N.Y.’s largest health vendor linked to owner accused of fraud, neglect

New York has contracts worth $27 billion with a company closely linked to a nursing home conglomerate that’s accused of fraud in a state attorney general’s investigation.

By Raga Justin April 7, 2024

The Schenectady Center for Rehabilitation and Nursing is a Capital Region nursing facility owned by the Bronx-based Centers Health Care. The nursing home conglomerate’s owner was named in a state attorney general’s lawsuit last year that alleged several fraud and neglect charges stemming from four other Centers facilities.

Will Waldron/Times Union

ALBANY— State Attorney General Letitia James stood at a podium late last June to announce her office had filed another civil case against allegedly nefarious nursing home operators, this one targeting four facilities and their Bronx-based parent company, Centers Health Care. 

James accused two Centers Health Care executives of orchestrating “multiple fraudulent schemes” that siphoned millions from the state’s Medicaid program to enrich themselves, their business associates and also to purchase a flailing Israeli airline. She pointed to disturbing, graphic examples of hundreds of elderly residents forced to endure harmful conditions for years because of the company’s alleged role in woefully understaffing nursing homes. 

“They ignored and violated laws meant to protect nursing home residents and they pocketed millions of dollars that should have gone to patient care,” James said of the nursing facilities, which are located in Queens, the Bronx, Westchester County and Buffalo.

The for-profit nursing home conglomerate’s chief executive officer, Kenneth Rozenberg, is the subject of intense ongoing scrutiny from state regulators as the attorney general’s civil lawsuit progresses through the court system. 

But six months after the allegations of widespread abuse and Medicaid fraud against him were made public, New York approved a 5-year, multibillion-dollar contract with the state’s largest and highest-paid managed care company — which Rozenberg also owns.

That company, called Centers Plan for Healthy Living, has had $27 billion worth of business with the state Department of Health since at least 2012, according to records maintained by the state comptroller’s office. Two contracts totaling nearly $17 billion have a start date of January 2022, likely around the time the attorney general’s investigation began. 

Still, both contracts were approved months after the investigation was made public — and after a state judge determined the attorney general’s office had presented enough evidence of fraud by Rozenberg and one of his close business partners and co-defendants, Daryl Hagler, to merit assigning an independent financial monitor for Centers Health Care’s operations. 

And last spring, while under scrutiny from state authorities and as the investigation crept closer to becoming public, Centers Plan for Healthy Living entered into a $10,000-per-month lobbying deal with noted health care lobbying firm Hinman Straub — the company’s first such activity, according to lobbying records, despite doing business within New York since at least 2013. 

The situation raises questions about what vetting process the state uses to examine its highest-paid vendors, especially in the complex world of government-funded health insurance plans. In that sector, the relatively new health payment system known as managed care has been criticized for, in some cases, enabling profit-seekers to flourish while providing care to the state’s most vulnerable residents. 

State contracts of that magnitude typically are reviewed by multiple entities, beginning with the agency which entered into them and then by the state comptroller’s office, which issues final approval.

Mark Johnson, a spokesman for the comptroller’s office, said the agency’s contract approval scope is narrow. Its vetting process is limited mostly to whether the vendor has violated labor laws by failing to pay workers proper wages.

Melissa Pomeroy, a spokeswoman for the Department of Health, said the agency would not comment on Rozenberg’s case because of pending litigation.

When asked about the department’s policy for dealing with vendors who are facing civil or criminal penalties, Pomeroy said there is a general review process at the time a contract is approved and when it is renewed. 

She noted that if a person or entity who is providing Medicaid services has “engaged in an unacceptable practice,” the department’s Office of the Medicaid Inspector General can impose sanctions, including censure or exclusion from state contracts.  

A spokesman for Centers Plan for Healthy Living and Centers Health Care declined to comment.

‘A duty to act’

The sole reference to Centers Plan for Healthy Living in the 366 pages of the state’s civil complaint against Rozenberg and Centers Health characterizes the insurance plan as the largest managed care organization in New York. These types of plans essentially function as the payment intermediary between Medicaid enrollees with intensive medical needs and their health care providers.

In the complicated parlance of health insurance, Managed Long Term Care plans help people who are chronically ill, have disabilities or otherwise need long-term care. The health plans help arrange for those medical services, like home health or nursing care, and receive payment from the joint state-federal Medicaid program to do so. 

New York has been increasingly reliant on Managed Long Term Care plans over the decades, and companies have flocked to provide such plans — including Rozenberg’s Centers’ conglomerate. 

