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TESTIMONY – Joint Legislative Public Hearings on 2024-2025 Executive Budget Proposal Public Protections

Posted on January 30th, 2024

Joint Legislative Public Hearings on 

2024-2025 Executive Budget Proposal 

Public Protection

Testimony by  

Kristin Brown, President and CEO

 

Introduction

 

Thank you for the opportunity to testify on this year’s Executive Budget. My name is Kristin Brown and I am President and CEO of Empire Justice Center. I am also co-vice president of the New York Legal Services Coalition and serve as co-chair the Coalition’s Steering Committee; the coalition consists of nearly 50 member organizations providing essential civil legal services to low-income and disadvantaged individuals throughout New York State. I also serve as a member of the New York State Unified Court System’s Permanent Commission on Access to Justice.

Empire Justice Center is a statewide, multi-issue, multi-strategy not-for-profit civil legal aid provider focused on changing the complex systems impacting low income and marginalized New Yorkers. With a focus on poverty law, Empire Justice takes a 360-degree approach to the areas of law we practice in, providing individual legal representation, policy research and analysis, training and technical assistance as well as impact litigation. Our work cuts across all significant areas of poverty law and involves three inter-related services:

We practice the law: Empire Justice Center provides a range of legal assistance from our offices in Rochester, Albany, Yonkers, White Plains, Central Islip, and Hempstead. We provide one on one representation and undertake impact litigation to address systemic issues impacting low income and marginalized communities.

We teach the law: Our history as a backup center for civil legal services providers began in the 1970’s and has developed so that we now also provide training, technical assistance and other
support services to a variety of other community-based organizations, keeping them apprised of changes in the law and regulations.

We change the law: In order to ensure that the needs of low-income families are heard within the state’s policy making processes, we engage in both legislative and administrative advocacy on a range of issues impacting our clients and we do the same as needed at the local and federal levels.

 

In today’s testimony, I am respectfully asking you to consider the following:

  1. Reject the proposal in the Executive Budget to sweep $100 million from Interest on Lawyers Account (IOLA) to the General Fund. 
  2. Support a multi-phase plan to achieve pay equity across government funded public interest legal systems. 
  3. Support the proposal in the Executive Budget to ensure funding for services for victims of crime.
  4. Support the Office of Court Administration (OCA) budget proposal to include cost of living increases for Judiciary Civil Legal Services and IOLA funding and 3% funding increases for JCLS

 

Reject the proposal in the Executive Budget to sweep $100 million from Interest on Lawyers Account (IOLA) to the general fund.

Empire Justice Center is deeply concerned about the proposal Executive Budget to sweep $100 million from the Interest on Lawyers Account to the general fund. IOLA funding not only supports essential services that help low-income New Yorkers obtain help with civil legal problems affecting their most basic needs, such as food, shelter, jobs and access to health care, it is a critical source of infrastructure dollars that the civil legal services community is in desperate need of. These funds are accumulated for distribution at the next round of grants to civil legal services providers, which are intended to assist in addressing the dual crises of an estimated $ 1 billion civil justice gap and community wide salaries that are at least 30% below counterparts in similar public interest and public sector fields.

 

There is an IOLA or IOLTA fund in every state across the country. Here in New York our fund was established in 1983, under New York State Finance Law (§ 97-v). With the recognition of the vast need for to fund civil legal services, these funds were created for the sole purpose of funding civil legal assistance. The legislative intent was as follows:

Legislative findings and declaration. The legislature finds that the availability of civil legal services to poor persons is essential to the due administration of justice. The purpose of this act is to provide funding for providers of civil legal services (emphasis added) [1] in order to ensure effective access to the judicial system for all citizens of the state to extent practicable within the means available for that purpose.

The Interest on Lawyers Account (IOLA) fund established by this act will be authorized to receive funds from any source for disbursement to nonprofit legal services providers for charitable purposes, including the delivery of legal services in civil matter to poor persons. The IOLA fund will receive the interest earned by qualified client funds held by attorneys in unsegregated interest-bearing accounts designated IOLA accounts. Funds which qualify for deposit in IOLA accounts are those which, in current practice, attorneys do not deposit in segregated accounts because insufficient interest would be earned to justify the expense of administration. When pooled in an IOLA account, funds which would be unproductive as individual accounts will generate income, the beneficial  interest in which will be held by the IOLA fund exclusively for charitable purposes (emphasis added).

