Earlier this week, the New York Senate and Assembly each provided their response to Governor Kathy Hochul’s Executive Budget proposal. The Senate and Assembly’s responses set the stage for final budget negotiations between the three parties. CDR had previously analyzed the Governor’s budget proposal, which focused heavily on increased funding for institutions such as hospitals and nursing homes, at the expense of community-based alternatives. Our full analysis of the Governor’s budget proposal can be found here. Because of several factors related to both the Constitutional powers of the Governor and politics, the Legislative houses are somewhat confined in their response to the budget; however, as always there are many substantial differences and we note that while an institutional preference is still clear, both houses of the Legislature take steps to actively recognize the importance of investments in community-based supports and services.

In this report, we analyze each houses legislation in relation to the Governor’s original proposal.

Appropriations – Aid to Localities

Independent Living Center funding

CDR and the ILC network have once again asked for a $9 million increase in ILC funding from $16 million to $25 million in annual funding. The Governor had cut last year’s funding for ILCs from $16.75 million to $16 million.

Assembly – The Assembly not only restored the Governor’s $750,000 cut, but they also added another $750,000 in funding for a total allocation of $17.5 million.

Senate – The Senate restored the Governor’s proposed $750,000 cut, matching last year’s total ILC funding appropriation of $16.75 million.

CDR appreciates the Senate’s restoration of the Governor’s cuts; however, we call on all parties to accept the Assembly’s effort to increase overall funding for the ILC network for a second year in a row after over a decade of neglect. While this is not a solution to the funding shortfall faced by the network, this incremental approach does alleviate some financial pressures limiting centers’ effectiveness.

Assistive Technology Innovation Center

Not included in CDR’s initial budget analysis, Governor Hochul had proposed $5 million in funding for a new Assistive Technology Innovation Center to be housed at SUNY Albany. With corporate partners including Google, Apple, and Microsoft among others, the Center is supposed to work with the disability community to develop new forms of Assistive Technology that aid Disabled New Yorkers in participating in the workforce, and by extension, the community at large.

Assembly – The Assembly accepted the Governor’s proposal with no changes.

Senate – The Senate accepted the Governor’s proposal with no changes.

CDR supports this proposal, acknowledging the potential it has to develop technology to further the lives and independence of Disabled people. For this project to succeed, it must have continued support and be driven by Disabled people, not merely engineers and academics who think they know what is best for the community.

Fashion Innovation Center

Not included in CDR’s original budget analysis, Governor Hochul proposed spending $60,000 in seed funding for a Fashion Innovation Center intended to develop clothing options intended to fit Disabled people more naturally.

Assembly – The Assembly accepted the Governor’s proposal with no changes.

Senate – The Senate accepted the Governor’s proposal with no changes.

CDR is supportive of this proposal while also calling on all parties to recognize that this, and proposals like it, cannot replace or substitute for substantive investments in Disability that are necessary for Disabled people to live independently in their communities.

Appropriations – Capital

Access to Home

Governor Hochul cut funding for Access to Home from the $5 million allocation in last year’s budget to $1 million. CDR and the ILC network were calling for a doubling of last year’s funding to $10 million to address need.

Assembly – The Assembly restored Governor Hochul’s cuts to Access to Home funding, restoring the allocation to $5 million.

Senate – The Senate restored Governor Hochul’s cuts to Access to Home funding, restoring the allocation to $5 million.

CDR supports the Senate and Assembly’s proposal that at least restores funding to previous years’ levels.

Article VII – Education, Labor, Family Assistance (ELFA)

Supplemental Security COLA pass-through

The Governor proposed language that would allow for any cost-of-living adjustments for those receiving supplemental security payments to be passed through to recipients. This is standard language that is enacted annually.

Assembly – The Assembly accepted this proposal.

Senate – The Senate accepted this proposal.

New Senate Proposal – Establishment of a Fiscal Cliff Task Force

The Senate proposed the creation of a Fiscal Cliff Task Force that would examine the fiscal cliff within different public benefit programs to determine what is impacting fiscal cliffs and what steps can be taken to mitigate the impact of these cliffs or eliminate them altogether.

CDR is supportive of this proposal as Disabled people are too often forced to decline work opportunities, forego raises or promotions, and even remain unmarried due to the need to remain eligible for public benefits programs that allow them the freedom and independence to engage in the very activities they are forced to limit. This is a critical opportunity that has been previously vetoed as stand-alone legislation, as the Governor indicated it must pass in the budget. We therefore call on all parties to support the Senate’s proposal and enact this critical first step.

Article VII – Health and Mental Hygiene

Medicaid Global Cap

The Governor proposed to renew the Medicaid Global Cap, which artificially caps the growth of Medicaid spending based on a 10-year average of defined expenses, for a two-year period. This has been done every year since its enactment in 2011.

Assembly – The Assembly accepts the Governor’s proposal.

Senate – The Senate rejects the Governor’s proposed extension and instead repeals the Medicaid Global Cap.

