Senate Bill S4901

                                 BILL NUMBER:  S4901

 TITLE OF BILL :
An act to amend the mental hygiene law, in relation to the
implementation of a trend factor for payments to certain intermediate
care facilities


 PURPOSE :
To provide a 3% trend factor in the OMRDD budget for the current
fiscal year to rates funding under 31 bed ICF/DDS and Home and
Community Based Waiver programs operated by non-profit agencies.

 SUMMARY OF PROVISIONS :
Section 1 of the bill amends Article 43.02 of the mental hygiene law
to direct the OMRDD Commissioner to add a 3% trend factor for the
current fiscal year for all rates of payment for under 31-bed
intermediate care facilities for the developmentally disabled and all
rates of payment for home and community based waiver services.

Section 2 of the bill states that additional appropriations shall be
necessary to effectuate the purpose of this act and shall be made
pursuant to a chapter amendment.

Section 3 of the bill provides for an immediate effective date
retroactive to January 12, 2009.
              

 EXISTING LAW :
The budget for OMRDD has included a trend factor for each of the last
approximately 30 years.

 JUSTIFICATION :
New York State has long recognized that a trend factor is essential to
provide critical resources necessary to safeguard the health, safety
and even lives of our State's most vulnerable citizens.  Thus, for
three decades the budget for the Office of Mental Retardation and
Developmental Disabilities (OMRDD) included a trend factor for its
major Medicaid programs. This year the trend factor was discontinued.

This action is of extreme concern to the parents, family members and
advocates whose loved ones depend on services funded through OMRDD's
budget. Many receive 24 hour care. They are often non-ambulatory, have
severe and/or multiple disabilities, are medically frail and/or have
behavioral issues that pose a risk to themselves or others. As events,
including recent events, have shown they are uniquely at risk,
sometimes mortal risk.  Their safety depends on the care of adequate,
trained and capable staff. (Note: Questions have been raised about the
adequacy of staffing at a state operated group home that recently
resulted in the deaths of four individuals in a fire in Wells, New
York.)

However, these staff face an extremely challenging occupation.
Recruiting and retaining them depends on providing wages and benefits
which are at least minimally acceptable. The Medicaid trend factor is
central to providing such wages and benefits. Further, unlike other
health care providers, Medicaid is the sole source of funding for
these programs which are also faced with ever rising costs of
pharmaceuticals, food, utilities, workers compensation, liability
insurance, health care, technology, compliance, record retention and
reporting paperwork and other unfunded mandates. All of these factors
force these providers to operate on the margin in the best of times
with reserves which, on average, compare poorly to hospitals, nursing
homes, school districts and other major human services employers.

It should be noted that while nursing homes and home care programs did
receive a trend factor for the first calendar quarter, hospitals, home
care, nursing homes and personal care programs received more than $265
million in recruitment and retention funding. This funding fulfills
the same purpose as a trend factor. On the other hand, OMRDD programs
received no recruitment and retention funding.

The vast majority of OMRDD's consumers are served by community based
non-profit providers.  Since 1996, the OMRDD service system has grown
from about 65,000 consumers to over 135,000. The health, safety and
even lives of all the individuals served by this vast mainly nonprofit
infrastructure is highly dependent on a stable funding system. That
stability rests on the presence of the Medicaid trend factor. This
year the Governor has chosen to discontinue the trend factor. This
bill would reinstate it.

 LEGISLATIVE HISTORY :
New bill.

 FISCAL IMPLICATIONS :
To be determined.

 EFFECTIVE DATE :
Immediately and shall be retroactive to January 1, 2009.