 

Even during the most extreme financial crises in the past, IOLA funds have never been swept or used for any other purpose than to provide civil legal services to low-income New Yorkers. Now is not the time to divert or undermine the purpose of this critical resource.

 

IOLA distributes the accumulated interest dollars through competitive requests for proposals issued every two years. IOLA also collects and distributes outcomes and they are impressive. In 2023, IOLA grantees closed over 307,000 client cases, benefiting over 639,000 low-income New Yorkers. The top five areas of service from 2023 are housing, immigration, family law, education and health.

 

Since its inception, interest rates have fluctuated wildly. In the early days, this resulted in dramatic swings in funding for civil legal services, causing uncertainty and financial crisis for providers and loss of services for client communities. To guard against this, IOLA rightly shifted to a “rainy day” approach that creates a reserve of funds that can be used to avoid cuts in funding and thus civil legal services during periods where interest rates and thus earnings are low. This funding stability has been a godsend.

 

Furthermore, this attempted sweep could not come at a worse time. The civil legal services community faces a complex crisis. The value of and need for civil legal services has never been more front of mind in our state. Recognition that there is no civil Gideon for folks facing bankruptcy, loss of home, healthcare – the essentials of life – has grown among the public and policy makers as a result of educational efforts. The Access to Justice Gap, the space between the civil legal needs of low-income New Yorkers and the resources available to meet those needs has now been documented and assessed at a $1 billion over what is currently in the system. As noted in the Permanent Commission on Access to Justice’s 2023 report to the Chief Judge, “the Permanent Commission recently adopted its Funding Working Group’s report finding that between $842 million and $1 billion is a realistic estimate of the additional annual funding, over and above existing funding, to close the justice gap.” [2] Notably, this analysis focuses only on those earning up to 250% of poverty and does not include immigration related legal services.

 

Demand and need for our community’s services is vast, but the resources are not there, leaving far too many New Yorkers facing life altering legal junctures without an attorney who understands the process. At the same time, salaries, in comparison to any other government funded attorney services are so low, it is becoming impossible to compete with state, county and city positions. With the well deserved and long overdue increase in rates for assigned counsel in criminal matters, civil legal services salaries have fallen even further behind. The IOLA funds that are to be swept are slated to help address these very issues.

 

The New York Civil Legal Services Coalition is preparing a white paper that will be released in the near future to shed additional light on this issue, but as an overview, New York’s civil legal services providers, like Empire Justice Center, which provide legal services to low-income New Yorkers on behalf of the state, are funded at levels that hold entry-level salaries at 30% to 45% lower than other government funded legal services providers, and those inequities only grow throughout their careers. The widening salary gap is making it increasingly difficult to attract and retain legal talent and do the work that we are contracted with the state to do. Unfilled positions result in clients not served – unlawful evictions executed, homes lost to foreclosure, lifesaving health coverage not received.

 

In addition, IOLA has just launched a multi-year Justice Infrastructure project that will assist our under resourced community improving the delivery of services and create efficiencies across programs. The accumulated funds are what made it possible for the IOLA Fund to pursue this project.

 

We need the legislature’s support in addressing the needs of our client community through rejecting the proposal in the executive budget to sweep funding from IOLA. IOLA has been a key partner in all of our efforts to increase services and more recently to address pay parity. There is increased appropriation authority in the Executive Budget for IOLA to take a first step forward, with the expectation that the next round of competitive funding will be significantly larger and utilized to address both the crisis in salaries and the societal imperative to make progress toward closing the Justice Gap for in New York State. These funds, along with OCA’s efforts are essential to our community’s ability to make gains against the justice gap and to be able to fulfil existing promises for representation through being able to compete against others in our field for employees.

ASK: Reject the $100m sweep of IOLA funds and support pay parity for civil legal services providers

 

Ensure supports to Victims of Crime

Empire Justice Center is very supportive of the Governor’s proposal in the Executive Budget to support services for crime victims through the inclusion of a multi-year commitment of funding to support victim assistance programs through the Office of Victim Services and we urge the legislature to support this. In part, these funds support critical legal services that help victims of domestic violence rebuild their lives, including obtaining divorces and orders of protection, secure the safety and custody of their children, legally terminate joint leases, and assisting in maintaining employment while victims address their immediate needs. Empire Justice Center utilizes these funds to run the Crime Victim Legal Assistance Network, which provides training, resources, support and research to legal services organizations representing crime victims, as well as warm referrals for crime victims. We also provide individual legal assistance to immigrants who are victims of crime on Long Island and in Westchester County.

