Mental Retardation and Developmental Disabilities, Office of

Note: Most recent estimates as of 12/16/08.

Mission

The mission of the Office of Mental Retardation and Developmental Disabilities (OMRDD) is to help people with developmental disabilities live richer lives. The agency’s vision is to assure that people with developmental disabilities enjoy meaningful relationships with family, friends, and others in their lives; experience personal health and growth; and live in homes and fully participate in the communities of their choice.

Budget Highlights

The 2009-10 Executive Budget recommends over $4.5 billion All Funds ($1.5B General Fund; $3.0B Other Funds) for the Office to continue to support a comprehensive system of care serving more than 125,000 persons with disabilities and their families, reflecting the State’s commitment to serving the needs of persons with developmental disabilities. This is a decrease of over $9 million from 2008-09, which is largely attributable to the annualization of prior year initiatives and savings associated with program efficiencies, as outlined below. The Executive Budget recommendations for 2009-10 preserve essential direct care and maintain the quality of services for individuals with developmental disabilities in both not-for-profit and OMRDD-operated programs.

The overall recommendation maintains the State’s commitment to serve a wide range of developmentally disabled New Yorkers, including the medically frail, the behaviorally challenged, those who have been placed out-of-State or who are "aging out" of other child care systems, as well as those living at home.

OMRDD continues to improve the efficiency and cost-effectiveness of its operations and the network of not-for-profit providers it supports. Major budget actions to promote cost efficiency, maximize revenues, and rationalize reimbursement include:

• Streamlining/Consolidating Various Administrative Functions and Research Operations. In 2009-10, OMRDD will save roughly $12 million - annualizing to $27 million - by:
  • Consolidating the Administration of the Valley Ridge DDSO with the Broome DDSO, thereby reducing staff by 5 FTEs and saving $0.2 million in 2009-10 ($0.7M in 2010-11). These 2 district offices are located within the same geographic catchment area, and consolidation will result in a district office that is comparable in size to other DDSOs throughout the State. Under this recommendation, the Center for Intensive Treatment will continue to operate at Valley Ridge, with some of its administrative functions assumed by the Broome DDSO.
  • Consolidating, Centralizing and/or Regionalizing DDSO Administrative Functions, including business office and human resources activities. OMRDD will also strengthen Central Office oversight where needed, by establishing and coordinating centralized processes governing workforce management. These actions will result in a reduction of 50 FTEs and overall savings of $1.6 million in 2009-10 that annualizes to $3.3 million in 2010-11.
  • Closing Unnecessary/Underutilized Institutional Capacity. The 2009-10 recommendation calls for the closure of Bernard Fineson DDSO’s Howard Park campus and the Taconic DDSO’s Multiply Disabled Unit (MDU). Howard Park, a satellite unit of the Bernard Fineson Developmental Center located on the Hillside campus in Queens, is a 140-bed institution that is obsolete, inefficient, and no longer required. The 41 individuals currently residing there will be relocated to the Hillside Campus, or into community settings as appropriate. The net impact of this action will reduce the number of administrative staff by 28 FTEs, producing a savings of $0.9 million in 2009-10 that annualizes to $1.8 million. The Taconic DDSO’s MDU, where 65 individuals currently reside, will be phased out over a 5-year period. This institutional capacity is no longer necessary as these individuals can be more appropriately served in the community. The State staff currently supporting the individuals in the MDU will be redeployed to community homes and day service programs as they are developed; an additional 43 positions will be required to meet the enhanced staffing needs of these individuals.
  • Streamlining Research Operations. OMRDD will streamline activities at IBR. Specifically, 11 research-related positions will be eliminated in areas that are neither core to the OMRDD Mission nor leverage significant grant funding. Further, OMRDD will consolidate IBR’s business and payroll functions with those of the neighboring Staten Island DDSO, resulting in a reduction of 7 administrative positions. These actions will produce a net savings of $0.9 million in 2009-10 that annualizes to $1.8 million and will not affect the operations of the Jervis Clinic or laboratory services at IBR.
  • Reducing Safety and Security Officer Staff. OMRDD has reviewed the duties and functions of its Safety and Security Officer staff and has determined that a 20 percent reduction (50 FTEs) can be achieved statewide without adversely impacting individual and staff health and safety. This reduction will not affect agency operations as the functions these staff perform are either redundant or can be carried out by other existing staff. This action will not impact any of OMRDD’s secure facilities, and will generate $1.6 million in savings in 2009-10 that annualizes to $3.3 million in 2010-11.
  • Restructuring Central Office. Central Office staffing authorization will be reduced by 65 positions through various efficiencies, streamlining, and consolidations. This will result in savings of $3.1 million in 2009-10 that annualizes to $6.2 million in 2010-11.
  • Managing Position Vacancies. OMRDD will be able to reduce its fill level by 68 positions in 2009-10 without impacting quality of care by continuing to limit new hires to only those vacant positions that are critical to individual health and safety or essential to agency operations. This will result in savings of $2.4 million in 2009-10 that annualizes to $4.5 million in 2010-11.
  • Controlling Non-Personal Service and Capital Costs. In 2009-10, OMRDD will realize $1.8 million in savings by implementing a variety of controls on spending that will neither impact quality of care nor the safety of the individuals being supported. Specific actions include monitoring food expenditures, consolidating non-residential leases, automating certain administrative processes, reducing utility consumption with energy efficient improvements, and mothballing closed/vacant buildings. OMRDD will also be eliminating or deferring preservation and minor maintenance projects that are not essential to maintaining individual health and safety.
• Reducing Cost-of-Living Adjustments. The recommendation generates savings by reducing the 2008-09 Human Services Cost of Living Adjustment (COLA) from 3.2 percent to 2.2 percent effective January 1, 2009 (savings of $2.1M). Additionally, the Executive Budget recommends no COLA for 2009-10 (savings of $13M). To continue the State’s long-term commitment, these adjustments are planned to resume April 1, 2010, and this budget also recommends extending the COLA for a third year in 2012-13.
• Eliminating Enriched Unified Services Funding. The 2009-10 recommendation eliminates Unified Services funding of $1.7 million, which provides enriched rates of State reimbursement to 5 counties - Rensselaer, Rockland, Warren, Washington, and Westchester. Most counties or not-for-profit provider agencies and the State share equally in funding for the delivery of local assistance services, pursuant to approved local service plans. However, these 5 counties receive enhanced State reimbursement, ranging from 69.3 percent to 96.9 percent based on a 1974-75 plan that was originally intended as an incentive to reduce the use of State inpatient services; since that time, the State has shifted nearly all residents to the community such that the 30-year old incentive is no longer warranted.
• Reforming/Rationalizing Local Assistance. The Executive Budget continues OMRDD’s multi-year efforts to rationalize, reform, and restructure provider reimbursement. OMRDD will impose tighter controls on Medicaid and non-Medicaid payments to its non-profit provider network and rationalize reimbursement and achieve efficiencies where appropriate in myriad programs, including sheltered workshops, Medicaid service coordination, day habilitation, respite, supported employment, prevocational, and clinical services. Specific actions include: implementing regional rates based on actual costs for day habilitation services, reducing reimbursement for less intensive case management services, removing income exemptions that currently increase State funding requirements for long-term sheltered workshops, and eliminating enhanced funding to certain Article 16 and Article 28 clinics. It is anticipated that these controls and restructuring efforts, as well as other efficiencies, will produce savings of $32 million in 2009-10 that annualize to $24 million in 2010-11, while supporting the program direction of OMRDD.
• Maximizing Non-State Revenues. Through a combination of revenue maximization efforts, OMRDD will achieve a savings of roughly $179 million on a recurring basis through actions such as recognizing increased Food Stamp benefits, maximizing utilization of Home and Community Based Services (HCBS) waiver programs and services, and continuing the healthcare reimbursement initiative. OMRDD and its partnering not-for-profit providers will also continue efforts to require families and individuals with developmental disabilities to apply for all Medicaid and Medicare benefits to which they are entitled. To assure that these benefits are accessed appropriately, OMRDD will provide education and assistance to families and individuals with developmental disabilities seeking or receiving supports and services that can be funded by Medicaid and/or Medicare.
• Restructuring Services for Out-of-State Placements. OMRDD has identified 88 individuals currently served in out-of-State facilities, or who have "aged out" of in-State schools, who would be better served in more appropriate OMRDD-certified adult residential and day programs. Therefore, the recommendation provides individuals and their families with the option of relocating to an in-State OMRDD certified program or continuing to reside in their current setting and receive reimbursement at an amount no greater than what OMRDD would reimburse the appropriate in-State program. This proposal will realize $3.3 million in savings in 2009-10 growing to $5.5 million in 2010-11.