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Since at least 2012, the Department of Health has approved six contracts with the Staten Island-based Centers Plan for Healthy Living. Most recently, the department entered into two 5-year contracts beginning January 2022 and running until December 2026. That contract term is standard for Managed Long Term Care plans.

The first contract, worth $16.1 billion for services simply characterized as Managed Long Term Care, was approved by the state comptroller’s office on Dec. 15. Another agreement for $599 million for a health plan for dually-eligible Medicaid and Medicare enrollees was approved on Nov. 15. 

Both contracts would have been entered into by the Health Department around the time the massive investigation had been launched by the state’s Medicaid Fraud Control Unit, a bureau within the attorney general’s office dedicated, in part, to rooting out dishonest health care practitioners. 

Contained in that lawsuit are multiple allegations that Rozenberg and Hagler submitted misleading or false information to Department of Health regulators related to funding and ownership structures for some of their nursing homes. 

But officials elsewhere had quickly reacted to the severity of the allegations.

Last July, state Supreme Court Justice Melissa Ann Crane found evidence of “repeated and persistent fraud” so credible that she appointed a financial monitor and health monitor to assess and manage Centers Health Care’s operations. 

“Although respondents have promised to cease payments to related entities and that principals will take no further draws, the sheer magnitude and variety in the fraud that has allegedly persisted warrants the imposition of an independent financial monitor,” Crane wrote in a decision. “In all likelihood, the massive self-dealing will continue without a monitor.”

New Jersey officials also found the allegations serious enough to issue temporary suspension notices in January, targeting two facilities owned by Rozenberg and Hagler in that state. 

In a release, New Jersey State Comptroller Kevin Walsh cited “poor conditions … and evidence of massive Medicaid fraud in New York.”

“When there is evidence of fraud of this magnitude, and when a judge has acted to prevent further siphoning and self-dealing, we have a duty to act,” Walsh said. “To protect New Jersey Medicaid and the residents who rely on it, we must stop the flow of Medicaid funds to these individuals, and we must require them to step aside.” 

Several New York lawmakers said they were only vaguely familiar with the company and did not recall being approached by a lobbyist concerning Centers Plan for Healthy Living or Centers Health Care. 

But lobbying filings indicate both organizations have retained Hinman Straub, though the specific focuses of that lobbying were not disclosed. While Centers Health Care has been listed in lobbying records since 2019, Centers Plan’s CEO Mark Bloom signed its first agreement with the lobbying firm in March 2023 for unspecified health care lobbying activities, including with the governor’s office.

The agreement, which runs until the end of this year, is for $10,000 a month. 

According to his profile on Centers Health Care, Rozenberg credited the shift that states have taken in recent years towards managed care as the reason behind forming Centers Plan for Healthy Living. The health insurance organization services all of New York City, plus Rockland, Niagara and Erie counties and has plans to expand further. 

The company did not respond to questions about how much control, if any, Rozenberg currently exercises over Centers Plan for Healthy Living, or over Centers Health operations. 

Allegations

The attorney general’s lawsuit alleged that while the COVID-19 pandemic shone a spotlight on illegal conduct from Rozenberg and his associates, he had been engaged in fraudulent activity since well before 2020 — and had continued through the time of the filing.

James claimed that from 2013 to April 2022, Rozenberg, Hagler and multiple other LLCs and business associates in their network extracted tens of millions of dollars in Medicaid reimbursement funds as up-front profit from nursing homes they controlled, cutting staff expenses and paying low wages to do so. The breadth of the allegations include claims that Rozenberg and others filed false documents with the Department of Health to hide the amount of money they were transferring to themselves.

“In so doing, respondents repeatedly prioritized their personal enrichment by minimizing staffing expenses while maximizing revenue from admissions and ignoring and violating many state and federal laws designed to protect nursing home residents,” the lawsuit contends.

The allegations in the state’s lawsuit encompass a disturbing array of patient care violations, including several instances where elderly residents were left covered in feces and other waste while they waited hours for nurses to come to their aid. Many developed gaping bed sores from not being turned regularly; when residents repeatedly rung call bells, they were ignored by overworked staff. 

In several messages attached to the lawsuit, supervisors at the facilities allegedly pleaded to bar new admissions to the nursing homes and informed executives about the dismal staffing ratios leading to harmful conditions for residents. But the corporation declined to cease intake, admitting new residents even as staff struggled to provide for the residents already in their care. Staffing levels remained dismal.

Recruiting long-term care staff has long been a difficulty in New York.