 

This funding is critical. As we testified at the Senate Committee on Social Services and Committee on Women’s Issues Joint hearing on Human Services Programs for Domestic Violence Survivors last fall, the largest and most crucial source of funding for the Office of Victim Services grants to Victim Assistance Programs is the federal Victim of Crime Act (VOCA) Victim Assistance fund. Yet due to shrinking deposits into the federal Crime Victims Fund, annual VOCA grants to states have declined, and with more uncertainty in the future. This fiscal uncertainty is especially problematic for legal services, who commit to a client for the length of a case, which may last beyond a grant.

 

We need a federal solution for this, but, in the meantime, we are grateful that Governor Hochul proposed a multi-year commitment to address this problem

 

New York can and must take steps to ensure crime victims have access to the services they need, and we urge the legislature to support the governor’s proposal.

 

ASK: Support Governor Hochul’s allocation of $20m in this budget and $100m in the next three subsequent budgets to ensure that crime victims have consistent access to critically needed services, including legal assistance.

 

Support the Office of Court Administration (OCA) budget as proposed including cost of living increases for Judiciary Civil Legal Services and IOLA funding and 3% funding increase for JCLS.

The Judiciary Civil Legal Services (JCLS) funding is a critical revenue source for Empire Justice Center and our peers and is a key element in our ability to help our clients access justice under the law. These funds support provision of civil legal services in the essentials of life. For Empire Justice Center, they primarily support our school discrimination, LGBTQ+ work, which includes providing assistance with name and gender marker changes and improvements to school-based practices, as well as improving access to government benefits, particularly for individuals with disabilities.

 

We are deeply grateful for the cost-of-living adjustments which help us to address the consistent growth in overhead costs and annual salary increases for staff. We are also very appreciative of the 3% increase proposed by OCA for our JCLS grants. Of course, we know that we have a long way to go to close the Access to Justice Gap and it will take all branches of government coming together to work toward that goal.

 

ASK: Support the cost-of-living adjustment and 3% increase in Judiciary Civil Legal Services

 

Conclusion
Thank you for this opportunity. I am happy to answer any questions you may have.

 

[1] Chapter 659 of the laws of 1983

[2] Permanent Commission on Access to Justice’s 2023 report to the Chief Judge, November 2023. https://www.nycourts.gov/LegacyPDFS/accesstojusticecommission/23_ATJ-Comission_Report.pdf

 


TESTIMONY – Health – Joint Legislative Budget Hearing 2024

Posted on January 24th, 2024

Joint Legislative Public Hearings on 

2024-2025 Executive Budget Proposal 

Health  

Written Submission by  

Alex Dery Snider, Policy and Communications Director 

Amanda Gallipeau, Policy and Communications Manager 

Alexia Mickles, Senior Attorney 

Fiona Wolfe, Managing Attorney  

 

Empire Justice Center is a statewide, multi-issue, multi-strategy non-profit law firm focused on improving the “systems” within which poor and low-income families live. With a focus on poverty law, Empire Justice Center undertakes research and training, acts as an informational clearinghouse, and provides direct representation and support to local legal services programs and community-based organizations. As an advocacy organization, we engage in legislative and administrative advocacy on behalf of those harmed by poverty and discrimination. As a non-profit law firm, we provide legal assistance to those in need and undertake impact litigation in order to protect and defend the rights of disenfranchised New Yorkers. The health law team is dedicated to ensuring access to quality, affordable health coverage for all New Yorkers. 

 

New York Should Increase Funding for Community Health Advocates  
(CHA) to $5.5 million in FY25 

CHA helps New Yorkers navigate today’s complex health care system by providing individual assistance, outreach, and education to communities throughout New York State. Since 2010, CHA has handled over 509,000 cases for consumers, helping them save approximately $197 million in healthcare related costs.1 CHA reduces or eliminates consumers’ medical debt in over 91% of its cases. Every dollar invested in CHA yields an estimated $5.73 in savings to consumers. Empire Justice Center is grateful that the Governor’s budget includes $3.5 million for CHA, and we urge the Legislature to allocate an additional $2 million in funding. 

