by Lara Kassel | Mar 21, 2023 | News
Medicaid Matters and advocacy partners are circulating a new memo to urge the Governor and Legislature to provide independent, individual advocacy assistance services for people with intellectual/developmental disabilities (I/DD) in this year’s final budget.
People with I/DD, their family members and their advocates need individual assistance navigating the complex system of services and care coordination intended to provide for their needs and choices.
We thank Governor Hochul for including $2 million in the Office for People with Developmental Disabilities (OPWDD) budget to create the program.
Thanks to Senator John Mannion, the Senate one-house bill includes the provisions of S.3108 (sponsored in the Assembly by Assembly Member Marianne Buttenschon, A.1577), which would create the program in law. We need this Article VII budget language to be included in the final budget.
This program would:
- Provide individual assistance to people with I/DD, their family members and advocates;
- Be available statewide;
- Advise and advocate on individual cases and concerns; and
- Provide accessible education on various aspects of state programs and CCO services.
Some advocacy and assistance programs for people with I/DD do currently exist, but they are ear-marked for specific reasons for specific populations, and they are not readily available statewide.
Independent individual assistance services of this type are already available to people enrolled in Managed Long Term Care (MLTC), Health and Recovery Plans (HARP), and the Fully-Integrated Duals Advantage program for people with I/DD (FIDA-IDD) through a program called the Independent Consumer Advocacy Network (ICAN). Similar services are available to people seeking mental health care and treatment for substance use disorder through a program called the Community Health Access to Addiction and Mental Healthcare Project (CHAMP).
According to anecdotal reports, the Care Coordination Organizations (CCOs), in place since 2018 to provide essential services previously provided by the Medicaid Service Coordination (MSC) program, do not universally operate in ways that allow people and their advocates to successfully navigate the care coordination system. CCOs are charged with assessing individual needs and wishes, helping individuals execute a Life Plan, and ensuring Life Plans are successfully implemented.
People with I/DD deserve an independent avenue for addressing their concerns. CCOs have internal mechanisms for addressing individual concerns. In addition, the state has a network of regional offices administered by the Office for People with Developmental Disabilities (OPWDD), one function of which is to address individual issues that arise with the CCOs. Neither the CCOs nor the state regional offices adequately address people’s concerns and are not independent.
Such issues may include (but are not limited to) failure of a care coordinator to be responsive to individuals in their case load, individual dissatisfaction with how their Life Plan is being implemented, failure of the CCO to provide adequate training of care coordinators, and more.
On and off for several years, OPWDD has explored the possibility of imposing mandatory enrollment in Medicaid Managed Care for people with I/DD. People need assistance services whether their services are moved to managed care or not. Should managed care be implemented, assistance services related to managed care could be integrated into an already-existing assistance program.
The Office of the Advocate for People with Disabilities was reinstituted in 2022. We applaud the Governor for making the commitment to advance and protect the interests of people with disabilities within her administration. An independent advocacy assistance program is still critically important. While it would be funded by the state, it would operate independently. The independent nature of the program is vital, as people with I/DD need a venue for resolution of issues accessing services and navigating the complex system intended to serve them, some of which are provided and/or authorized by the state.
by Lara Kassel | Mar 3, 2023 | News
As part of New York’s annual budget process, Medicaid Matters submitted testimony to the Joint Legislative Budget hearings on Health/Medicaid and Mental Hygiene.
Medicaid Matters Coordinator, Lara Kassel, delivered testimony in person at the Health/Medicaid hearing on February 28, 2023. She used individual quotes of three different people who have Medicaid for their insurance coverage to illuminate the importance of the program. Written testimony can be found here, and the archived video of her testimony can be found here (courtesy of the NYS Assembly).
Medicaid Matters submitted written testimony for the Mental Hygiene budget hearing in support of the Governor’s allocation of $2 million to create an ombuds program for people with intellectual/developmental disabilities (I/DD). The testimony also calls for statutory language in the enacted budget to accompany the allocation to create the program in state law. The testimony can be found here.
by Lara Kassel | Feb 20, 2023 | News
The Coverage4All campaign, Health Care for All New York and Medicaid Matters New York hosted a webinar to raise more awareness about the need for advocacy to push for an affordable public health insurance coverage option for income-eligible immigrants, regardless of immigration status.
The advocacy groups were pleased to be joined by Senator Gustavo Rivera and Assembly Member Jessica Gonzalez-Rojas for the webinar, which drew dozens of advocates and community members.
The webinar included information about the status of the issue, described the need for urgent action, and provided information on how to get involved. Specifically, a volume of comments is needed on the State’s application to the federal government to expand the Essential Plan, because it fails to include undocumented immigrants.
Find the webinar recording here and the slide deck here.
by Lara Kassel | Feb 13, 2023 | News
Medicaid Matters has joined the #Coverage4All campaign and Health Care for All New York to call on state policymakers to include an affordable public coverage option for all New Yorkers, regardless of immigration status, in this year’s budget. Find our joint flier here.
Help New York State Keep Its Promise to Expand Healthcare Coverage to Immigrants
Governor Hochul’s budget proposal backs away from her promise last year to include immigrant coverage in the 1332 Waiver application.
- The Waiver application was supposed to use the existing federal-funded Basic Health Plan/Essential Plan Trust Fund to pay for immigrant coverage and an increase the Essential Plan income eligibility for all New Yorkers up to 250% of the FPL.
The BHP/EP Trust fund has an $8 billion surplus which increases by $2 billion each year.
Federal rules say this trust fund can only be used to pay for health insurance coverage.
The Governor could ask the federal government to pay for health insurance for immigrants at no cost to the state.
The Waiver language presented in the Governor’s FY24 budget proposal inexplicably excludes immigrants.
- From a fiscal perspective, the Governor’s stance is indefensible. Seeking immigrant coverage through the Waiver would yield the following savings.
New York spends $544 million on Emergency Medicaid (NYS DOB data) for immigrants every year—this $544 million could be repurposed for other priorities.
Our vital safety net hospitals uncompensated care spending ($1,174 per person covered each year) would be reduced.
NYC would save $100 million by retiring its NYC Cares program, since that population would be eligible for health insurance.
- Other states have permission from CMS to cover immigrants (Colorado and Washington) using 1332 Waivers. California and Illinois pay for immigrant coverage through their Medicaid programs.
New York’s omission of immigrants in its Waiver proposal is analogous to “red” states’ refusal to expand Medicaid coverage to their low-income residents. Expanding public health insurance has numerous benefits, such as keeping hospitals open in rural and underserved communities and protecting people from medical debt.
- Plus, it is the right thing to do.
Health care is a human right.
Increasing access to health care makes everyone safer in the face of on-going global pandemics (e.g., Covid, Ebola, M-pox, HIV). Health insurance coverage is the best response to a pandemic.
Fiscal prudence—not politics—should govern New York’s health policy.
Next Steps:
- Comment on the Department of Health’s Waiver Request during the 30-day period.
- Ask Governor Hochul to include immigrants in her 30-day budget amendment.
- Ask the Legislature to include immigrant coverage in their one-house budget bills
by Lara Kassel | Jan 3, 2023 | Hospital Issues, News
Medicaid Matters has joined with other health care consumer advocacy groups, community members across the state, NYC Health + Hospitals, and labor representatives to call for equitable distribution of safety-net hospital funding.
Our one-pager, including the legislation we will advocate for in 2023, can be found here.
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