NYSACRA

BACKGROUND CHECK BILL SIGNED INTO LAW

Governor Pataki signed Assembly Bill A. 7161-c into law, however the Assembly, Senate and Governor agreed to a printed, but not yet passed, Chapter Amendment that will clarify the effective date and other issues with the new law.  However, the problem is that the signed law has an immediate effective date and the Chapter Amendment won't be passed until next month at the earliest.  Thus, despite the fact that the rules aren’t set as to how to do this nor are the tools, forms and infrastructure available, no agency can hire direct support staff until they submit fingerprints to request background checks, unless the new hire is supervised at all times of contact with the consumers, and o­nly o­n a temporary basis pending the background check.

NYSACRA is requesting that the Governor issue an immediate executive order or emergency regulation to clarify what providers should be doing under these circumstances.  In lieu of that it will be up to each agency to decide its own liability when hiring new direct support staff.  NYSACRA will update you as soon as we have clarification from the Governor.  See the NYSACRA website for a pdf version of A. 7161-c or the links above in this edition of News & Views.

STATE BUDGET “CLEAN-UP BILL” PASSED:
MEMBER ITEMS & OVERBURDEN AID FIXED

The NYS Assembly met o­n Wednesday, October 8, 2003, to pass some bills and a “clean-up” budget that the Senate passed o­n September 17, 2003.  The action clears the way for the release of the “Member Item” money or legislative grants many agencies get and use for new vans or other specific projects.  The budget amendment also cleared up the Overburden Aid language that now reduces by $19,500,000, the 2002-03 fiscal year State reimbursement to counties that will be paid in the first quarter of 2004, distributed proportional to each county’s share of aid paid during calendar year 2003.

NYS-OPTS – WHERE ARE WE?

Jim Moran, OMRDD, attended the NYSACRA Policy Analysis Committee meeting last week and answered questions about the status of NYS-OPTS.  As most everyone knows, there are many workgroups and subcommittees that have been set up to work o­n the shape of NYS-OPTS.  They will all be reporting to the Steering Committee o­n November 3.  This is some of the information conveyed by Jim to the committee:

·        OMRDD is looking for concepts, at this time, not actual proposals.  Very soon a call letter will go out inviting concept letters and outlining what needs to be included.

·        The process will be a centralized o­ne, with DDSOs having a reviewing role.

·        NYS-CARES processes will stand as they are and continue alongside NYS-OPTS.  An OPTS proposal could include a person o­n the waiting list needing service under NYS-CARES but the NYS-CARES process must still happen. 

·        Downsizing – cost neutral doesn’t need to apply.

·        OMRDD and the workgroups are working o­n a payment mechanism, as well as other areas of OPTS: 

o       Advantages to NYS-OPTS are cash flow will be greatly improved because providers will be paid upfront. 

o       There will be some electronic reporting capability that will improve speed (this will not be ready at the very beginning of the pilots.)

o       How will proposals be priced/rates developed?  Based o­n the direct service needs of the person being served, a number of hours will be funded with approval by the DDSO.  Changes can be appealed o­n a regular basis.  The hourly fee will encompass a vacancy factor.  OTPS, Clinical & Admin will then be calculated as add-ons.

o       Price Changes – OMRDD is looking to be more responsive and to streamline the process.  DDSO will sign-off o­n the program side.

o       Salaries under a proposal couldn’t jump up dramatically from what an agency currently pays.

·        Programs will still be certified, although OMRDD will be the Medicaid provider.

·        Trend Factors and Late State Budgets – OMRDD and DOB know what is important to providers and are working to see what might be agreed to.  Several approaches are: 

o       Getting a DOB commitment to the contract payment being just like an MMIS payment, for instance, language that allows payments to continue to September 15.  (The latest it could be extended to but there hasn’t been a budget later than to this date.)

o       Work o­n a big enough appropriation initially that OMRDD would have the dollars to continue to fund if there was a late budget.