CDR strongly supports the Senate’s proposal to eliminate the Medicaid Global Cap, noting that artificial spending limits do not account for actual need in the Medicaid program, which disproportionately harms the disability community.

Enhancing Quality of Adult Living (EQUAL) and enriched housing subsidy program

The Governor proposed eliminating funding for the EQUAL program and the enriched housing subsidy program, which provide small grants to individuals in adult homes and enriched housing facilities. Unlike many other programs, these grants must be decided on and approved by residents – meaning they directly benefit those forced into the institutions and not the owners.

Assembly – The Assembly rejected the Governor’s proposed cuts to these programs.

Senate – The Senate rejected the Governor’s proposed cuts to these programs.

CDR supports the Assembly and Senate’s restoration of these funds. While we aim for a society where nobody is forced into institutions, programs such as these are critical to enhancing the quality of life for those who currently are in some of the most notorious institutions that exist.

Hospital at Home Program

The Governor proposed to allow hospitals to provide acute healthcare to individuals on an ongoing basis in the home. While the legislation forbids hospitals from providing home care services, they are allowed to provide any services that they would be able to provide in the hospital. This exception makes the prohibition on delivering home care services meaningless, as hospital services include most, if not all, home care services.

Assembly – The Assembly rejected the Governor’s proposal.

Senate – The Senate accepted the Governor’s proposal.

CDR supports the Assembly’s rejection of this measure as it will destabilize the community-based long-term care system, which disabled people rely on to live independently in the community.

Nursing Home Capital Funding

The Governor had proposed restoring a previous 10% cut to nursing home capital rate funding.

Assembly – The Assembly increases the total funding increase for nursing homes from the Governor’s proposed 10% to 15%.

Senate – The Senate increases the total funding increase for nursing homes from the Governor’s proposed 10% to 15%.

CDR opposes the Governor’s original investment and strongly opposes the Assembly and Senate’s action to further increase the rate increase for nursing facilities. We call for those funds to be invested in home and community-based services and other supports and services that allow people to remain free from institutions and in their communities with friends and family.

Medicaid Buy-In for Working People with Disabilities

The Governor proposed instituting a 3% premium for the Medicaid Buy-In for Working People with Disabilities (MBI-PWD) for people with incomes over 150% of the Federal Poverty Level (FPL). This is not for the MBI-PWD expansion that was passed three years ago and the Governor says it is needed to comply with premiums in the state plan amendment.

Assembly – The Assembly rejected this proposal.

Senate – The Senate accepted the Governor’s proposal.

CDR supports the Assembly’s rejection of this proposal. MBI-PWD premium contributions were clear in the enacting legislation. Any differences with the state plan should not have occurred without prior approval from the Legislature, and if the Legislature allows this change to advance, it provides tacit authorization for the Executive to rewrite laws after the fact via the state plan approval process without the Legislature playing its Constitutional role.

Long Term Care Services in the Essential Plan

The Governor proposed to eliminate long-term care services from the Essential Plan’s benefit package. These services were included in 2022; but Federal approval was never obtained.

Assembly – The Assembly accepted the Governor’s proposal to remove long-term care benefits from the Essential Plan.

Senate – The Senate included a provision to accept the Governor’s proposed elimination of long-term care benefits from the Essential Plan until the original 2022 law enacting this change expires. Upon expiration of the benefit package that excludes long-term care, the current benefit package including long-term care benefits would automatically take its place.

CDR supports the Senate’s proposal to ensure the safety of the Essential Plan in the current environment while allowing the long-term care benefit package to resurface at a future date, when a different Federal government may be willing to approve it.

Allow Certified Nurse Aides (CNAs) to administer medications in a nursing facility

Governor Hochul proposes allowing CNAs to receive an extra credential that would allow them to administer some medications within a nursing facility.

Assembly – The Assembly rejected the Governor’s proposal.

Senate – The Senate rejected the Governor’s proposal.

CDR strongly supports the Assembly and Senate’s rejection of this proposal that would place disabled people in nursing homes in even greater jeopardy than they are in today.

Targeted Inflationary Increases for Human Service Providers

Governor Hochul proposed a 1.7% increase in contracts for human services providers not in the Medicaid system as a cost-of-living adjustment for non-executive workers. The funding must be spent on wages for non-executive direct care or service staff. Independent Living Centers, because they are funded through the State Education Department, are not included.

Assembly – The Assembly increases the Governor’s 1.7% targeted inflationary increase to 4%. The additional funds are meant to support fringe expenses as well as support staff and non-direct services staff that are in a non-executive position. The funding does not include Independent Living Centers.

Senate – The Senate increases the Governor’s 1.7% targeted inflationary increase to 4% and expands the pool of eligible agencies to include entities not included in the Governor’s proposal, including Independent Living Centers. The proposal would allow for 1.7% mandated to direct services staff, with the remaining funds to be spent on support staff, non-executive administrative staff, and others.

CDR strongly supports the Senate’s expansion of the targeted inflationary increase that includes independent living centers (ILCs). ILCs have been left out of these adjustments for too long merely because they are funded through the State Education Department, which Executives historically do not wish to fund because it is an independent state agency that operates pursuant to the Board of Regents, not the Governor.