Stephen Hanse, president of New York State Health Facilities Association which represents nursing and assisted living providers, referred to a “change in the paradigm” nearly a decade ago, citing minimum wage hikes that meant nursing home workforces started shifting towards other, lucrative options in the labor market like retail stores or fast food restaurants.

As a result, the long-term care workforce was decimated, and remains so, Hanse said. 

By Raga Justin

Raga Justin is an investigative reporter covering politics and policy with the Capitol Bureau, where she was previously a Hearst fellow. She is a native Texan and University of Texas at Austin graduate and has worked for the Hearst Connecticut Media Group, the Dallas Morning News in Washington, D.C., and the Texas Tribune. Send tips, feedback or rants to raga.justin@hearst.com.

Assemblymember Seawright’s OpED

Opinion

Op-Ed | Don’t leave our most vulnerable New Yorkers behind in budget negotiations. We need a COLA without contingencies!

By Assembly Member Rebecca Seawright, Chair of the Assembly People with Disabilities Committee

Posted on March 29, 2024

Direct Support Professionals and non-profit provider agencies are the backbone of our state’s care service sector with over 85% of the responsibility for supporting people with intellectual and developmental disabilities.  The forecast is bleak with no relief in sight with the hemorrhaging of staff costing providers $100.5M annually.  We must fund a comprehensive 3.2% Cost of Living Adjustment in our final State Budget without contingencies.  The system serving I/DD New Yorkers simply cannot serve the demands of a fragile population in the face of an annual 30% workforce turnover, and agency vacancies in excess of 17%.  

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Op-Ed | Don’t leave our most vulnerable New Yorkers behind in budget negotiations. We need a COLA without contingencies! | amNewYork

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As negotiations are underway and the Budget’s April 1 deadline has been extended, we continue the fight against the contingency language in the current proposal for the COLA.  Essential costs like energy, insurance, transportation, maintenance, food and technology to name a few would be excluded from the increase.  From 2022 to 2023, salary and benefit costs alone grew by 14%, and workers compensation by a staggering 66%.  

Provider agencies are not immune to inflationary forces that are pushing a vital sector into a deleterious state.  Cost increases related to mandated fringe benefits, repairs and maintenance, utilities, food, supplies, transportation, and insurance over the past year has resulted in untenable and constricting financial pressure on agencies. Additionally, since the I/DD provider agencies are solely funded by Medicaid, agencies are unable to increase reimbursement for services to compensate for increased costs of operations.

Historically, we have championed a strong COLA in years past to both improve the recruitment and retention of our workforce, as well as to provide for the inflationary increases in operating costs.  Meeting operational costs is fundamental to keeping programs open.  If providers cannot meet the soaring costs, they will close their doors cutting off services to over 130,000 New Yorkers with disabilities.  Flexibility in the COLA is necessary to increase salaries for hardworking DSPs and to fulfill commitments to fringe benefits, care management staff travel costs, and worker’s compensation.  

We have an obligation to workers who are also not immune to inflationary pressures and are being pushed further into poverty.  A recent survey by the New York Disability Advocates (NYDA) found that while DSPs are working to support I/DD New Yorkers, they can’t sustain themselves with nearly half of all DSPs reporting that they have limited access to sufficient food and shelter. It is reprehensible that the low pay and understaffing causes DSPs to take on multiple jobs and work long and demanding hours, causing distress and burnout.  Women of color dominate this field and suffer the most from the inequities of a deteriorating system. 

Agencies are closing these vital programs and I/DD New Yorkers are being pushed further toward exclusion, isolation, and institutionalization, the antithesis of the promise of the Olmstead decision.  

I am unequivocally committed to fully funding the 3.2% COLA without restrictions, supporting care coordination organizations and further investing in DSPs with the passage of a Direct Support Wage Enhancement allocating $4,000 to each employee to supplement their hourly pay.  We must secure these important policies to protect and uplift DSPs, non-profit agencies and the beneficiaries of their vital service, New Yorkers with disabilities. 

Lawmakers ignored warnings about New York’s broken guardianship system for decades. Here’s how they can fix it.

From public funding for guardians to more scrutiny of nonprofit providers, experts say policymakers could take several actions to bolster the state’s foundering system for caring for its most vulnerable.

By Jake Pearson,ProPublicaMarch 23, 2024

Gift Article

Experts and observers have detailed what’s wrong with New York’s guardianship system, and offered a short list of potential solutions. But so far, legislative action has been subdued.

