Residential Reimbursement

The Issue
New York State is facing a significant budget deficit which will unfortunately impact agencies such as ours. There has been swift action at the state level to start closing this financial gap — with funding cuts which will directly impact the reimbursement rates for residential providers operating under the New York State Office for People With Developmental Disabilities (OPWDD). This modified reimbursement methodology will be implemented on October 1, 2020 for providers and will:

• Reduce reimbursement rates to residential programs with vacancies by eliminating any occupancy adjustment for those vacancies.
• Reduce reimbursement by 50% to providers whenever residents spend time away from their home (i.e., overnight visits, time spent in a hospital or rehab).
• Cap the allowable days we can submit for the reduced reimbursement for residents away from home at 96, effectively reducing that reimbursement to 0% when the cap is reached. In other words, if you take your loved one home for an overnight visit up to 96 days, we would receive 50% of our reimbursement for the time spent away from the home. After 96 days, we would not receive any reimbursement for time spent away from the home.

Get Involved
Join other advocates cross New York State and send a letter to lawmakers: https://p2a.co/bABMXzE

What’s Happening: Negotiations are underway for the next COVID-19 Stimulus Package bill.
What We’re Asking For:  We’re calling out for provisions to ensure the independence and mobility of people with developmental disabilities, specifically:

• Dedicated funding for Medicaid home and community-based services (HCBS). These funds are necessary to serve people with disabilities in their homes and communities. It will provide better wages and support for the direct care workforce. Again, such funding will limit the risk of people with disabilities being put in institutions.
•  Personal protective equipment (PPE) for direct support professionals. This is urgently needed to protect the health and safety of this critical workforce. DSPs must be designated as essential workers so that they can get access to the PPE and medical supplies they need.
• Paid leave for all caregivers. As more people with disabilities lose their usual sources of care, family caregivers are scrambling and need access to paid leave and sick days to help their loved ones. All family caregivers should be included in the emergency paid leave provisions.
• Economic impact payments for all people with disabilities. Stimulus payments must be available to everyone, including adults with disabilities who are claimed as dependents.​vTake Action Today!

Get Involved:
Toolkit for Family/Friends

The Issue:
Thousands of New York State citizens with intellectual and developmental disabilities are waiting for placement in a community residential setting, and many are in immediate need. The state has not provided an adequate way for families to plan for the future when providing care at home becomes difficult or impossible. People with intellectual and developmental disabilities and their families face an onerous placement process without a clear understanding of that process or the extent of their wait.

However, while thousands await suitable placements, many residential vacancies go unfilled. Vacancies within certified residential settings have grown in recent years because of an administrative requirement to fill the opening with someone from the “Emergency Need” placement category. Often, the care needs and behaviors of these individuals are incompatible with the home in which the vacancy exists. In these cases, the vacancy remains unfilled, despite the fact it may be a suitable placement for individuals from the Current Need or Substantial Need categories.

Offering housing almost solely on an emergency basis, makes it impossible to guarantee placements will be found in the most appropriate, least restrictive home environment. These restrictions also lessen the individual’s opportunity for choice in their own housing.

We are working with OPWDD to improve the flexibility and timeliness of the placement process, to more expeditiously place individuals into available vacancies that are compatible with their needs. The Arc New York will also continue to collaborate with Keep the Promise Family Coalition to advocate for solutions.

The Position:  
We continue to advocate for increased residential development, and an improved placement process, especially for people living at home with aging caregivers. We propose the following actions be taken to ensure there is sufficient residential development to meet the growing need:

-transparently assess the number of people who have requested or need residential services and keep a wait list with a publicly available summary;
-streamline the eligibility process so that people on the wait list can have their eligibility rapidly assessed and established;
-make administrative enhancements necessary to more efficiently match people seeking placement with existing vacancies;
-match and place individuals in already existing residential settings which can meet their individualized needs; and
-provide capital and operating funds to establish as many new residential opportunities as necessary to meet the needs of New Yorkers with intellectual and developmental disabilities, particularly for those individuals with behavioral and psychological needs.

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The Issue:       
Even though many people with intellectual and developmental disabilities want to work and have the skills to do so, there are limited employment opportunities available to them. As a result, the majority of adults with intellectual and developmental disabilities are either unemployed or underemployed.

The Arc New York recently initiated the Customized Job Programs legislation A.1415 (Santabarbara)/ S.6626 (Skoufis). This bill would establish a pilot program that subdivides state jobs into simpler component parts to provide opportunities for minimum-wage, integrated employment for people who could effectively perform some, but not all aspects of a job.

The Position:   
The Arc New York supports increased employment opportunities for people with intellectual and developmental disabilities, and will work to:

-enhance employer tax credits for hiring people with disabilities;
-secure additional funding for job coaches and other supports;
-create new state job opportunities for people with intellectual and developmental disabilities;
-pay a subminimum wage when appropriate;
-pass the Customized Job Programs legislation; and
-continue to transform sheltered workshops into integrated businesses where appropriate.