nysacra: political. fiscal, and policy environment in new york state manatt, phelps & phillips,...

NYSACRA: Political. Fiscal, and Policy Environment in New York State

Manatt, Phelps & Phillips, LLP

December 4, 2015

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NYSACRA| Manatt, Phelps & Phillips, LLP

Agenda

Overview of political, fiscal and policy environment in New York—and implications for NYSACRA members

Critical issues and opportunities facing NYSACRA and its members in New York

Discussion of priorities and strategies to affect their outcome

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Political Environment: Governor

Governor Andrew Cuomo entering second year of second term:

Despite some dip in popularity, still the dominant force in State politics and policy—particularly after Silver and Skelos departed

New team on the “second floor”: Bill Mulrow, Jim Malatras, Alfonso David

Paul Francis Deputy Secretary for Health & Human Services

Acting Commissioner Kerry Delaney at OPWDD

Health policy driven by Department of Health/Medicaid

Political dynamics: De Blasio, Clinton, and the 2016 Elections

Preet Bharara and corruption investigations/prosecutions

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Political Environment: State SenateNew leader of narrowly-controlled coalition-run State Senate:

Republican-led Coalition remains in control—and makeup not altered by special elections

Control of Senate hangs in balance in 2016—with outcome of ongoing trial of former Majority Leader Skelos a potential factor

Majority Leader John Flanagan (R-Long Island) about to commence first full legislative session

Changes in key roles in Senate: new Finance Chair, with the other dominoes to follow, and potential for new staff changes

Senators Hannon and Ort address Health/Mental Hygiene issues

Flanagan-Cuomo relationship

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Political Environment: State Assembly

New Speaker putting his mark on Democratic majority:

Speaker Carl Heastie entering his first full session

Former Speaker Sheldon Silver convicted of federal charges earlier this week

No significant leadership/chairmanship actions in 2015—more to come?

New dual counsels to the Speaker: Kathleen O'Keefe, Legislative Counsel and Howard Vargas, Executive Counsel

Heastie-Cuomo relationship

Assemblymembers Gottfried (Health) and Gunther (Mental Hygiene)

Heastie-Cuomo relationship

6Fiscal EnvironmentImproving budgetary prospects

Increased tax revenues coupled with lower than expected spending, puts NY in strong fiscal shape at midpoint of 2015-16.

State's general fund ended the first half of the year with a balance of $10.7 billion, up 33 percent from last year

Continued fiscal discipline will be tested in legislative election year

While “global Medicaid cap” has kept healthcare off the budget-cutting table, it has not extended to OPWDD services

Status of bank and other settlements—and potential uses of the funds that keep poring in—will be key focus in 2016

Major funding responsibilities include Tappan Zee Bridge and MTA funding agreement and upstate infrastructure funding


7Key Issues in 2016

Continued Education Reform Debate

Next Round of Economic Development

Progressive Agenda: GENDA, Criminal Justice Reforms, Contraceptive Coverage, other labor issues

Heroin/Opioid Epidemic

Public Ethics/Campaign Finance Reform

Health Republic Fallout

All likely to be overshadowed by political positioning for the 2016 elections


8Key Issues for NYSACRAMinimum Wage

Credentialing of DSPs

OPWDD Transformation Agenda, including fiscal sustainability, strengthening the provider infrastructure, access to residential services, employment reforms

Delivery System Reform Incentive Program/Value-Based Payment reform

Continued implementation of Medicaid Redesign

Justice Center reforms

Budgetary support: Funding in NYS Budget outside of Medicaid cap


92014 Flashback

“Front Door” Overhaul: S.6641-C (Carlucci)/A8846 C (Weisenberg): Vetoed, 11/21/14

DISCOs and OPWDD NFP Service Providers: S.7400-B (Carlucci)/A.9766-A (Gunther): Vetoed, 11/21/14Task Force on Adults with Developmental Disabilities: S.6659-A (Carlucci)/A.8835-A (Gunther): Vetoed, 11/21/14People First Act of 2014 – S.1109-D (Maziarz)/A.8452 (Gunther): Vetoed, 11/21/14


102015 Budget Residential services: Required OPWDD to issue a report by

2/15/16 of a statewide review of individuals with developmental disabilities currently on the residential waiting list

Employment : Required plan by 2/15/16 to assist individuals transition to integrated work settings that will “provide choice of work settings for individuals with DD”

Transformation panel: Directed transformation panel by 2/15/16 to recommend strategies to maintain fiscal viability of services, to promote access to self-directed models of care and to integrated housing and employment opportunities, and to review program design and fiscal model for managed care

Front Door: Required OPWDD by 2/15/16 to report on the front door policy and its success in connecting individual needs to available services


11Strategic positioning of NYSACRAContinued and broadened engagement with key state

policymakers on OPWDD Transformation

Continued leadership on workforce issues, including credentialing, quality and minimum wage implications

Continued analysis and advocacy relating to DSRIP/Value-Based Payment for OPWDD providers

Strengthen relationship with Medicaid/DOH, while continuing to work closely with OPWDD

Maintaining a client-focused advocacy posture, strengthened by testimony at Transformation Forums/Assembly hearing

Continue strong strategic alliance with other organizations in field, while maintaining a distinct NYSACRA voice


12Discussion and Questions


nysacra: political. fiscal, and policy environment in new york state manatt, phelps & phillips,...

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