CDR Responds to the SFY2024-25 Final Budget

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CDR's Logo that reads "civil rights, integration, independence."

Governor Hochul has signed the SFY24-25 Final Budget, the details of which will directly impact the lives of all New Yorkers, both Disabled and otherwise. Having a thorough breakdown of its implications is a matter of equity and fairness; all New Yorkers deserve to be made aware of and educated on the policies that will directly implicate us and our rights. To that end, the Center for Disability Rights reviews and responds to the State Budget annually. We do this with the aim of providing Disabled New Yorkers a better understanding of how the upcoming changes to fiscal planning impact our rights, lives, and freedom.

The Final Budget contains several proposals and provisions that clearly signal that we Disabled New Yorkers are a priority for this fiscal year, and we here at CDR appreciate these efforts to make life for Disabled individuals more free, fair, and equitable. We are happy to see increased efforts to address New Yorkers’ mental health, funding for postsecondary special education, and increased resources for Disabled New Yorkers within the justice system. We are also greatly pleased to see Governor Hochul committing to the development of an Olmstead Plan; the funding for the development of this will help ensure that Disabled New Yorkers are able to receive services in the most integrated settings possible.

Simultaneously, we are very disappointed that the Governor has not committed more to supporting the Disabled Community, and we believe more can be done to protect and preserve the rights of all Disabled New Yorkers. This Budget includes ADL eligibility changes as part of MRT-II, extends the global Medicaid cap, and commits to a significant 10% Medicaid rate increase for institutions like hospitals and nursing homes, signaling an ableist and concerning focus on institutional placement over home-based services. Likewise, while we are happy to see the Governor and Legislature making efforts towards increasing rates of employment among the Disability Community, we are deeply worried about the Budget’s silence on the state’s structurally ableist and racist subminimum wage policy. While we are glad to see the steps that the Governor has taken to protect the Disability Community in some policy areas, these sorts of exclusions are noteworthy and will undermine the ultimate goal of disability equity.

We are relieved to see certain protections carved out for ILCs and consider this a major win on the part of our activists who went down to Albany to advocate for these crucial organizations and programs. The protests organized by CDR and others in the New York Disability Community have directly ensured a future for ILCs in the Consumer Directed Personal Assistance Program (CDPAP) where one otherwise would not exist; this is extremely noteworthy and deserving of acknowledgement and thanks. However, we are still concerned about elements of the budget’s language around the implementation of a singular fiscal intermediary, and intend to continue fighting to protect this program for all Disabled New Yorkers. Our direct action in Albany over recent weeks has helped to minimize the overall impact to consumers during this process, and we are honored to have been able to protect the broader Disability Community. With that said, we still call upon the Governor to further fund and support Independent Living Centers as the non-profit, disability-led organizations that are able to best speak to the needs of our own community.

What We’ve Won With This Budget

The Budget contains multiple victories for the New York Disability Community, and we are happy to see indications that Governor Hochul is acknowledging and respecting the needs of her Disabled constituents. One of the most notable inclusions in the budget is the commitment of $250,000 towards the creation of the state’s Olmstead Plan in 2024. An Olmstead Plan for New York will be essential in ensuring that Disabled New Yorkers have the right to receive care within their communities in accordance with the Olmstead Decision of 1999, rather than being forced into institutions and nursing homes. We here at CDR look forward to working with the Chief Development Officer and the Olmstead Director on the State’s Olmstead Plan with this additional funding; this represents a step forward in the fight for integrated and equal life within our communities as disabled people.

We are similarly excited to see several changes to medical debt protections taking place over several months that will greatly improve the lives of countless Disabled New Yorkers. Effective in six months, Hospital Financial Assistance (HFA) will apply to all general hospitals, not just those receiving certain assistance. Additionally, a new HFA sliding scale will make care more affordable and accessible, particularly to low-income families and individuals; there will be no asset test for HFA, HFA payment plans will not be able to be more than 5% of a patient’s gross family income, and the interest rate will be cut to 2%. This will make affordable healthcare a far more plausible reality for many New Yorkers, who otherwise would not qualify for adjusted healthcare costs. No lawsuits will be allowed against patients with incomes under 400% of the federal poverty limit, and no lawsuit or debt collection activity will be permitted for the first 180 days after the first post-service bill is issued; this, again, makes it easier for low-income individuals to seek out healthcare without fearing losing their life savings. Additionally, consent to pay for health care must not be given before the patient receives such services and discusses the treatment costs, giving patients more room to self-advocate in their care. We here at CDR greatly support these measures to ensure that all New Yorkers, particularly the Disabled Community, are not financially penalized for seeking access to healthcare.