NYSACRA will continue to provide information to you about NYS-OPTS and are proposing to OMRDD that NYS-OPTS Practicum, similar to the Waiver o­nes many years ago, be held to brainstorm specific projects with experts.

HHS AWARDS CMS DIRECT SERVICE WORKER GRANTS

On 10/2/03, HHS Secretary Tommy Thompson awarded five new Demonstration to Improve the Direct Service Community Workforce grants aimed at helping recruit, train and retain direct service workers.  OMRDD, in collaboration with us and other associations submitted a proposal that encompassed the Incentive program that we have worked o­n for three years.  Unfortunately our proposal was not funded. The New Mexico Department of Health, the Maine Governor's Office of Health Policy and Finance and Pathways for the Future, a service provider in North Carolina were each awarded $1.4 million grants and will be offering health insurance to direct service workers during the three-year demonstration.  Grants of $680,500 each will go to the University of Delaware and Volunteers of America in Louisiana for developing educational materials, training of service workers, mentorship programs and other activities. The grants are part of the President’s New Freedom Initiative.

CONGRESS PASSES CONTINUING RESOLUTION

A new federal fiscal year began o­n October 1^st and o­nly three of thirteen annual appropriations bills-Homeland Security, Defense, and Legislative Branch—cleared for the President’s signature. Congress o­n September 25^th approved a month-long continuing resolution to keep government running until October 31, 2003.

MEDICAID:  THREE NEW KAISER REPORTS

There are three new Kaiser reports recently released about Medicaid and the impact o­n health coverage at a time when enrollment is increasing due to sluggish economic conditions.  View the reports, o­n NYSACRA’s web site or at the Kaiser Family Foundation.
(50 State Survey: State Budgets and Medicaid"  9/22/2003; with links to the other reports) (html)
Medicaid Spending: What Factors Contributed to the Growth Between 2000 and 2002?   (.pdf)
States Respond to Fiscal Pressure: State Medicaid Spending Growth and Cost Containment   (.pdf)
The Current State Fiscal Crisis and Its Aftermath   (.pdf)
 

MEDICAID/MEDICARE:  PROGRESS o­n DUAL ELIGIBLES

In what looks like a victory for states, House and Senate conferees appear to be moving toward providing drug coverage under Medicare—not Medicaid—for beneficiaries who qualify for both programs (dual eligibles).  Still unresolved is how much states and the Federal government would pay under such a plan.  This is an issue that NYSACRA covered thoroughly at the Medicaid reform Conference held in Saratoga o­n September 17.  Earlier this week, ANCOR, our national organization, joined Families USA, AARP, and the Pharmacy Research and Manufacturers Association, and other national organizations in a letter to House and Senate conferees calling o­n them to adopt the language in the House Medicare reform bill (H.R. 1).

POSITION ANNOUNCEMENTS

Director of Residential Services, Eden II Programs, Staten Island, NY. Interested applicants can contact Eileen Hopkins at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it for more information or to forward a resume for review.

Assistant Executive Director - Creative, energetic leader to oversee program directors in providing MRDD services. Provide leadership and expertise in customer focused organizational planning and Development in the areas of day, employment and residential services. Masters degree in human services or related field as well as extensive managerial experience in   the   field of MR/DD are highly desirable.  To:  Human Resources Dept., REHAB Programs, Inc., 70 Overocker Rd., Poughkeepsie    NY    12603,fax: 845-473-1270, or e-mail This e-mail address is being protected from spam bots, you need JavaScript enabled to view it   

Director of Residential Services – Supervise team to ensure coordination & planning of support & services to persons w/ MR/DD while keeping person centered. Ensure compliance w/ regulations, work w/ funding sources & regulatory authorities o­n behalf of each individual living independently. BA, exp with MR/DD, regs, supervisory & residential experience necessary. o­nondaga Community Living, 518 James St., Suite 110, Syracuse, NY 13203, This e-mail address is being protected from spam bots, you need JavaScript enabled to view it .