To: Dr.

Kastner 1/15/21

CC: Governor Cuomo, Legislative Representatives, Related Agencies and Associations

Re: 2021-2022 Budget

Thank you for asking us to engage with you in the difficult task of budget planning in these extraordinary times. Like all
New Yorkers, we are acutely aware of the financial challenges that the state is facing. Perhaps even more daunting is
the need to redesign and re-imagine the services for individuals with I/DD in the pandemic and post-pandemic world.

To begin with, we trust this engagement will continue throughout the budget process and beyond.

Regarding the 2021-2022 budget, we do not think that the service system can or should absorb a 5% cut per the call
letter. The challenges facing the service system are extraordinary and a reduction like this will be devastating and
destabilizing. The services and supports provided by and through OPWDD are vital to the lives of individuals with I/DD
and their families. Over the last several years there has been significant growth in the number of consumers needing
services as well as investment in the workforce that has driven costs up. We know that the administration is seeking
budget reductions from every agency. But we also know that there are tremendous unmet and under-met needs for
OPWDD services and that any cuts to services and supports will only add to the problem.

Perhaps the most useful input we can give you at this time is to start by saying what should not be cut. To begin with,
direct services and direct service staff should not be cut. Covid -19 has only exacerbated the workforce crisis.
BFair2DirectCare was a start, but the workforce crisis remains and without continued investment will only worsen.
Second, we do not think that OPWDD should outsource its management responsibility by contracting with managed care
organizations, provider-led or otherwise. It is beyond our comprehension that the administration continues to consider
that a transition to managed care is a viable alternative given the extraordinary cost of implementation and the lack of
any evidence that managed care would improve quality, access or cost. We know, however, that there is an enormous
regulatory burden that adds cost at every level and every function of our service system without improving quality. We
know that the system needs to function more efficiently. We know that the reimbursement structure needs to be
modified to deliver services to those who need it most. We’re encouraged that OPWDD is considering acuity and
performance measures to be built into the reimbursement structure, and we want to work with you on a system that
truly meets the needs of people with I/DD.

The solutions to the many challenges that the I/DD service system faces will not be found easily or quickly. We are
confident, however, that by working collaboratively and respectfully with OPWDD and the other stakeholders that we
can find these solutions. And we must. Lives depend on it.

Respectfully submitted,

Self-Advocates and Families Representing Individuals with Intellectual and Developmental Disabilities across New York