Medical equipment suppliers are closing. Hochul can help.

By Mike Alvaro
For the Times Union

For people with intellectual and developmental disabilities, independence is rarely one dramatic breakthrough. It is built from ordinary things most New Yorkers never think about, whether it is a hospital bed at home instead of in an institutional facility, a lift that lets a parent safely move an adult son, or the incontinence supplies, feeding supplies and bath safety equipment that make it possible to live in the community rather than an institution.

Durable medical equipment and supplies are not a line item. They are the infrastructure of an independent life. But the independence of people with intellectual and developmental disabilities depends on a supplier network that is disappearing.

New York has lost roughly a quarter of its durable medical equipment suppliers since 2013. In a growing number of counties, a family caring for a child with a developmental disability, or a residence supporting adults who depend on medical equipment and supplies, has fewer and fewer places to call. The result: longer waits for deliveries, equipment that goes unrepaired and people who end up in a hospital or nursing facility because the basic supplies that kept them at home stopped arriving.

Each year New York pays Medicaid managed-care plans hundreds of millions of dollars to cover medical equipment and supplies for their members, and it pays those plans in full. But the plans are under no obligation to pass that money along. By the time the funds reach the companies that deliver, fit and service the equipment, a large share has vanished.

Based on analysis of claims data conducted by the Northeast Medical Equipment Providers Association, claims are being paid at roughly 62 cents on the dollar. Some plans pay less than half the state’s Medicaid fee schedule for identical items, and some route suppliers through third-party administrators that take a cut on top.

The fix to this problem is awaiting action by Gov. Kathy Hochul, and it will cost the state nothing. Legislation (S.8838-A/A.10576) passed this year by both houses with bipartisan support would require Medicaid managed-care plans to pass through not less than 100% percent of the state’s Medicaid fee schedule to suppliers of durable medical equipment.

The legislation does not raise rates. It does not expand coverage. It ensures that money the state has determined is the proper price for medical equipment and supplies reaches the people who provide them, instead of being absorbed along the way.

Gov. Hochul vetoed an earlier version of this bill last December, citing cost. That concern deserves a straight answer: The state has already paid these plans. The only question is whether the plans keep the money or the equipment gets delivered. This bill asks the state to spend nothing more than it already has, and to get what it already paid for.

People with disabilities fought for decades to win the right to live in their own homes and communities. They should not lose that right to a reimbursement gap most New Yorkers never knew existed.

Mike Alvaro is executive director of the Cerebral Palsy Associations of New York State.—

Upcoming Incident Management Sessions

  Are you looking to learn more about how Incident Management Systems work for our loved ones who live in group homes? We are alerting you to these upcoming sessions where we will continue to delve into the details surrounding what happens when there is an incident involving your loved one. 

The sessions are designed for those currently living in OPWDD Certified Group Homes and their family advocates. You can attend one or all three of these Advocacy Sessions. 

All sessions are 7:00 – 8:30pm.

Together we are going to learn how to respond to incidents in our loved one’s group home!

https://us02web.zoom.us/MEETING/REGISTER/2TSUOI4WTSOQOFIP8DNBNQ

For those who have already registered, we appreciate your response.

Justice Department Deems Major ADA Guidance ‘Not Enforceable’

by Michelle Diament | July 20, 2026

The Trump administration is tossing aside key guidance that federal officials have used to steer enforcement of the Americans with Disabilities Act for more than a decade.

The U.S. Department of Justice issued a notice Monday clarifying that its long-standing guidance on enforcement of the ADA’s integration mandate and Olmstead v. L.C. is “not enforceable.”

“The department will not rely upon the Olmstead guidance in its enforcement of Title II of the Americans with Disabilities Act,” reads the notice from Harmeet K. Dhillon, assistant attorney general for civil rights.

At issue is a Q&A document from 2011 that was last updated in 2020 which details implementation of the Supreme Court’s Olmstead decision. The 1999 ruling found that “states are required to provide community-based treatment for persons with mental disabilities” so long as certain conditions are met.

