State Budget Implementation

June 13, 2022

As you might expect, I have been pestering OMH and OASAS for concrete updated information on the status of various state budget provisions.  

Below and attached please find an update from OMH re: mechanics on some rate changes, including documents with updated fees and links to rates being processed, and some basic insight on status of each.  Note: There are three primary mechanisms which govern resources flow for the 5.4% COLA and residential increases.  This information, while not comprehensive, is a good place to start if you are looking for a status update.  Please let me know if this information is helpful?  

  1. Direct Contracts – OMH issued direct contracts for the NYC cycle which already assumed COLA being available post budget passage.    OMH is in the process of issuing all existing contracts for both the 5.4% COLA and the Residential Investments (e.g., SH, SRO and CR GIN model increases).   We expect all contracts will be fully issued on or before the end of the quarter with the April 1, 2022 effective date for all investments.  Accordingly, providers should have a clear picture of the enhancements on these instruments to start programming resources with no risk.  The State has moved all our contracts to multi-year instruments AND electronic execution which speeds up the flow of funds.  We would stress to providers to prioritize the return of all contract documents to ensure the State can process cash payments behind all these amendments. 

Attached are copies of the SH stipend chart and SRO stipend chart.  Note, while GINs are provider specific based on mix of beds, we will be moving toward separating these in future cycles so we can share quicker factual updates to the models.   Also attached is an exempt income letter we issued to CR providers making it clear OMH’s intent not to collect prior year exempt income which will help to make instant resources available for programming. 

  1. State Aid Letters (SAL) – Funds are used to support LGU administered contracts.  OMH already updated all April State Aid Letters for the COLA and residential investments and we are actively engaged with counties to ensure timely flow of funds.    Similar to the State process, LGUs will be reissuing the contracts and focused on execution and getting payments moving.
  2. Medicaid  – NYS already issued public notice for implementing the COLA, and is submitting State Plan Amendments required for CMS approval AND rate packages for DOH and DOB approval. This process typically takes 3-6 months depending on how quickly CMS turns these submissions around.  We would expect more timely action given these are technical COLA adjustments with authorizing statute.   Below is a link on adjustments to all Medicaid rates reflecting the latest rates in motion.  NYS has already notified MC plans of the rate updates and will require retroactive implementation to the April 1, 2022 effective date.

On this webpage is also a link to the Federal investments which supported rate increases that started in the current year with breakouts to the components that are either permanent vs. one-time Workforce R&R funds.  All the original eFMAP increases submitted for October effective dates were already approved and paid out retroactive so initial funds flowed for ACT, PROS, CRs but further increases are coming with the COLA and residential investments.   The Clinic rates are still pending CMS approval as well as DOH and DOB rate sign-off.  We expect action on this in the coming weeks. The chart below re Fed investments is on the website.   The COLA is not reflected in these numbers so the additional 5.4% is applied on a compounded basis on top of the permanent increases.  The rate postings will be updated as the State Plans are submitted so this website is actually a helpful resource for all CFOs to confirm accurate understanding of rates.    

American Rescue Plan Act Rate Increase Summary    
  Workforce Recruitment and Retention HCBS Enhancement      
Program Rate Inc. WRR Eff. Date Rate Inc. HCBS Eff. Date Ongoing Rate Increase    
ACT 8.5% 10/7/2021-3/31/22 10.4% 10/7/2021-Ongoing 5.0%    
Mental Health Outpatient Treatment and Rehab Services (OTRS) 11.5% 2/1/22-9/30/22 5.0% 2/1/22-3/31/23 5.0%    
HARP HCBS/CORE 10.1% 10/1/21-3/31/22 40.0% 10/1/21-3/31/23 10.0%    
PROS 13.1% 10/14/21-3/31/22 22.3% 10/14/21-Ongoing 10.3%    
Community Residence 10.1% 10/1/21-3/31/22 9.6% 10/1/21-Ongoing 4.8%    
Note: Does not reflect 5.4% COLA, effective 4/1/22