Friday, August 23, 2013
New York State Early Intervention: Roadmap through the end of 2013
My email box is flooded from colleagues asking about the NYS Early Intervention program - so I thought I would lay out the likely path toward the end of 2013 so people can plan appropriately for what lies ahead.
I also have a roadmap through 2014 and 2015 which will be published as a part of this series. Stay tuned.
Fall, 2013: The already stressed EIP will continue to come apart at the seams. Payments to providers will continue to be excruciatingly slow and complex. Even more providers will leave the system creating even longer waiting lists for children and families.
There will be no immediate 'fix' because the legislature is out of session until January.
Governor Cuomo and his administrative team will continue to blame the insurance industry for the problem and will refuse to acknowledge their own roles in creating the mess. This will lay the groundwork for insurance reforms that will be introduced next year in the Governor's Budget. The State will stick to the party line of offering 'safety net payments' and as providers go out of business they will claim that they could have taken advantage of the safety net payments that may or may not be a loan depending on what day of the week it is at the DOH.
In mid-Fall, with much fanfare, the NYS DOH will say goodbye to their interim fiscal agent. However, workers at James McGuiness and Associates will not have to fear for the immediate loss of their jobs because it will take months to get all of the payments processed through their systems. Additionally, they will fade back into obscurity and will revert back to their roles as billers for County preschool payments.
Sometime in the Fall the new State Fiscal Agent, Public Consulting Group, Inc., will introduce new early intervention billing systems that will tie the provider community up in knots. With all the negative press, they might consider removing the smirking dude on their website with the caption that reads "Our team has extensive experience with the full range of payment models and techniques that drive performance and reduce net state/municipal costs for health care services." They might not have to remove it though because most early intervention providers spend their time appropriately attending to the needs of children and have not yet noticed the smirking dude on their website and what he is really saying. If enough people read and think about what Public Consulting Group, Inc.'s expertise really is they might link it to the smirking dude on their website and that could be an image problem they want to avoid so we will see if that gets changed.
Since people might not notice the smirking dude on their website they might not also notice that NYS tax dollars are going to be paid to the Public Consulting Group, Inc. so they can increase jobs in.... TENNESSEE? Yes, that's right - the call center support for the NY Early Intervention Program is hiring people in Nashville, TN. Someone might want to make a call to Governor Cuomo about that because it is unfortunate that NYS would contract with someone who takes our tax dollars and then promptly applies them to the unemployment problem in Nashville. Of course that link will be dead as soon as they hire the folks for the Nashville office - so go check it out now please.
Late in the year the provider community will receive tax guidance on how to process the loan money that is not really loan money. Then it will become crystal clear that it is really not loan money because loan money is not taxed in NYS but your safety net payments sure will be. Providers will gnash their teeth and regret ever taking the loan money that is really not loan money because they will find themselves in a very unfortunate tax situation.
As things continue to boil over the next couple months it is extraordinarily unlikely that there will be legislative action because that would take Governor Cuomo calling for an emergency session. He can't take the risk of having legislators talking about the Early Intervention meltdown (reference the next post on Roadmap through 2014 - coming soon - hint: it has to do with elections) so unless he can find a way to control the spin or link it to some other heroic action on Upstate flooding or maybe the Women's Equality Act that the Senate did not pass it is much more likely that he will put on a SuperMan suit sometime in the Fall and announce yet another form of administrative financial support to prop up the program 'while we give the State Fiscal Agent time to get on its feet' or something like that. He will make some speeches and people who know better will make statements like 'You can't put band aids on bullet wounds' but he will find enough sycophantic reporters to print that he has saved the day that he will remain unscathed if not heroic. Then people will go into winter hibernation mode with visions of sugarplums and possible legislative proposals in their heads for the 2014 session. Like I said - more on that soon.
Bottom line: good things are not on the horizon. You heard it hear first.