The Budget also contains funding for several new mental health programs and criminal justice initiatives that could prove very beneficial to the Disability Community, and we at CDR are looking forward to their implementation. The Budget contains up to $1.5 million in funding for a Daniel’s Law pilot program that will take place here in Rochester, NY, as well as $2.8 million for Intensive and Sustained Engagement Team programs. Both of these programs will work to keep New Yorkers in crisis out of the criminal justice system and out of penal institutions, instead opting for mental health-informed and community-driven solutions over criminal ones. These programs may very well be life-changing for the individuals to whom they apply, who may otherwise be subjected to coercive Kendra’s Law Outpatient Commitment orders. Similarly, another $8.2 million was allocated in the final budget to provide court-based mental health navigators for Disabled individuals currently being subjected to the criminal court system, as well as another $33 million to improve engagement with those in the criminal justice system with mental health disabilities. We are optimistic about these various programs and anticipate that they will be a massive asset in protecting Disabled New Yorkers from an unjust justice system that all too frequently discriminates against and incarcerates the disabled for our disabilities.

Finally, this Budget contains several major wins for the Disability Community in the areas of housing, education, and community services. Access to Home, a program that provides funding to low- and middle-income for accessibility improvements at home, is now funded at $4 million, an increase of $1 million. With this additional funding, more Disabled New Yorkers will be able to afford the otherwise costly adjustments needed to make their homes livable, keeping more Disabled New Yorkers at home and out of institutions. The Governor has also committed an additional $2 million in funding for postsecondary students with disabilities, ensuring the New York Disability Community will have greater access to higher education. This is a victory that will have a long-term, beneficial domino effect for disability rights. As more Disabled individuals are able to access higher education, we will be increasingly able to access fields from which we have been systemically barred: medicine, law, education, government, and more. As more Disabled individuals gain access to these professions, we will be better able to implement policy changes that will improve the lives of the broader Disability Community. Some of these future policy changes may look like some of the additions we have seen made to community services in this year’s Budget; the 2024-25 Budget includes $119.5 million for a variety of community services. These include home and community-based services waiver slots, supported housing, mental health urgent care walk-in centers, mobile engagement teams, first episode psychosis teams, family resource centers, evidence-based family support services, peer-operated recovery centers, suicide prevention services, community forensic and diversion services, telepsychiatry, transportation services, and family concierge services. We are encouraged by this funding and this focus on community-based services, and hope to see this pattern continue. We particularly are hopeful for what this funding will mean for preventing suicide, as suicide prevention is key in promoting disability justice and civil rights. To this end, we will continue to fight against legislation legalizing assisted suicide, which would effectively eliminate suicide prevention for the terminally ill and disabled.

We anticipate that all of these changes will significantly improve the lives of all Disabled New Yorkers and are happy to have the Governor’s support on these matters. This additional funding will go a long way toward promoting the freedom, independence, and rights of the New York Disability Community, and we here at CDR look forward to the work we will be able to engage in for our rights as disabled individuals with these new resources made available.

What We’re Still Fighting For

However, not all of the changes made within the 2024-2025 Budget were strictly positive. We have several concerns with some of the programs that either did not see funding increases, had their funding reduced, or were otherwise adjusted in ways that may prove harmful for Disabled New Yorkers. While overall we are proud of the victories we have secured during this budget session, we believe that these areas could prove problematic towards the ultimate goal of disability equality, and we look forward to working with our elected officials towards finding better solutions for all New Yorkers.

We at CDR are greatly concerned by the inclusion of ADL eligibility changes passed as part of MRT-II, as well as other aspects of the Budget that would impact the eligibility of Disabled New Yorkers applying for assistance. The implementation of this will directly harm Disabled New Yorkers seeking assistance with daily living. These changes will result in institutionalization, hospitalization, injury, and even potential death for many New Yorkers who are otherwise unable to live within the community. We believe these changes violate the terms of the Community First Choice Option, are blatantly discriminatory, are dangerous for Disabled individuals, and are absolutely unacceptable. While we understand that this is a difficult fiscal year and COVID funding is running out, the solution does not lie in cutting programs that enabled countless New Yorkers to access daily living assistance and remain in the community. We call on Governor Hochul and the Legislature to take further action to protect Disabled New Yorkers who will be impacted by these changes.

