January 2023
Dear Governor Hochul,
Happy New Year! We welcome in the New Year with renewed hope for people with Intellectual and Developmental Disabilities (I/DD) and their families. Our independent family and self-advocacy organizations continue to oppose Managed Care support services for people with I/DD, and are against extending NYS legislative authorization to continue further exploration when it expires this year. The effort to pursue Managed Care for I/DD support services has already been extended for more than a decade. We believe that too much time and money has already been wasted. Extending the authorization will only result in delaying any effort to implement other needed changes to the service system.
In November of 2022, OPWDD awarded a $1.44 million consulting contract “to study and evaluate how the implementation of managed care would assist in improving Long Term Services and Supports (LTSS) for people with I/DD.” Previous studies to determine the effects of Managed Care for I/DD services show no evidence of cost benefit, improved access to services or quality of care in states that have attempted to transition.
- A 2019 study funded by the Texas Legislature concluded: “While there are savings achieved on Long Term Services and Support claims, the amount of increased administrative expenditures outweighs savings from claims” (www.tinyurl.com/TX-IDD-Deloitte-Report )
- The Medicaid and Chip Payment and Access Commission, a non-partisan group of experts concluded in 2021: “While much research has been conducted on whether Managed Care delivery systems result in better outcomes than fee for service (FFS), there is no definitive conclusion as to whether managed care improves or worsens access to or quality of care for beneficiaries www.macpac.gov/subtopic/managed-cares-effect-on-outcomes )
Even more disconcerting is a NYS funded study by Deloitte that estimates the cost for initial implementation of Managed Care for I/DD services would be $200 million and would result in a similar increase in annual administrative costs.
The money spent on studying managed care over the last decade might have been put to better use serving the needs of people with I/DD and the workforce supporting them. Given the urgency of stabilizing and improving the workforce, increasing residential options, improving access and diversity as laid out in OPWDD’s Strategic Plan, this continued distraction over managed care comes with the even greater cost of failing to take needed action to implement these goals. Please let the authorization to explore Managed Care expire so that stakeholders can immediately get to work accelerating changes that have a meaningful and positive impact on people’s lives.
Respectfully submitted on behalf of Families and Self-Advocates Representing People with Intellectual and Developmental Disabilities across New York State
CC: Dr. James V. McDonald, Acting Commissioner Department of Health
Kerri Neifeld, Office for People With Developmental Disabilities
Jihoon Kim, Deputy Secretary for Human Services and Mental Hygiene
Kim Hill, Chief Disability Officer
Kathryn Garcia, Director of State Operations
Sandra L. Beattie, Division of Budget
Senate and Assembly Disability Committee Chairs
Senate Majority Leader
Assembly Speaker
Senate and Assembly Legislators
ENYDDA 