19 is repealed on July 31, 2025.

Justice Center Investigations Unit Expansion – Includes $1.3 million for the Investigations Unit to support an additional 18 FTEs across six different titles. This expansion will address the anticipated need for investigative services driven by mental health investments, improve cycle time for investigations, and shorten the time staff accused of unsubstantiated charges are out of work.

OMIG audit target $100 million Increase – The final budget includes the Governor’s $100 million OMIG target increase which is apparently not related to any other actions and with the only rationale that the Medicaid system has grown so they should increase the target. Continues OMIG funding at $57.5 million.

Interagency Coordinating Council for Services to Persons who are Deaf, Deafblind, or Hard of Hearing – Provides for an additional FTE to better support the Interagency Council for the Deaf, Deafblind, or Hard of Hearing within the Office of the Chief Disability Officer (CDO) and the deafblind community.

Paid 30–minute break for nursing mothers – Requires employers to provide 30-minute paid break time and permit use of existing paid break or mealtime to allow an employee to pump breast milk for their nursing child up to three years following the birth.