Will Waldron/Times Union

Three decades ago, New York’s guardianship system was in desperate need of an overhaul. Ad

Investigators had found that the legal arrangements, which were supposed to protect people who could not care for themselves, had actually deprived individuals of their rights and were poorly monitored, enabling guardians to abuse, neglect and defraud those under their care. In response, state lawmakers passed progressive legislation to codify wards’ civil liberties and safeguard their welfare.

But just five years into the new statute, known as Article 81 of the Mental Hygiene Law, the judges overseeing the system noticed it was insufficient to protect the “unbefriended,” those who have nobody else to help them and little or no money to their name. For them, the state relied on a patchwork system of loosely regulated nonprofits and private attorneys who take the cases pro bono. The setup, judges found, was straining to meet the crushing demand for services.

Charles Devlin, at the time a judge overseeing guardianship cases in Westchester County, traveled to the state Capitol to lobby for the members of this largely invisible constituency, who are often tucked away in nursing homes and other facilities, far from public view. Specifically, he advocated for the creation of a role of public guardian, a state-funded entity to care for New York’s most vulnerable.

The meetings didn’t go well. “New York state was not interested,” Devlin recalled in an interview. “They said, ‘Nope, sorry, goodbye.’”

In the years since, others have made similar trips, sounding alarms about New York’s overtaxed guardianship system, which now covers 28,600 people statewide — 60 percent of whom live in New York City. But state lawmakers have done little in response.

Today the system is in shambles, a ProPublica investigation published earlier this month found. There are not enough guardians to serve the needs of the “unbefriended,” nor are there enough overseers to check guardians’ work. And the quality of the care provided by the groups that do cater to this vulnerable population can be shockingly poor.

For example, the organization featured in the ProPublica report, New York Guardianship Services, placed one of its wards in a dilapidated, rat-infested Queens home for years, often without heat, taking $450 a month from her meager income as compensation while ignoring her complaints, according to interviews and internal records. She was one of about 400 wards who relied on the company to manage their financial and personal affairs. A company executive said he couldn’t answer questions about any specific ward, adding in a statement that NYGS is “accountable to the Court and our annual accounts and reports are scrutinized by Court appointed examiners and any issues would be addressed.” He also said ProPublica’s story was inaccurate but provided no details.

Experts say there are fixes policymakers can and should make to close the gap between Article 81’s promise and its practice. Here are six.

Public financing for guardians

As Arthur Diamond, then the supervising guardianship judge in Nassau County, bluntly put it to lawmakers in 2018: “It’s very, very sad that the state of New York has not been able to find a way to take care of this population.”

Following the roundtable where Diamond spoke, the state Legislature awarded Nassau and Suffolk counties $250,000 each to run pilot programs to find guardians for those without the means to pay for them. But the funding wasn’t renewed, and the state has not established a dedicated financing stream to cover the costs of guardianships for thousands of poor New Yorkers. Meanwhile, two of the organizations in the small nonprofit network that serves as the backbone of the system abruptly shuttered due to financial hardship.

Guardianship Access New York, a coalition of nonprofits that’s seeking to improve guardianships, has proposed that the Legislature secure $15 million “in sustained funding that would comprehensively support guardianship services statewide.” Advocates say those guardians don’t have to be lawyers, as traditionally has been the case, and should include social workers and other specialists familiar with the needs of the elderly and infirm.

Others have argued for the creation and funding of a separate public entity tasked with serving wards who have little or no money and nobody else to look after them. Some states, including Illinois and Delaware, have such an office, though experts warn they’re no panacea and without proper support and oversight can fail wards as easily as any other guardian can

Bolstering the regulatory ranks

Prior to a small bump in 2019, examiner pay hadn’t been increased in 14 years, resulting in thin ranks of reviewers to ensure proper oversight of guardians. Lawyers make just a few hundred dollars per case annually — a feeble payday that they say isn’t worth the effort.

A recent judicial guardianship task force report has recommended a pay raise for examiners so that the courts can recruit an adequate bench. Today New York City has only 157 examiners to monitor the care and finances of more than 17,000 wards.

Experts say the system needs more court clerks too. These workers play a key role in the oversight process, reviewing examiners’ reports before passing them up to judges, who ultimately sign off on the paperwork. But Diamond and others have said that deep budget cuts to the courts from more than a decade ago drastically reduced the ranks of these employees. More than 400 people — including clerks — were laid off following state budget cuts in 2011. This funding, they said, should be restored.

Finally, Diamond said, judges could be more proactive about monitoring case activity, scheduling regular compliance conferences so that guardians and examiners are forced to explain to the court what accounts for delays in completing their reports.