The 2009-10 recommendation also continues the State’s commitment to several key ongoing initiatives, including the following:

• New York State Creating Alternatives in Residential Environments and Services (NYS-CARES) Program. The Executive Budget continues support for NYS-CARES by including 530 new residential opportunities at a cost of over $22 million annually. By the end of 2012, 7,800 residential opportunities will have been developed under NYS-CARES which, when coupled with the 36,000 funded community beds already in the system, will provide significant opportunities for persons seeking an out-of-home residential service option.

• Community-Based Services to Special Populations. OMRDD, in partnership with its not-for-profit provider network, will develop 90 new residential and day-service options to accommodate individuals aging out of educational environments and those in other human services areas, such as nursing homes, at a cost of $6 million in 2009-10. This represents a reduction from previous plans to develop 140 of these beds at a cost of nearly $8 million. In addition, 138 new residential opportunities to either repatriate children placed out-of-State, or to mitigate such future placements will be developed at a cost of approximately $10 million when fully annualized. This reflects a reduction from previous assumptions by 49 beds, lowering State funding by almost $4 million.

• Targeted Family Support and Autism Services Enhancements. The Executive Budget recommendation continues 2008-09 funding to support Family Support Services opportunities to as many as 3,000 families to help them care for their loved ones with disabilities at home. This will support respite services, mobile crisis teams, family training, and intervention services. In addition, the Executive Budget continues funding from 2008-09 to support services to approximately 1,300 individuals with autism or autism spectrum disorder.

• A Multi-Year Plan to Downsize Developmental Center Capacity by Creating Additional Community Capacity. Over the next 3 years, OMRDD will expand State-operated community residential capacity by 108 beds for difficult-to-serve individuals who are currently living in institutional settings, including nursing homes. This effort will be complemented by an additional 414 State and not-for-profit residential opportunities over each of the next 3 years that will help reduce and virtually close the Developmental Centers, leaving only the special population institutional settings. The Western New York Developmental Center remains scheduled for closure in 2010-11.

• Employment and Other Support Service Expansion. The Executive Budget continues resources to support 1,500 individuals who need employment and other day services and 500 individuals in need of in-home supports all funded through the HCBS Waiver.

• State and Not-for-Profit Capital Infrastructure Needs. Infrastructure will be maintained through new capital appropriations of $127 million and reappropriations of $319 million. Capital funding for institutional projects continues to support the reconfiguration of the Bernard Fineson Developmental Center in Queens, as well as focus on the need to reinvest resources into preserving and maintaining long-term institutional capacity, mostly for a core population of individuals who have severe behavioral treatment needs.

In total, these recommendations - through the combination of both new and existing services - will support more than 6,100 new day and residential opportunities in the community during 2009-10. This reflects nearly 1,800 people placed in new residential opportunities and more than 4,300 into new non-residential opportunities. Services to individuals and families have been expanded within Family Support Services.

2009-10 Executive Budget — Agency Presentation
Mental Retardation and Developmental Disabilities, Office of (PDF)