Recommendation: We ask the legislature to include $2 million in funding for CHA, and we request that the final budget include $5.5 m for CHA 

 

Children in New York State Should Be Provided with Continuous Coverage from Birth to Age Six 

We are delighted to see the Governor’s commitment to include this issue in the 1115 waiver amendment request. Children eligible for Medicaid and Child Health Plus at birth should stay eligible for continuous comprehensive coverage until age six, without the risk of losing their health insurance during the annual renewal process. Low-income families should not have to climb over administrative hurdles in order to keep their youngest children enrolled in public health coverage. Oregon and Washington have been approved for this continued Medicaid coverage, and Oregon’s data showed that fewer than 1% of children lost Medicaid coverage because their families were no longer income eligible. This means that more than 99% of children who lost their coverage did so for administrative reasons, such as problems completing the redetermination process. New York should take similar steps to protect and invest in its youngest residents, by ensuring that young children do not churn on and off coverage, which puts them at risk of missing or delaying important childhood screenings and check-ups. Empire Justice Center agrees with Governor Hochul, and echoes Medicaid Matters NY (MMNY) and Health Care for All New York (HCFANY) (both of which we are member organizations), as well as our partner organization, New York Legal Assistance Group (NYLAG), that New York should offer the same continuous coverage to children from birth to age six. 

Recommendation: New York State should provide continuous Medicaid and Child Health Plus coverage to children until age six. 

 

Protect New Yorkers’ Access to Medications 

I. Retain Prescriber Prevails  

The Executive Budget once again proposes to eliminate “prescriber prevails.” This longstanding requirement (for Medicaid fee-for-service (FFS) and Managed care enrollees) ensures that an individual’s medical provider has the final say in any disputes over which drug would treat their patient safely and most effectively. In 2023, most Medicaid enrollees had their pharmacy benefit moved from managed care to the FFS program, NYRx, with the goal of improving and streamlining access to medications. The prior authorization process in NYRx, which incorporates prescriber prevails, is a clear benefit of the pharmacy transition and allows many issues to be addressed by the enrollee’s prescribing physician and without the need for individuals to go through the arduous fair hearing process to receive their necessary prescriptions. If prescriber prevails is eliminated, this will result in many more denials and disruptions to Medicaid enrollees who need access to their specific medications, including those who rely on drug combinations to treat complex medical conditions. Without prescriber prevails, New York will be jeopardizing the short and long-term health outcomes for the individuals who would be impacted by this change. It is more important than ever that this important protection remains in place. Empire Justice Center endorses the positions of MMNY and NYLAG 

 II. Retain Notice and Comment Period for Over-the-Counter Drug Lists 

Empire Justice Center opposes the Governor’s proposal to allow the Department of Health (DOH) to reduce coverage of over-the-counter (OTC) drugs and supplies without prior Notice and Comment. Allowing DOH to unilaterally remove items from the list of Medicaid-covered OTC drugs without a public comment and rulemaking process would be detrimental to Dual Eligible New Yorkers who rely on the Medicaid program for their OTC medical needs. The reasoning behind the proposal is to align NYS Medicaid coverage with the federal Medicare Part D program. However, this would have the opposite effect. Since all OTC drugs are explicitly excluded from the federal Part D benefit, Medicaid is only aligned with Part D when it covers all OTC drugs excluded from Part D. This means that products such as allergy medications, laxatives, head lice treatments, and more, are at risk of being unilaterally removed without public input. Many, if not all, Medicaid recipients lack the disposable income to pay for these medically necessary items out of pocket. Empire Justice Center fully endorses the statements of MMNY and NYLAG. 

Recommendation: New York needs to keep Prescriber Prevails, as well as prevent the removal of a Notice and Comment period for OTC drug lists. 

 

New York Should Provide Medicaid Eligibility Equity for People with Disabilities and Older Adults by Increasing the Asset Limit 

Empire Justice Center was delighted that last year’s enacted budget included Medicaid income eligibility expansion for people with disabilities and older adults, raising their eligibility from 84% of the Federal poverty level (FPL) to 138%, the same as the level for other adults. Income eligibility was also increased for the Medicare Savings Program. Both of these increases are already making a difference to so many New Yorkers. 

We commended the Governor for including in her 2022-23 budget repeal of the Medicaid asset test for older people and people with disabilities, but that provision fell out during budget negotiations. This means that currently, people who are over 65 years old or who have a disability are the only people whose assets are scrutinized when enrolling in Medicaid. As the basic costs of living continue to spiral, and we see only nominal increases to the Social Security Cost of Living Adjustments (COLAs), all New Yorkers should be encouraged to set aside what they can for the future. More than ever, lower income seniors should not be unduly penalized for having modest savings. We fully endorse the position of MMNY and NYLAG and urge you to consider increasing the asset limit this year for this group of people. Short of full repeal, increasing the liquid asset limit will make access to health care more equitable. California has already eliminated the asset test, following a two-phased approach. In 2022, the asset limit was increased to $130,000, and then eliminated in 2024. New York can follow a similar approach, by passing A.5940A Kim/S.4881A Cleare, and raising the asset limit and then eliminating it thereafter.     

