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2006 LEGISLATIVE TALKING POINTS

Message:  Please Support Proposed 2006--2007 Executive Budget

Budget:  NYSACRA commends the Governor for proposing a trend factor of 3.03% in Medicaid programs, for recognition of prior year cost and for the 2.5% COLA to non-Medicaid programs.  These increases allow not-for-profit agencies to provide services to people with MR/DD and their families in their own communities.  We wholeheartedly support NYS-CARES II and urge that it continue to be fully funded and expanded.  NYS-OPTS is becoming a new “tool” in the toolbox to offer more creative options to families and people with disabilities

 WORKFORCE - NYSACRA will forcefully advocate for permanent, structural increases in salary, benefits and career paths for direct support professionals.  The proposed trends and the health initiative in the OMRDD budget will help a great deal.  This will allow voluntary not-for-profit agencies to continue to provide quality, person centered, community services in New York State and will ensure that direct support professionals stay in jobs they love and that can provide them a living wage. 

TALKING POINTS

(Note:  You will get a final copy of this document in your packet when you arrive)

I.                   ADMINISTRATOR/BOARD MEMBER POINTS

- Budget – Ask for support to approve the Governor’s proposed budget.  The Medicare D Wraparound benefit needs to be made permanent.  Not just for 6 months.  See detail in Leave Document in packet.

-Workforce- - Talk about the difficult job of direct support professionals.  Give legislators examples of the complex work that is done in the community, helping individuals with every aspect of their lives and to achieve their desired goals.  Direct support professionals may work without ready access to supervisors as they provide support in scattered sites.  Point out they are highly responsible and do all aspects of the job described and more!  Personal care, health care, transportation, advocacy, financial management, medication admin, to name just a few.

-Recruitment – High turnover has serious negative consequences.  It is associated with low morale, absenteeism and “burn-out”.  Staff work many extra hours in intense environments and are tired and may then be prone to making mistakes.  Talk about the costs of continuous recruitment ($3-5,000).    Discuss that there are few career paths available in the field for direct support workers – you need to go to a different job to progress.  There is increased demand for community/human services as more services are provided in the community.

-Morale - Speak about losing qualified employees to other arenas, including state jobs (same work, higher salaries), use specific examples with businesses in your area.  Make the point that many of the staff you know, love their work and want to make a career of it.  But sometimes they move on to improve their own quality of life and that of their families.

-NYS-CARES II and NYS-OPTS - The implementation of NYS-CARES and OPTS will hinge on a solid, quality workforce – help us achieve this. (Mention any problems opening new homes because of staffing.)  Increased demand for community supports has increased the recruitment and retention problems.  There have been many since NYS-CARES began 9 years ago – let’s not go back to a time when there was no hope of an out-of-home placement and years on the waiting list with frustrated, aging parents as caregivers.  NYS-OPTS is evolving and has potential to offer a more individualized approach to serving people. 

-The economy & demographics – New York’s economy is recovering and new staff may be more available. When the economy is doing well there are less individuals available to work.  We want off this treadmill.  We are aware of demographic projections that indicate harder times to come as the general population ages, there is a greater need for supports and there are fewer individuals in the replacement pool of workers.  We need to develop new pools to recruit from, value and retain workers longer, build career paths, provide competitive wages and benefits, training, mentoring and credentialing programs to truly professionalize this work.

II. DIRECT SUPPORT PROFESSIONAL’S POINTS

-The need for a living wage - Staff persons can discuss their hourly starting wage; how dedicated they are and how they work hard and long hours. Discuss the problems associated with low pay such as working several jobs, difficulty paying personal bills and loans and the desire to further their education with no time or money to do this.  Discuss the lure to other jobs for more money when you’d rather stay. 

-Supervisor –Poor supervision contributes to high turnover while good supervision is a factor in decreasing turnover.   Much of the current training that is available in our field for supervisors focuses primarily on the administrative aspects of the job.  The staffing shortage has resulted in a lack of available qualified people for supervisory positions.   In addition this has forced organizations to prematurely promote people into supervisory positions for which they are ill prepared. Attention to this area is needed.