Strengthening the examination process

Though Article 81 requires guardians to file wards’ annual financial accounts by May of the following year, there is no such deadline for examiners. In practice, that means that accounts of wards can — and do — go years without any kind of examination. In the case featured in ProPublica’s investigation, the ward’s file was missing reviews for four whole years, during which time she faced horrendous living conditions and the threat of eviction. The examiner did not respond to questions about the missing reports for that period.

ProPublica also found that examiners tend to focus almost exclusively on financial paperwork when determining the care and condition of wards. They rarely, if ever, see wards in person.

Experts say that requiring face-to-face check-ins can prevent guardians from hiding horrific situations and that judicial leaders tasked with appointing and overseeing examiners should require such visits. That’s what happens in Davidson County, Tenn., which includes Nashville: Social services workers there visit wards, review their medical records and interview guardians and their doctors.

Mandating more training for guardians

Only 10 states nationwide require professional guardians to be certified by the Center for Guardianship Certification, the only national group of its kind. A handful of other states require guardians to be licensed by state agencies, in the same way as plumbers, barbers and other skilled professions.

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New York requires neither. Under Article 81, prospective guardians need only take a daylong course to get certified.

Advocates say the state should mandate more stringent training. Guardians should also be required to take regular refresher courses, just as lawyers are, experts say.

Vetting nonprofit providers

Once certified, private guardians are required to attest that they haven’t been found to have violated any criminal, civil or professional rules. Nonprofits, however, undergo no such vetting. In fact, they are not even required to provide proof of their charitable status.

That’s a critical gap in oversight given the outsized role nonprofit organizations currently play in caring for the unbefriended.

ProPublica’s investigation found that NYGS repeatedly represented itself as a nonprofit in its court filings and promotional material as it took on more and more cases. Yet authorities told us that the organization is not registered as a charity with the state attorney general’s office nor does it have tax-exempt status from the Internal Revenue Service.

Sam Blau, NYGS’ chief financial officer, declined to answer questions about the company’s tax status, but said in a statement that “a large percentage of our cases are done completely Pro Bono,” which “is certainly in line with our mission to help people of minimal financial means.”

Policing the nonprofit sector is critical, experts say, especially since charitable organizations are exempt from court rules that cap the number of cases and the amount of compensation guardians can receive annually.

Issuing guidance for proper staffing

One of the key indicators of a failing guardianship system involves caseloads that are higher than a 20:1 ratio of wards to staffers, according to a recent report by the country’s premier guardianship researchers. Some states, like Colorado and Virginia, recommend such a cap. But New York offers no guidance.

At New York Guardianship Services, the group ProPublica featured in its report this month, the ward-to-staff ratio has topped 83:1. One worker who was responsible for dozens of wards every day said she quit after six months because she couldn’t keep up with the unrelenting needs of the company’s clients. NYGS did not respond to questions about its caseloads.

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Caseload caps, experts say, would improve services and help states more easily identify potential guardianship abuse.

This article was reported by ProPublica, a nonprofit devoted to producing investigative journalism in the public interest. Visit www.propublica.org/newsletters to sign up to receive “The Big Story,” a newsletter devoted to its major stories. 

March 23, 2024

By Jake Pearson

Dear friends and colleagues,

I hope you’re finding this Developmental Disabilities Awareness Month to be a time of pride and excitement when you see people with developmental disabilities asserting who they are in OPWDD’s “I AM” campaign and hear from self-advocates in our Empowerment videos as they explain how they want to be seen and what advocacy means to them. It is a month of speaking out, and I hope that motivates you as it does me.

I am excited to announce that today, OPWDD and our service provider agency partners have launched a statewide Direct Support Professional recruitment campaign called #MoreThanWork. It is our sincere hope that this joint effort will provide a central, user-friendly hub for job seekers to find rewarding opportunities in our field and will help strengthen and grow the ranks of the direct support workforce that is so vital to our shared mission.

The campaign goals are to educate the public and, in particular, the job-seeking public, about the importance and fulfilling nature of direct support work and to connect potential job candidates to opportunities supporting New Yorkers with developmental disabilities across the state. The campaign will be highly visible throughout our communities with compelling, authentic tv and radio advertisements and on social and digital media. It will point interested job seekers to a central, non-governmental website www.directsupportcareers.com where they can connect directly to service providers to learn more about the career opportunities that are available near them. It will also create and make available to service providers effective recruitment resources that can enhance their ongoing recruitment activities. 