New York State is also committing to a 10% Medicaid rate increase for institutions like hospitals and nursing homes. This is expected to translate into a combined $825 million in Medicaid payment increases to hospitals, nursing homes, and assisted living facilities. This is concerning and disappointing, given the comparative demand and lack of investment in community-based services over institutions. We at CDR would much rather see a system that funds home-based and community-based services over institutions. This signals a step in the wrong direction from a funding perspective.

Other worrying elements of this budget include the omission of various proposals and plans that would have prevented particular forms of disability discrimination at the systemic level. The 2024-25 Budget omits a plan to guarantee marriage equality for Disabled New Yorkers. While CDR supports the Budget’s proposal to authorize the pass-through of any Federal SSI Cost of Living Adjustment, which will help in this matter, we are also aware that this will not be enough on its own to ensure Disabled New Yorkers have full marriage equality on par with our non-disabled peers. We call upon the Governor and Legislature to work with the Disability Community to develop a five-year plan to eliminate the SSI marriage disincentive in our state and guarantee marriage equality for all New Yorkers. We are also extremely disappointed that the final budget did not contain several proposals that would have protected vulnerable populations from abuse and neglect, including the creation of an Interagency Council of Elder Justice, and plan to push for these proposals to be included in future legislation. Finally, while we are happy to see Governor Hochul taking steps towards increasing rates of employment within the disabled community, we are outraged that this is accompanied by silence on the issue of subminimum wages. The Budget says nothing about this structurally ableist and racist state policy that allows disabled workers to be paid less than minimum wage, while pushing for our increased hiring; this is a clear example of exploitation, both of the working class and of the disabled community. We call on Governor Hochul and the Legislature to immediately end this ableist double standard and ensure that disabled workers are compensated fairly and equally to our non-disabled peers.

How Our Protests Protected ILCs & Consumer-Directed Care Options

This Budget contains both clear victories and setbacks for the New York Disability Community. While that is exemplified throughout the entire budget, the issue of Independent Living Centers and the Consumer Directed Personal Assistance Program demonstrates this best. The state budget has added $750,000 to the current ILC funding of $16 million, and while this is a positive development, we believe more could have been done, especially in light of the CDPAP changes and the diverse range of services ILCs provide to ensure people with disabilities can live independently in the community.

Similarly, while this budget will preserve CDPAP and no longer includes the originally proposed Designated Representative changes or wage parity cuts, CDR is still extremely unhappy with the final proposal that replaced the more damaging original. The currently proposed changes to CDPAP will require a statewide fiscal intermediary to contract with subcontractors, specifically including the eleven Independent Living Centers currently providing FI services and at least one other entity “per rate setting region.” We are relieved that ILCs have been preserved in this system as full fiscal intermediaries; however, this is only a partial solution. We are gravely concerned that the statewide fiscal intermediary settled on in the Budget’s outlined ‘mini bid’ process will not operate with consumers’ best interests and personhood in mind. We at CDR are concerned about the disruption in care it may cause, and we intend to continue fighting in every way we can to protect and preserve this critical program on behalf of all Disabled New Yorkers.

Final Takeaways: The Fight Isn’t Over

The Center for Disability Rights is encouraged by the victories we’ve won with this budget, and particularly by the victories that we were able to guarantee through our direct action and the hard work of the collective Disabled Community. The changes to this year’s Fiscal Budget, the various new pilot programs being introduced, and the protections we were able to secure for existing organizations and programs will be essential in improving the lives of all Disabled New Yorkers. With that said, we are disappointed that the Governor has fallen short in the areas that she has; we would have liked to have seen more funding for major pre-existing disability resources and programs, more cost of living adjustments to account for inflation, and more protections for vulnerable populations, all of which would contribute to the rights and freedom of the New York Disability Community. We are also aware that the fight to specifically protect Independent Living Centers and the Consumer Directed Personal Assistance Program is far from over; this is a program that has come under threat time and time again, and this will not be the last time we will arrive in Albany to protect it. We here at CDR are prepared to continue our fight for the rights of all Disabled New Yorkers to live freely, independently, and in community with our loved ones. We call on Governor Hochul, as before and as always, to join us and take a stand in the fight for disability rights. We appreciate the support shown by the Governor and other elected officials so far and encourage further, more vocal, more active engagement with your disabled constituents as we move into the coming year.

Finally, we once again want to take a moment to thank our activists who demonstrated in Albany during the course of these budget negotiations; your commitment to the Disability Community and your brave action in the Capitol both made history and directly influenced the outcome of this year’s Budget. As both an organization and as a collective of disabled individuals, many of whom rely on the program you physically defended with your protests; you have changed countless lives, ours here at CDR included.