Recommendation: Provide equity in New York State’s Medicaid Program by increasing the Medicaid asset limit to 600% FPL for those who are elderly, blind, and disabled. 

 

New York Should Promote Community-Based Services and Supports 

I. New York Should Prioritize Fair Pay for Home Care Workers 

The staffing shortage in the home care workforce continues to negatively impact New Yorkers who rely on the services to live safely in the community. The lack of available aides across many regions – urban, suburban and rural – jeopardizes the rights of people with disabilities and older adults to live independently in their own homes. This problem will not fix itself. The home care workforce will not grow without adequate pay for its workers. Empire Justice Center fully endorses the position of MMNY and NYLAG that the State must invest in community-based services by raising wages for home care workers.  In addition, we urge the Legislature to maintain Wage Parity for workers in the Consumer Directed Personal Assistance Program (CDPAP).       

II. New York Should Repeal the Activities of Daily Living (ADL) Restrictions  

Currently, Personal Care Services (PCS) and CDPAP are available for those needing assistance with one ADL. In 2020, the budget included a provision that will limit access to PCS and CDPAP to those who need physical assistance with three ADLs. There is only one exception: those with dementia may qualify if they need cueing or supervision with two ADLs. This means that individuals with traumatic brain injury (TBI), developmental disabilities, vision loss, cognitive impairments other than dementia, and more, will be denied these vitally important services – simply because they do not need physical assistance with three ADLs. New York’s most vulnerable populations will now find themselves in a situation where they are at significant risk of institutionalization. 

This provision has not yet been implemented and Empire Justice Center echoes MMNY and NYLAG in strongly urging the Legislature to repeal it by passing S.328/A.6346. 

III. New York Should Repeal the Look-Back Period for Community-Based Long-Term Care Medicaid Services  

In 2020, the budget included a provision that added a look-back period for eligibility for community-based long-term Medicaid services. The proposed goal of the lookback is to prevent wealthy individuals from accessing Medicaid for long-term care. However, in practice, wealthier individuals can always find ways to shelter assets, via trusts, waiting out penalties, and retirement accounts, rendering them exempt from Medicaid. This means that individuals with moderate means, who tend to have savings in cash rather than a home or retirement accounts, end up being the ones who are penalized with a lookback. This provision has not yet been implemented and Empire Justice Center agrees with MMNY and NYLAG that the Legislature should repeal it. We are already seeing longer delays at local districts as understaffed offices process full Medicaid renewals for the first time since the public health emergency. If the new lookback is implemented, and districts are forced to process even more paperwork, this will undoubtably have a detrimental effect on the system that is already stretched too thin. As a result, New York’s most vulnerable populations will bear the brunt of the consequences.   

Recommendation: New York needs to support those who receive Medicaid home-based care through the fair pay of workers and retaining wage parity for CDPAP aides, repeal restrictions on activities on daily living, and repeal the look-back period. 

 

New York Should Take Steps to Reduce Medical Debt 

I. New York Should Adopt and Expand the Governor’s Budget Proposal to Improve the Hospital Financial Assistance Law 

Empire Justice Center echoes the position of HCFANY, and fully urges the Legislature to improve upon Hospital Financial Assistance Law (HFAL) by adopting provisions from the Ounce of Prevention Act (S.1366A/A.6027A).  Modernizing HFAL is an immediate and concrete step that New York can take toward addressing the devastating financial harm that too many individuals and families face as a result of needing medical care. Between 2015-2020, over 54,000 New Yorkers were sued by non-profit hospitals. We applaud the Governor for proposing an increase in the income eligibility limit for HFAL from 300% to 400% of the federal poverty level (FPL), and for eliminating the 90-day application timeframe. But there is still much more that can be done. These hospitals receive $1 billion annually in Indigent Care Pool funds to support their uncompensated care losses. However, most patients are never told about New York’s HFAL. The Ounce of Prevention Act would increase the income eligibility cut off from 300% to 600% FPL, simplify and improve the discount schedule,2 eliminate the 90-day application time frame (many patients do not even receive medical bills within this time frame), and eliminate the resource test for low-income patients. Additionally, the final HFAL should incorporate last year’s budget provision that requires hospitals to use a uniform application form provided by the Department of Health. 

