NYS Budget Update - Impact for Early Intervention

If the number of hits to this blog regarding early intervention and the NYS budget are any indication - this is a MAJOR point of concern for therapists. Our traffic has been influenced heavily by this issue in the last month. Also, it is not just NY traffic - people around the country have been watching the proposed budget cuts to the NYS Early Intervention Program.

This week the Senate and the Assembly each put forward their own modifications to the budget and the budget reconciliation process begins. Click on the links to get to the respective budget proposals.

These documents don't always contain all the actual legislative language so it is sometimes difficult to precisely understand where specific budget lines are reflected. It appears that in the Senate version they are 'concerned' about the EI cuts and they are waiting on information about fund availability to see how they can 'minimize the impact of the Executive Proposal.' The Assembly version is more clear in that it 'rejects provisions to reduce the EI rate 10% and require providers to bill Medicaid directly.'

Insurance companies can rest easily, however, because in both the Senate and Assembly proposals they reject the requirements for expanding the mandate for commercial insurance companies to cover the Early Intervention Program. It is unfortunate that legislators didn't recommend a more reasonable cost-shifting plan that respected issues like network status of the provider, place of service, and prior authorization. Instead, they apparently over-reached by requiring a blanket mandate - and I can't really say I would support a blanket mandate either. It is reasonable for the insurance companies to have some typical process of utilization management but all or none thinking in this case will skew to the side of nothing happening. Big win for the insurance companies - big loss for the taxpayers. Blame the politicians for this one by being lazy and thinking a heavy governmental hand would be an effective strategy.

I am aware of several efforts to write in to legislators opposing the reimbursement changes. I am also aware of what appears to be a proto-union group that was able to get an Assembly bill introduced that would prohibit additional reductions to early intervention rates. I have corresponded with this group's leader and expressed some concerns about groups or professionals banding together (formally and informally) to set rates or to have the appearance of colluding about rates. I also have some personal philosophical concerns about the concept of collective bargaining against government entities. I was told that this was not a proto-union effort but this is one of those situations where if it looks like a duck and quacks like a duck it is probably not a rabbit.

Actually I admire this group's intent, and the group is comprised of parents and not only professionals, but I still think that this is like Little League playing at Yankee Stadium.

The lesson in all of this is that the way to effect change is to take the two following approaches:

1. Spend more money on lobbyists and become more active in the political process as it stands.

2. Instead of trying to be a break wall against the need for reform, try instead to ride the wave into another direction. In this case, it might mean helping families find the help they need from sources OUTSIDE of government mandated programs. That's a big mindset change against what many people perceive as an entitlement culture that exists in this state.

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