News & Articles
2010 New York State Budget: A Mixed Bag
By Dan Lukens
Governor Patersonâ€™s 2010 OMRDD budget introduced on January 19 is not the catastrophe that many advocates feared, but it does, however, pose any number of significant challenges for agencies like Camp Venture.
The good news is that the 2010 proposal contains Medicaid trends and there will be a sixth round of the health care enhancement that has helped agencies to keep from passing on additional out-of-pocket health care costs to their staff. Trends are cost of living rate adjustments. According to OMRDD (New York State Office of Mental Retardation and Developmental Disabilities) officials, the Governor and members of the legislature were significantly impressed by the parents and self-advocates that they heard from and that their expressions of concern were pivotal in the decision to include a trend in this yearâ€™s Executive budget.
The bad news is that the budget also contains deep cuts to a number of core programs. Most notably, it contains a 4% cut to Day Habilitation programs, a 3% cut to IRA residences (group homes), and an 18% cut to MSC (Medicaid Service Coordination which is an important information and referral service and a key to the viability of a providerâ€™s ability to be reimbursed for the services that they provide). In addition, the Unified Services funding enhancement to community programs is eliminated. There is some new program development in the 2010-2011 budget, but the growth of new services will be minimal in this budget and will focus mainly on At-Home and other less than 24-hour supports with the exception of some new programs for special populations.
Camp Ventureâ€™s IRA and Day Habilitation programs are the agencyâ€™s two largest and funding to these two services represents the lionâ€™s share of the agencyâ€™s revenue.
The local news is also mixed. A plan to adjust the MTA tax, if passed, would redistribute the impact of this recently enacted payroll levy and place the greater proportionate burden on those areas of the region that benefit most from the MTA system. Rockland, which receives little in the way of MTA service, would see a reduction and local businesses and not-for-profit organizations, like Camp Venture, would benefit if, indeed, this proposal makes it through the budget process. Elimination of Unified Services, which is also proposed and is very likely to pass, would have a significant negative impact on the County of Rockland and on Rockland agencies that provide either mental health or developmental disabilities services under local assistance contracts.
What all this means is that, though some additional money will be added, we are also facing some big funding reductions. And, in the coming months, as the budget negotiations proceed, the advocacy efforts of Camp Venture and other agencies across the state will focus on restoring some of the cuts.
The stateâ€™s intent in developing this budget, according to OMRDD Commissioner Diana Jones Ritter, was to comply with the Governorâ€™s mandate to reduce recurring costs while at same time providing workforce enhancement essential to the stability of the service system. What agencies will be charged with doing is to reduce operating costs without compromising services in a manner that allows direct support staff to benefit from the trends.
In our view, the stateâ€™s commitment to the workforce is laudable, as is its aspiration to hang on to the program quality that weâ€™ve built over the years in spite of their very pressing need to cut costs. But their position, of course, needs to be considered in the context of a service system that has, in the past two years, already piled cut upon cut. Most agencies like Camp Venture have mostly exhausted their cost-cutting bag of tricks last year. Moreover, the rate appeals on file, which are the requests for additional funding from providers to cover prior-year losses, in the past couple of years have documented losses in the system by a good percentage of agencies. This suggests that many providers are already under-funded and will have a very difficult time squeezing savings out of programs that are already under significant budget pressure.
In a February 10, note to providers from Deputy OMRDD Commissioner James Moran concerning the day habilitation program, the Deputy Commissioner offered suggestions for providers as to how efficiencies in Day Habilitation programs could be achieved. The note also stipulated that the OMRDD would be expecting providers to submit operational plans for their day habilitation programs to their local DDSOâ€™s by April 1, outlining how the programs would achieve savings and, also how trend monies would be used.
The bottom line is that the Camp Venture agency will do everything it can to preserve our programs and to pass along what ever we can to our workforce -plan requirement or no plan requirement. And, though the suggestions offered are helpful, the list includes mostly approaches that Camp Venture is already actively pursuing or that the agency is already implementing or has implemented.
Ironically, the agencies that already are working the hardest to add the most value to the services that they provide to the people that they serve, will probably have the most trouble coming up with the additional cost cutting needed to avoid netting out the trend monies. Agencies like Camp Venture whose administrative overhead is 8.5% and whose rates for programs like day habilitation are relatively low, do not have extra fat that can be easily shed.
Nonetheless, whatever angst we experience in trying to reconcile these reductions and in working to comply with the stated goals, it needs to be considered in a relative context. We are not being forced to take services away from the people we care for and in this economy thatâ€™s something to cheer about. The task before us is, indeed, a difficult one but, then again, thatâ€™s our job.
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