We support the appointment of a director of patient advocacy to work on (among other things) the important issue of patient’s rights related to hospital financial assistance.  

II. New York Should Pass the Prohibition on State-Operated Hospitals Suing Patients for Medical Debt Act 

Empire Justice Center supports the position of HCFANY and fully supports the Prohibition on State-Operated Hospitals Suing Patients for Medical Debt (S.7778/A.8170). Among the five state-funded hospitals, it was found that patients are sued at higher rates than non-state hospitals, and that over 50 percent were in zip codes were predominantly people of color. 77% of those who were sued lived in zip codes with incomes that would have made them eligible for hospital financial assistance, for which these hospitals already receive substantial funding to cover the cost of care.    

III. New York Should Eliminate Insurance Copayments for Insulin  

By supporting Governor Hochul’s proposal for Zero-Cost Insulin, New York can lead the way for the 738,000 New Yorkers living with diabetes who use insulin. Although New York State has capped the cost at $100 per month, the cost is still $1200 per year for diabetes medicine alone. It is shown that diabetes impacts communities of color at higher rates than their white counterparts. Diabetes-related complications such as blindness, limb-loss, and kidney failure impact people of color at higher rates, and Black New Yorkers are twice as likely to die from diabetes-related issues than those who are white. By eliminating cost-sharing, medication adherence increases, which improves health outcomes for all communities. In doing so, health plans will save money. One study, led by Blue Cross Blue Shield of Louisiana in 2021, found that eliminating co-pays for prescription medications that treat chronic conditions, including insulin, increased medication adherence for most enrollees, especially those with the lowest incomes. The follow-up evaluation of the program found a 10 percent decrease in medical spending, leading to an average net savings of $63 per member per month.3 

 Empire Justice Center fully endorses the position of HCFANY. 

Recommendation: New York needs to reduce the burden of medical debt on families by adopting and updating provisions from the Ounce of Prevention Act, passing the Prohibition on State-Operated Hospitals Suing Patients Act, and by eliminating copayments for insulin. 

 

New York Should Expand Eligibility for and Improve Access to Public Health Insurance Programs 

We support the budget provisions that improve healthcare affordability and access for all lower income New Yorkers – the increased premium subsidies for Qualified Health Plans will help consumers who are over the income limit for Essential Plan but who cannot afford high deductibles and coinsurance. 

In 2023, we applauded Governor Hochul for expanding the Essential Plan eligibility from 200 – 250% of the federal poverty level. Once again, we applaud the Governor for the planned expansion of the Essential Plan through the updated 1332 Waiver which now includes Deferred Action Childhood Arrival (DACA) recipients. However, this leaves New Yorkers between the ages of 19 and 64 uninsured due to their immigration status. Despite this shortfall, the Governor’s proposed budget excludes affordable and comprehensive health care for people who do not have immigration documentation.  

Empire Justice Center joins with MMNY, HCFANY, and NYLAG, in calling for access to affordable health coverage for all New Yorkers, regardless of immigration status. This can be achieved with S.2237B Rivera/A.3020B Gonzalez-Rojas, using federal funds to cover the cost of expanding the Essential Plan. 

Recommendation: New York should pass S.2237B Rivera/A.3020B Gonzalez-Rojas to expand Essential Plan coverage to immigrants aged 19-64. 

 

Conclusion 

Empire Justice Center supports the proposals in the Executive Budget that would expand access to health insurance coverage and health care. However, there are still clear shortfalls in certain areas – such as access for immigrants, and seniors and people with disabilities who seek to live independently at home. By addressing these inequities, the Legislature can help the entire system reach greater equity for all New Yorkers, but there is more to be done longer-term. The health care patchwork that exists today is failing New Yorkers, insured and uninsured alike. A single-payer program would eliminate coverage disparities based on income and immigration status, as well as funding disparities between safety-net hospitals and hospitals in wealthier communities.  

 

Recommendations 

 Thank you for this opportunity. 


