The budget is out, and, while it could have been worse, it could have been much better. The Legislature did not restore most of the Governor’s proposed cuts to CDPA. There were improvements, and we are hopeful that those improvements will help to stop some of the worst outcomes; however, the program has been changed, drastically.
The budget allows the Department to contract out for services. This means that Fiscal Intermediary authorization that was passed in 2017 is now irrelevant. There is no guarantee that any Fiscal Intermediary will get a contract; however, the language does provide much more in the way of protections than the original language did, and there is little likelihood that one FI takes over the entire state. The Department will be forming a stakeholder workgroup to determine criteria for contracting, and CDPAANYS will do everything in power to protect our members.
There are also very good transition rights that were added. They ensure that consumers will have sufficient time to switch fiscal intermediaries if necessary and ensures the process for doing so will run smoothly. In any other budget year, we would have considered this a victory for consumer rights.
Reimbursement for administrative costs to FIs was changed from per hour to a per member per month (PMPM) formula. This is an extreme cut in most cases, and will jeopardize most FIs’ ability to continue operating as they are today. The rates being discussed would pose a 25-66% cut. However, the PMPM amounts are not written in statute, and we are hopeful that we can demonstrate the impact that these rates would have on FIs, resulting in change.
Together, we fought our best fight. You responded at every turn to keep these cuts from happening. We cannot stress enough how impressed we were at how this entire community came together to fight these changes. We taught 213 Legislators about this program in two months. Because of you, everybody in State government not only knows about, but cares about, CDPA.
We will keep up this fight, and we hope that you will stay with us.
This was a setback. It was a large setback, but that is all it was. It is not the end. We will take a quick breath and work with leaders to figure out the best way forward. We will move forward, because the arc of history demands nothing less.