The campaign was developed with input from self-advocates, non-profit service providers, family members and members of diverse communities. Their guidance helped shape the overall look and feel of the campaign, and the ready participation of many of our developmental disability service providers has been a tremendous support. By working together, we can continue to do everything in our collective power to address the workforce challenges that are impacting the lives of people we seek to support and empower.  

I hope you will visit our campaign website and begin to see our #MoreThanWork ads in your own travels, online and in your community. I also hope you will follow the campaign on social media and share its posts and its important message. I invite any service providers who have not yet joined the campaign to do so by contacting OPWDD at Communications.Office@opwdd.ny.gov.  There is no cost to do so, and it’s not too late to make sure your agency is recruiting through this very visible and moving campaign.

I look forward to seeing the developmental disabilities field and the important work of our dedicated direct support professionals take on greater visibility as our #MoreThanWork campaign promotes awareness, appreciation and support for more caring professionals to join our workforce.

Sincerely,

Kerri E. Neifeld
Commissioner

The Justice Center congratulates Executive Director Denise Miranda on her nomination to serve as Commissioner of the New York State Division of Human Rights.  Her decades of experience and strong commitment to justice and equality will help New York continue its legacy of combatting discrimination and hate statewide.  Ms. Miranda begins her new role effective today.

The Justice Center’s Maria Lisi-Murray has been designated Acting Executive Director.  She previously served as the Justice Center’s Deputy Director of Audit, Control, and Quality Management.  Ms. Lisi-Murray is an admitted attorney with more than 20 years of private and public litigation experience in both state and federal courts, most recently as Assistant Attorney General in the Office of the New York Attorney General.  She also served as Chief Risk Officer at the Department of Motor Vehicles and began her career in the Binghamton Police Department.

As always, Ms. Lisi-Murray and the entire team at the Justice Center look forward to working with stakeholders at all levels to help individuals with special needs live their lives with dignity and respect. We welcome your continued partnership in this mission.

Commentary by Elizabeth Martin, Albany Times Union 3/7/2024

For decades, our society relegated people with disabilities to institutions, then looked away as abuse and neglect ran rampant. Those dark days were exemplified in the horrors at Willowbrook State School on Staten Island: overcrowding, filthy living conditions, physical and sexual abuse, and unethical medical experimentation. It took a Geraldo Rivera television exposé in 1972 — “Willowbrook: The Last Great Disgrace” — to force us to acknowledge the inhumanity that results when we devalue people with disabilities.

Multiple factors led to the conditions at Willowbrook and other institutions. Two of those factors were chronic underfunding and understaffing. While much progress has been made since those days, New York faces an impending human rights crisis for people with intellectual and developmental disabilities — and once again, underfunding and understaffing are to blame.

Direct-support professionals play an essential role for individuals with intellectual and developmental disabilities, enabling them to lead fulfilling lives. While direct-support professionals never got rich off their earnings, there was once a time when they earned closer to a living wage, and average staff vacancy rates were much lower than they are today. But wages endured years of stagnation, and without cost-of-living adjustments, the profession is on the brink.

Starting pay is now just barely above the minimum wage. Average turnover rates for nonprofit direct-support professionals in the Capital Region is just over 36%, and the average staff vacancy rate is alarmingly close to 20%.

The consequences of this workforce shortage are incredibly dire. Not only is it leading to program closures, it leaves individuals confined to isolation and impedes their access to medical care — hindering both their quality of care and their quality of life.

This chronic underfunding and understaffing not only devalues direct-support professionals’ labor, it devalues — by extension — the lives of those they serve.

Gov. Kathy Hochul’s initial efforts in 2022 to reverse years of cuts and disinvestment showed promise, with Medicaid rate adjustments and COVID relief bonuses for direct-support professionals. We were beginning to see some small improvements in staff turnover and retention rates. However, subsequent budget proposals have failed to keep pace with inflation or provide additional support for these valuable workers. Any small improvements we may have started to see appear to be regressing.

The continued funding inadequacy undermines the governor’s commitment to vulnerable New Yorkers. To safeguard the rights and dignity of individuals with disabilities, meaningful action is imperative.

A provider rate adjustment commensurate with last year’s inflation rate of 3.2%, coupled with funding for direct-support wage enhancement, will help us attract and retain qualified direct-support professionals. Gov. Hochul’s administration must honor our society’s collective duty and invest in the well-being of New York’s disabled community.

Elizabeth Martin is chief executive officer of Living Resources, an Albany nonprofit serving people with disabilities.