Memo of Support – NYS Department of Financial Services Private Education Debt Registry

Posted on November 30th, 2023

Memorandum of Support 

NYS Department of Financial Services Private Education Debt Registry

A.5286 (Epstein)/S.5056(Thomas)

We recommend you view the PDF Here

 

Empire Justice Center strongly supports A.5286/S.5056 which requires all private education creditors operating in New York State that are not already licensed or chartered by the Department of Financial Services (DFS) to annually submit information on their private education debt activity. Unlike federal student loans, private loans do not have consistently available data related to trends in originations, terms and conditions of debts, demographics of borrowers, default rates, etc. Making information about private and other student loan debt of New Yorkers available to policymakers and the public instills transparency and will lead to a better understanding of what New Yorkers are dealing with to inform regulations and ensure student debt borrowers are adequately protected.

 

Information about New Yorker’s federal student loan debts and borrower wellbeing are readily available from the federal government.1 Little is known, however, about the privately held education debts that New Yorkers owe. These debts may take the form of traditional student loans made by Wall Street banks, or may be shady financial products made by predatory lenders. Still, other debts are owed directly to the schools that students attend. The State currently has no comprehensive data about what entities own these debts, how much is owed, the paperwork and process by which they accrue, or the variety of collection practices borrowers experience.

 

A. 6/S.5056 would remedy this problem by requiring lenders and owners of these private education debts to annually report on their portfolios and collection practices to DFS and would cover both traditional private “student loans” and less traditional private “education debts” that do not take the form of a The reporting requirements are basic, including data related to:

 

Importantly, nothing in the bill would change any industry practices. It is merely a sunlighting bill to ensure that New York State policymakers and the public have the data they need to determine what additional policy interventions may be appropriate.

 

1 U.S. Dep’t of Educ., Federal Student Loan Portfolio by Borrower Location (Sept. 30, 2022), https://studentaid.gov/data-  center/student/portfolio (select “Portfolio by Location”).

 

Private education debts, which may take the form of credit or a past-due account at a student’s school, have real ramifications on New Yorkers’ lives. Although the State lacks comprehensive data about these debts, education debt creditors’ collection tactics reflect the severity of low-income New Yorkers’ struggles in this industry. Across the country and in New York, creditors are flooding state courts with debt collection actions. Non-loan education debts are also susceptible to collection activity. (The NYS Office of the Attorney General routinely files cases on behalf of the State University of New York system.) These debts may be loans owed to the school but may also be the result of financial aid packages falling apart, library fees, or even unpaid parking tickets. Schools themselves take action to collect these private education debts, both in and out of court.

 

Empire Justice Center is a statewide legal services organization that provides support and training to legal services and other community-based organizations and engages in legislative and administrative advocacy. We work on a range of consumer law issues including higher education and student lending.   In 2022, Empire Justice Center joined Community Services Society of New York’s Education Debt Consumer Assistance Program (EDCAP) and hired a student debt counselor to provide free, unbiased, one-on-one counseling to borrowers in the Capital District. We do a significant amount of outreach to get the word out about our services; the data mandated by A.5286/S.5056 will enable us to better target our outreach and reach more people to prevent consumer abuse.

 

One client we counseled owed approximately $132,000 in Parent PLUS loans with the U.S. Department of Education for her daughter. She was a state employee for almost eight years and was actively working towards Public Student Loan Forgiveness (PSLF). The client’s daughter stopped paying her portion of the monthly payment. In August 2022, a private lender advised the client to refinance with them to lower  her monthly payment. Due to a lack of education on private student loans and predatory lending tactics, the client co-signed the new private loan, which put her in a far worse financial position: the client lost  all of her credit towards PSLF, made herself ineligible for income-driven repayment plans, and prematurely put herself back into repayment after being in the COVID-19 forbearance.

 

Current New York State law does not require private student loan companies, including loan originators and subsequent purchasers of debt, to be licensed by the state unless the interest rate on the loan exceeds 16 percent, which is not common in student lending. This means that most private student loan companies are not regulated or otherwise overseen in any way by New York State. School-based private education debts, too, generally operate below the radar of financial regulators and policymakers  because all the data is held exclusively by the schools who own and collect these debts.

 

Student debt ranks second (to mortgage debt) as the largest current form of debt in the U.S. and it is rapidly growing. As a simple sun-lighting bill, A.5286/S.5056 will provide regulators, policy makers and the public a more accurate picture of the amount and nature of student debt owed by New Yorkers by requiring private education loan companies and schools to provide information using a uniform reporting about the debts they create, hold, and collect. The bill will not change these companies’ practices, and merely instills transparency leading to more informed decision-making for regulators and lawmakers.

 

For these reasons, Empire Justice Center strongly supports the passage of A.5286/S.5056 into law. This bill is a non-invasive and common sense approach, leading to better knowledge and information regarding student loan debt issues in New York State.