The guidance details what qualifies as the most integrated setting under the ADA and Olmstead, who should be able to access services in the community and much more. Subsequent Justice Department guidance on employment for people with disabilities and other related issues relied on the Olmstead guidance and the agency said this week that “similar guidance documents are not enforceable.”

Officials indicated that they plan to “revisit” the Olmstead guidance in light of a 2024 Supreme Court decision in Loper Bright Enterprises v. Raimondo on how courts should view agency guidance “to determine whether the Olmstead guidance is consistent with the ‘single, best meaning’ of the ADA.”

The Justice Department notes that the Q&A document itself indicates that it is not legally binding.

“Despite the non-enforceable nature of the Olmstead guidance, numerous courts have treated the Olmstead guidance as authoritative,” the Justice Department notice indicates. “The department is concerned about confusion over the non-enforceable nature of the Olmstead guidance and issues this clarification that the Olmstead guidance is not enforceable.”

The move to dissociate from the guidance comes roughly a month after the Justice Department’s Office of Legal Counsel issued a memo indicating that neither the ADA nor Section 504 of the Rehabilitation Act “require states to treat mentally disabled patients in the most integrated setting appropriate to their needs.” That stance runs counter to long-held interpretations of the Supreme Court’s Olmstead decision.

“The Department of Justice’s Olmstead guidance reflects the overwhelming consensus of courts in their interpretation of the requirements under the Americans with Disabilities Act and Section 504, their implementing regulations, and the Supreme Court’s decision in Olmstead v. L.C.,” said Alison Barkoff, a professor at George Washington University who oversaw development of the guidance when she served as the Justice Department’s special counsel for Olmstead enforcement. “Today’s notice from DOJ that it will no longer rely on the guidance is further evidence of their backing away from a decades-long commitment to enforcing the rights of people with disabilities to live and participate in their communities.”

Notably, the first Trump administration was responsible for the 2020 update to the Olmstead guidance that the Justice Department is now calling unenforceable, said Regan Rush, former chief of the special litigation section at the Justice Department’s Civil Rights Division who is currently tracking changes in the division’s policies as director and editor-in-chief of Red Line for Civil Rights at Democracy Forward.

“That guidance has stood the test of time. It is grounded in decisions by courts across the country and has been relied upon by states and the federal government alike since 2011,” Rush said. “States that follow DOJ’s cue and abandon their integration efforts risk violating the rights of people with disabilities, and they will have to answer for it in courts that have upheld Olmstead for decades.”

In the immediate, the Justice Department notice “is likely to create further uncertainty and confusion among stakeholders in the wake of DOJ’s June memo saying that there is no integration mandate,” said Jennifer Mathis, who served as deputy assistant attorney general for the agency’s Civil Rights Division under the Biden administration and is now deputy director at the Bazelon Center for Mental Health Law. “Neither of these things has the force of law, but they appear designed to undermine the rights of people with disabilities to live in their own homes and communities. The disability community will continue to fight these attacks on their hard won rights.”

The Justice Department did not respond to questions about the changes.

Opinion

Commentary: Are we forgetting the lessons of Willowbrook?

A state facility for people with disabilities has gone without air conditioning for years. It’s a reminder of how easily neglect can return when institutions are out of the public eye.

By Vicky Hiffa,For the Times Union July 19, 2026

Building 29 at Willowbrook Development Center on Staten Island is seen in this 1970s-era photo. Now long shuttered, the institution was infamous for abuse, neglect and dehumanizing conditions, and news reports of its conditions led to changes in laws governing institutional care.Jim Romano/New York Daily News via Getty Images

Sunmount, a state facility in Franklin County that is home to approximately 145 people with severe intellectual and developmental disabilities, has reportedly lacked functioning air conditioning for nearly three years. That is unconscionable — especially considering this summer’s oppressive heat wave that has brought temperatures above 90 degrees for multiple days.

Three years is not a repair timeline. It is a failure of responsibility. How was this allowed to happen? The state must demand an answer.