If the pandemic delivered challenges to everyone, the field of intellectual and developmental disability (I/DD) services faced a unique set of obstacles that complicated an already-difficult job. Before vaccines were available, people with I/DD faced higher hospitalization rates than the general population due to comorbidities and congregate living. Although most people supported by YAI are vaccinated, agencies across the U.S. are facing severe staffing shortages and are working around the clock to identify people committed to helping others live richer, more independent lives. But there are reasons to believe 2022 will bring bright things to YAI and the field in general.
Where we stand with Biden's plan
President Biden’s Build Back Better (BBB) bill originally included $400 billion in Home and Community Based Services (HCBS) funding, which would give states more money for staff. That amount was reduced to $150 billion as the BBB shrunk during negotiations. The bill passed in the House and is one vote short of passing in the Senate. Negotiations will reconvene in January but if BBB does not pass, all 50 states will need to find their own funding for a rate increase.
As part of the $150 billion in HCBS funding, an "enhanced FMAP" (Federal Medical Assistance Percentage) for I/DD services is included—this means that the federal government will match New York State's Medicaid spending at an enhanced rate, giving the state more money to spend on Medicaid-funded programs. The federal government already did this once with the American Rescue Plan, which passed earlier in 2021, and is currently funding retention, incentive, and vaccination bonuses for direct support professional (DSP) salaries. If the BBB does pass, it is possible that these bonuses will become semi-permanent for the next 10 years, amounting to a roughly 20% increase in DSP salaries.
Under this spending plan, large sums are devoted to workforce development and retention. Three separate bonus payments are intended to support the workforce, including COVID-19 incentives to support employees who continued to work during the pandemic, and workforce longevity and retention bonuses to encourage staff to extend their employment. It also includes COVID-19 vaccination incentive payments designed to get employees vaccinated before the end of 2021.
The new OPWDD Commissioner
The Office for People With Developmental Disabilities (OPWDD) oversees I/DD services throughout New York State. Kerri Neifeld, the new Commissioner who stepped into the role in November, previously worked as the Assistant Secretary for Human Services & Mental Hygiene in the Governor's office. Before that, she served as Assistant Deputy Commissioner at the New York State Office of Temporary and Disability Assistance. In both roles, Neifeld fostered close relationships with disability agencies so she knows what goes into quality service delivery. Thanks to her history and personal knowledge, Neifeld was well prepared to take over the agency at a critical juncture. OPWDD is now working to implement enhanced FMAP incentive payments, analyze managed care options for the future of the field, and handle the growing workforce crisis.
For YAI CEO George Contos, taken together, these are promising signs for the year ahead.
“We’ve been through a lot over the past two years,” Contos said. “But I’m glad that both the federal and state governments see the value of the work we do and the need for more funding. Our staff has made sacrifice after sacrifice to keep programs running, no matter what. As an agency, YAI will continue to do everything we can to support our staff and, in turn, people receiving services. Renewed interest from our partners in government will make a huge difference in the coming year.”