Memorandum in Opposition

For Immediate Release:  May 17, 2021

Re: A.6549-A (Gottfried) / S.5485-A (Rivera) — AN ACT to amend the public health law, in relation to blanket service limits in the early intervention program

This legislation, A.6549-A/S.5485-A, precludes the Department of Health from imposing any predetermined limitations, including limits on the length, duration, frequency, intensity, method of delivery, group size, or staff ratios, on authorized services under this title.  The bill also prohibits DOH from imposing any program-wide service limitations that restrict the ability of an individualized family services plan team to create an individualized plan of early intervention services most appropriate to accommodate the needs of each child and family.

The New York Health Plan Association (HPA) appreciates the critical importance of the Early Intervention program in helping children ages zero to three with developmental delays and disabilities meet specific milestones and reach their fullest potential, and supports the intent of the legislation to prohibit arbitrary limitations on service.  However, we also believe that the EI program is in need of an assessment and evaluation regarding service utilization and the extent to which evidence-based practices are being followed by providers participating in the program.  We do not support legislation that appears to preclude any ability to manage service utilization in the EI program.

Accordingly, HPA opposes A.6549-A/S.5485-A.

In response to the burden of the cost of the EI program on local governments, the Assembly included a provision in its FY22 one house budget that would have shifted a portion of the cost of the EI program onto insurance companies by increasing the covered lives assessment.  In response, HPA stated that most of the services provided under the EI program are developmental and educational in nature and therefore not covered under commercial insurance policies, that plans pay for all medically necessary covered services, and that a covered lives assessment increase would raise the cost of coverage for everyone.

Instead of proposals to shift costs or preclude any limitations on the program, the most prudent approach to addressing concerns with the EI program would be to require the state to perform a detailed analysis of the program in each county, including a review of eligibility, service utilization and whether evidence-based practices are being applied by providers.  Moreover, as other publicly-funded programs have evolved to focus more on outcomes measurement and a program’s ability to demonstrate improved outcomes, it is time for the same focus to be applied to EI.

For all these reasons, we OPPOSE A.6549-A/S.5485-A.