INDEPENDENT LIVING: New York State's fiscal crisis threatens Medicaid

Sarah K. Lanzo, Independent Living

February 28, 2020


As you've followed the news for the past several months, you probably heard that New York State has a staggering Fiscal Year 2020-2021 budget shortfall of at least $6 billion and is placing most, if not all, of the blame on programs funded through Medicaid. In particular, Governor Andrew Cuomo has chosen to point a finger at the increased need for long-term managed care over the past three years.

Nine years ago, when the Empire State was faced with a similar dilemma, the state Department of Health created a Medicaid Redesign Team (MRT), a committee of health care providers and other experienced stakeholders, which formulated practical improvements to the program to make it financially sustainable.

In response to the current mega-crisis, Cuomo has resurrected the idea with an "MRT II" panel, made up of 15 health industry representatives and only one consumer advocate with a disability. He is K.T. Small, director of policy and outreach at Concepts of Independence, Inc. in New York City, the agency that created the cost-lowering, ground-breaking Consumer-Directed Personal Assistance Services (CDPAS) 40 years ago.

Many advocates and community leaders have labeled the MRT II process a sham. While the administration announced that public meetings, whose purpose was to get ideas from New Yorkers on possible Medicaid reductions, would be held in New York City, Albany and Rochester, the actual locations of the gatherings were published less than 24 business hours before they occurred. This made them essentially inaccessible to many people with and without disabilities, as each was revealed too late for many of the stakeholders to arrange their schedules (time off from work, transportation concerns, childcare, etc.) and have their voices heard. Adding insult onto injury, the window of opportunity to make online comments closed on Feb. 21, less than two weeks after it was announced.

With the channels for public input closed, and essentially working in a near-vacuum, MRT II will be making its recommendations to the Governor in mid-to-late March. Advocates fear many programs that New Yorkers with disabilities rely on — and which, ironically, ultimately save taxpayer dollars — are headed for the chopping block. Among them are: long-term home care, including CDPAS; the "spousal refusal" provision, which helps keep families from being bankrupted by increasing costs of nursing home care; and several other areas of government-supported health assistance.

As they are issues of the state budget, which is not due until April 1, we still have some recourse through our elected legislators. However, first, the two houses have to submit their own budget proposals, which are due in the near future, and they have yet to do so as I write this.

I urge everyone reading this, particularly if you depend on any aspect of state health assistance, to follow developments in the state budget process affecting allocations for Medicaid programs, and have your state senator's and assembly member's office phone number close at hand.


Sarah K. Lanzo is the director of Independent Living of Niagara County, a member of the Western New York Independent Living Inc. family of agencies that serve individuals with disabilities. For more information, call 284-4131, extension 200.