-Turnover – Staff on the job are very much impacted by high turnover.  They are required to work additional, unscheduled hours and are often working with “green” employees who require lots of additional mentoring.  Frustration, stress, burnout, quality and morale issues frequently come up. 

-Career – Staff cannot choose this line of work as a career, and cannot support a family on the wages available.  Additionally, when we attract individuals highly interested in a career change, they often would need to take such a pay cut that it is an impossible option, (i.e. retired state troopers, teachers or those downsized in the same fields and from other jobs.)

III. PARENT/CONSUMER'S POINTS

-Quality - Parents/Consumers - make the point that your loved ones want and need continuity of services.  Consumer satisfaction decreases with constant staff changes.  Direct support professionals perform complex jobs and need to be well trained and duly compensated.  Turnover is a constant problem and new faces appear all the time.

-Community & NYS-CARES & NYS-OPTS– Staffing issues are a threat to the commitment to community supports and services.  Our children need substantial support due to their disabilities and help in gaining new skills, most will need this for the rest of their lives.

-Training & Education– High expectations and complex disabilities are not always met with the necessary training and education to develop new skills.  Training and education need to be pre-service, ongoing and moving towards a credential in direct support work.

NOTE: If your team does not include a direct support professional, parent or person with a disability, please make the above points on their behalf. It is very important to show that all parties in the Legislator's district are affected.

IV.  OTHER ISSUES OF IMPORTANCE – Please carry our above stated message to the Legislature. The below points are to be addressed after you ask for the Legislator’s support for the trends and what has been included in the proposed Executive Budget for NYS-CARES II and NYS-OPTS.

-Health Care & Insurance – related to our workforce concerns, health insurance premiums have skyrocketed – 13.9, 11.2 and 9.2% over the last three years.  Since 2000 premiums for family coverage increased by 73%.  Offering health insurance is an important recruitment tool.  We don’t want to lose ground here. OMRDD is providing some dollars to help in this area and we appreciate that.

- CLINICAL SERVICES—Clinical services for people with developmental disabilities have become a major focus in the last few years.  There are a multitude of reasons behind this shift from general “business as usual” to intense scrutiny. services.   Many persons with developmental disabilities do require clinical supports, a number require very complex treatment, some in their home and some in another setting.  They must have full access to the clinical services they need in the environment that is most appropriate for them. 

- FUEL & ENERGY COSTS  - Services for people with developmental disabilities are being negatively impacted by sharp increases in energy cost.  Not-for-profit service providers have been fortunate to receive favorable Medicaid trends over the past few years.  Money that should be going to direct support professionals to address recruitment and retention issues have to pay for increases in energy and fuel costs.  NYSACRA Position:  Not-for-profit providers cannot arbitrarily raise rates and fees for services.  New York State controls the reimbursement providers receive.  If government leaders are unable or unwilling to intervene to control spiraling energy costs, then they should recognize the negative impact it has on services to their constituents with disabilities and take actions to remedy the situation.

- MEDICARE PART D—We appreciate the New York State Department of Health’s efforts to manage the difficult transition of the Medicare Part D program created by the federal government (CMS) and to provide a seven days remedy as serious issues arose with implementation.   However, there are too many situations that are of grave concern with people being denied their medications and having to pay deductibles and high co-pays needlessly. 

·                     We urge the Governor and Legislators to implement emergency action that will allow Medicaid to continue to pay for medications for 90 days (rather than week to week action) while the Medicare Part D transition system in New York stabilizes.  

·                     The Governor’s proposed budget includes money for the wraparound benefit for six months. This is seriously not enough!  For many individuals with developmental disabilities who take multiple medications, no single plan will cover all such medications.  If the plan denies a request for exception (and ultimately a second level appeal) the individual must have fallback coverage to provide for their necessary medication.  This is a key protection provided by the wraparound, but the need for such protection will not be diminished at the end of six months.  We therefore strongly recommend the wraparound be made permanent. 

·                     OMRDD must reimburse providers for co-pays when they are occur. One agency of average size estimates their co-pays will cost $75,000 this year. 

NYSACRA is a catalyst and leading advocate for public policies, practices and organizations
that benefit people with developmental disabilities.