15 Mar Budget Update: Assembly One-House Highlights

ASSEMBLY ONE HOUSE 2023-2024 BUDGET BILL HIGHLIGHTS

OPWDD

• 5% COLA* – $290.6 million to increase the 2.5% COLA to 8.5%.
• OPWDD Managed Care – extends the legal authority for OPWDD to implement managed care plans through 2028 by extending the authorization through 2025.
• Rejects increased flexibility in delegating nursing tasks by restoring $700,000 and denying the ability of nursing tasks to be performed by non-clinical staff certified by OPWDD in non-certified community-based settings.
• Medicaid Buy-in – modify the Executive proposal to expand the Medicaid Buy-in Program for Working People with Disabilities by providing limitations on monthly premium payments to ensure parity with the Affordable Care Act.
• Member Items – $540,000 for certain legislative priorities.
• NO funding or mention of the $4,000 Direct Support Wage Enhancement

SED

• Methodology Study –amends the $2.5 million 4410, 853 & Special Act special education tuition methodology study to remove the cost neutral language, to ensure the fiscal stability of these programs, and to provide predictable annual funding levels
• Special Education Priorities – The Assembly One-House Budget proposal does not appear to include any of the other priorities (10% increase/parity, interim plus rates, 65/35 cost screens, staffing intensification and health and safety waivers only having to be revied by SED and not DOB, for 4410, 853 and Special Act Schools).
• 4201 Schools (Schools for the Blind and Deaf) -includes a $15 million increase over the Executive proposal including:
  • restores $2 million
  • provides a $10 million increase for a total of $118 million.
    • The Assembly also restores $3 million for the following 4201 schools:
      • $903,000 for the Mill Neck Manor School for the Deaf;
      • $903,000 for the Henry Viscardi School;
      • $500,000 for the Cleary School for the Deaf;o
      • $500,000 for the Mill Neck School for the Deaf; and
      • $150,000 for the St. Francis de Sales School for the Deaf.

DOH

• Early Intervention 11% Increase – $61 million to increase Early Intervention rates by 11%.
• Prescriber Prevails – rejects allowing the Commissioner of Health to remove certain over-the-counter drugs that are reimbursable by Medicaid and eliminate prescriber prevails protections under Medicaid Fee-For-Service and Managed Care.
• Medicaid Buy-in – modify the Executive proposal to expand the Medicaid Buy-in Program for Working People with Disabilities by providing limitations on monthly premium payments to ensure parity with the Affordable Care Act.
• Federally Qualified Health Centers (FQHCs) Telehealth – includes legislation to guarantee that FQHCs are paid their full Medicaid reimbursement rate for telehealth services regardless of the location of the patient or the provider or the modality of the service.
• 340B Carve out – $410 million to repeal the Medicaid Pharmacy Benefit Transition from managed care to fee-for service which would allow certain providers to maintain eligibility to receive funding under the federal 340B program.
• Statewide Health Care Facility Transformation Program V – modifies the proposal to provide $1 billion through the Statewide Health Care Facility Transformation Program V by establishing minimum funding amounts for community-based organizations and to provide $20 million for the creation of a Community Health Care Revolving Capital Fund.
• CDPAP – Rejects the Executive proposal to eliminate wage parity for Consumer Directed Personal Assistance Program (CDPAP) workers, as well as the corresponding investment in health insurance coverage.
• Health Homes – $30 million to reject the Executive proposal to recalibrate the health homes program.
• Prescriber Prevails – $8.7 million to reject the reduction of coverage for over-thecounter drugs and rejects the elimination of prescriber prevails provisions.
• 10% rate increase for:
  • Hospitals –$425 million
  • Nursing Homes – $157.5 million
  • Assisted Living – $9 million
• Voluntary Hospital Indigent Care Pool – $42.7 million to reject the proposed reduction.
• Financially distressed hospitals – $850 million in additional funding
• Financially distressed Nursing Homes – $100 million in additional funding
• Medicaid Rebasing – instructs the Executive to begin the process of rebasing hospital, nursing home, and clinic Medicaid rates in SFY 2024-25.
• $50 million to Community Based Organizations including:
  • $30 million to increase Federally Qualified Health Center telehealth rates,
  • $10 million to further expand the Certified Community Behavioral Health Clinic (CCBHC) Program, and
  • $10 million to expand the CCBHC Indigent Care Program.
• Quality Incentive Vital Access Provider Pool – $45.5 million
• Respite for High Need Family Caregivers -modifies the proposals to invest $7.2 million to provide respite care for high-need family caregivers, and $2.1 million to provide care teams for low-income older adults by shifting this funding from the DOH budget to the SOFA budget.

OMH

• 5% COLA* – $128.4 million to increase the 2.5% COLA to 8.5%
• Community Mental Health Loan Forgiveness – $5 million to support the expansion of the OMH Community Mental Health Loan Forgiveness Program, for a total of $19 million. Additionally, mental health professionals eligible for funding include Licensed Master Social Workers, Licensed Clinical Social Workers, Licensed Mental Health Counselors, Licensed Marriage and Family Therapists, Psychoanalysts, Creative Artis Therapists and Applied Behavior Analysts.
• Background Check Sharing – Rejects the Executive proposal that would authorize OMH and OASAS to share and receive criminal background information from the Division of Criminal Justice Services (DCJS);
• Joint BH Clinics – accepts the proposal that would authorize OMH and OASAS to jointly certify community behavioral health clinics (CCBHC); and
• Community Behavioral Health Clinic Indigent Care – modify the proposal that would establish an indigent care program for an eligible CCBHC by increasing the funding available under the program by $10 million.
• OMH Sanctions – rejects the proposal to authorize the commissioner of OMH to develop a schedule of sanctions and increase the maximum fine from $1,000 to $2,000 per day resulting from a service provider failing to comply with the terms of their operating certificate; and permit penalties resulting from any unauthorized bed closure to be considered at the individual bed level.
• Mental Health Housing Task Force – adds a proposal that would establish a task force to provide recommendations that aim to remove barriers for aging residents in mental health housing programs to receive both medical and mental health care.
• Qualified Mental Health Associate – rejects the Executive proposal to provide $650,000 to create the title of a Qualified Mental Health Associate.

*8.5% COLA

The Assembly increases the Human Services cost of living adjustment (COLA) by six percent for a total of 8.5 percent. The state fiscal year cost for the additional six percent, COLA for the Human Services agencies would be$486.5 million total and:

• $290.6 million for the Office for People with Disabilities;
• $128.4 million for the Office of Mental Health;
• $33.6 million for the Office of Addiction Services and Supports;
• $12.9 million for the State Office of the Aging;
• $20.4 million for the Office of Family and Children Services; and
• $480,000 for the Office of Temporary Disability Assistance.