New Senate Proposal – Permanently Carve NHTD out of managed care

The Senate includes a proposal that would permanently carve the Nursing Home Transition and Diversion waiver out of the managed long-term care program.

CDR strongly supports this proposal as managed long term care has proven a failed experiment that only diverts necessary funds from care.

Not Included – CDPAP Transparency and Accountability Act

CDR strongly supports legislation that would require a statewide fiscal intermediary to report data regarding utilization, the workforce and workforce payroll, outreach, facilitation, and financial health to the Department of Health for publication on the Department’s website. This exclusion of this common-sense reporting measure protecting CDPAP consumer safety, protecting workers, and ensuring the disclosure of information all other providers in Medicaid routinely provide is deeply troubling. We encourage the Assembly, Senate, and Governor to revisit this in the budget process.

Not Included – CDPAP Facilitator Protection,

CDR strongly supports language that would protect consumers using CDPAP by clarifying and strengthening provisions surrounding the facilitation of CDPAP services, a service that is critical for tens of thousands of consumers who benefit from increased supports that a facilitator can offer them and the failure of all parties to include this legislation in their budget proposals threatens to continue to erode participation in the program, leading to greater use of higher cost services such as traditional personal care agencies and nursing facilities.

Not Included – Elimination of Medicaid Eligibility Cuts to Home Care

CDR strongly supports legislation to repeal cuts to Medicaid eligibility for home care services that require a minimum number of activities of daily living in order to qualify for home care benefits. The cut is short-sighted and prevents savings realized through early use of home care benefits resulting that maintains an individual at a lower level of need. We also continue to note that the law, as structured, violates the Federal Community First Choice Act’s provisions that prevent discrimination based on type of disability, placing the billions of dollars in increased Federal matching funds that have been received through use of CFCO’s higher Federal match in jeopardy. CDR is troubled by the failure to restore this devastating and discriminating cut.

Article VII – Revenue

Expanding Rent Increase exemptions for senior citizens and persons with disabilities

The Governor’s budget extended the Senior Citizen Rent Increase Exemption (SCRIE) and Disability Rent Increase Exemption (DRIE) for two years and increased the income eligibility for both programs from $50,000 to $75,000. CDR had noted that while these programs do not currently apply outside of New York City and surrounding counties with rent control regulations, recent changes in state law that allows municipalities to impose similar controls could extend the applicability of these protections to more cities in the future.

Assembly – The Assembly rejected the Governor’s proposal in its entirety.

Senate – The Senate changed the expansion of income levels from the Governor’s proposal to adjust levels based on the cost of inflation, with a formula that extends to the entire state instead of only New York City. Applicability outside of certain counties would still be applicable only if those counties or cities within such counties voted to have the measures, or other rent-control measures, apply.

CDR recognizes that dramatic increases in rent have a disproportionate impact on Disabled New Yorkers who face much more difficulty in finding units that are accessible and affordable. Any provisions that make it easier for Disabled New Yorkers to afford rent, including higher subsidies, is welcome. CDR appreciates the Governor for extending and increasing the subsidy, but encourages the adoption of the Senate’s proposal that would codify a formula for future increases and automatically extend the program and increases to all applicable counties in the state. We are disappointed by the Assembly’s lack of any action on this critical affordability issue.

Taxing the Rich

While not an issue CDR has taken a position on, this issue is emerging as one that will dominate budget conversations. As such, many funding proposals in both the Assembly and Senate budgets, both of whom have proposals in this vein, may be reliant on some form of new tax revenue. Therefore, we mention it here.

Assembly – The Assembly proposes a tax cut for those earning less than $323,200 annually; a 2 percentage point tax increase for businesses with at least $10 million in annual revenue; a “mansion tax” that would increase the tax on home sales in excess of $5 million by 1.4 percentage points; and a 0.2% increase on personal income taxes for those earning more than $5 million and less than $10 million, with an additional bracket taxed at a higher level for those earning in excess of $10 million.

Senate–The Senate proposes a 1.75-point increase on businesses with at least $5 million in annual revenue; a 0.5 percentage point increase on incomes over $5 million; a “mansion tax” that would increase the tax on homes sales in excess of $5 million by 1.4 percentage points; and would end the sales tax exemption on gold bars and other precious metals.

CDR does not have a position on these measures; however, we reject the zero-sum financial policies that would force Disabled people to choose between critical health services, education services, housing services, transportation services, and more because of limited funds. In recognizing that cuts to any of these programs most often target the very programs that are most important to Disabled individuals, we call for the adoption of any measure that rejects this siloed approach to budgeting and furthers investment in disability services and supports across the New York budget.

Article VII – Transportation and Economic Development (TED)

Autonomous Vehicles

The Governor had proposed a demonstration program for the use of autonomous vehicles outside of New York City. CDR had recognized the potential value of this proposal to Disabled people if these vehicles were accessible.

The Governor eliminated this proposal from her budget in her 30-day amendments. Neither the Senate or Assembly included it in theirs.