Memo of Support – Provide Equitable Access to Child Care for Children Whose Parents Work Non-Traditional Hours

Posted on November 28th, 2023

Memorandum of Support 

Provide Equitable Access to Child Care for Children Whose Parents Work Non-Traditional Hours

S.5327A (Brisport) /A.4986A (Hevesi)

We recommend you view the PDF Here

 

When a parent or caretaker applies for a child care subsidy, social services districts limit the scope of hours approved to correspond to the parent or caregiver’s hours of work with a small amount of time added for transportation. When parents work irregular or split shifts or non-traditional hours, or if the parents or caregivers combine work with education and training, approvals are limited – the children’s attendance is split into parts of days, resulting in disruption for the children and transportation difficulties for the parents.

 

In 2022, the legislature attempted to correct this inequity and passed A.7661/S.6655-A. which was signed into law on December 16, 2022 as Ch. 694 of the Laws of 2022. As indicated by the sponsor’s memo to S.5327A/A.4986A, the goal of the 2022 legislation was to expand access to child care for children whose parents had non- traditional work schedules, but due to a technical drafting error, the applicability of the bill was limited to child care funded only with local funds. Because child care for working families is provided by a rich mix of federal and state dollars, the bill signed into law last year applies to few, if any children, and fails to accomplish its goal.

 

The Empire Justice Center strongly supports S.5327A (Brisport) /A.4986A (Hevesi), and urges Governor Hochul to sign this bill into law. This bill provides clear unambiguous language regarding its intent in its amendments to Social Services Law
410-x and 410-w.

 

If signed, this bill will provide the children of parents who work irregular or non- traditional hours with consistent care, allowing the children to thrive and their parents to succeed. New York State’s children deserve nothing less.

 

For more information:
Susan C. Antos (518) 935-2845
santos@empirejustice.org
November 28, 2023


UPDATED FACT SHEET! Health Insurance & the End of the COVID-19 Public Health Emergency: What does this mean for Medicaid, Child Health Plus, and Essential Plan beneficiaries?

Posted on September 25th, 2023

 

The COVID-19 federal public health emergency expired on May 11, 2023. Recertifications for public health insurance programs have started, and new information has become available from NYS on the renewal process. Read the UPDATED FACT SHEET to find out what this means for Medicaid, Child Health Plus, and Essential Plan Beneficiaries.

 

Questions? Contact Empire Justice’s Health Law Unit at health@empirejustice.org or 800-724-0490 x5822


Advocates Answer Call for Comments

Posted on July 28th, 2023

Over the past four months, advocates have responded to calls for comments on Social Security Administration (SSA) proposed rulemaking and other requests for information and input. Legal services programs and advocates, including the Disability Advocacy Program (DAP) Statewide Coordinators at Empire Justice Center and the Urban Justice Center (UJC), submitted comments addressing a range of issues, including SSA’s rules governing “in-kind support and maintenance” (ISM), rules for setting the manner of appearance at a hearing, ideas for reducing administrative burdens, and ideas for SSA’s Learning Agenda.

SSA’s current regulatory agenda includes a proposal to exclude the consideration of food from the calculation of ISM when determining the amount of Supplemental Security Income (SSI) payable. While the change is a positive one, the rules for ISM would remain burdensome and complex for both the agency and claimants even if the change was implemented. During the comment period that ended April 17, 2023, Empire Justice and UJC applauded the proposal as promoting equity and simplification but urged that more be done in the future. ISM should be eliminated entirely. Since doing so requires legislative change, the comments recommended that until Congress is willing to act, more steps be taken by SSA to limit the application of ISM. One measure would be to expand the definition of public assistance households so that SSI recipients who also received SNAP are excluded from ISM reporting.

A more recent regulatory proposal by SSA, published May 19, 2023, included changes to SSA’s rules in setting the manner or modality of a hearing. If adopted, the changes would allow claimants to continue utilizing all modalities of hearings – including in-person, video, and audio. However, SSA would revert to the pre-pandemic procedure of requiring a claimant to opt-out of a video hearing within a relatively short amount of time after a person is first given notice of the options of how they may be provided a hearing. Empire Justice and UJC urged SSA to retain in-person hearings as a meaningful choice, and highlighted the challenges faced by low-income claimants in particular, who may face lack of equipment, cell service, internet connection, private space, or even tech skills. The comments also pressed SSA to increase the clarity of the notices that explain how to elect a modality, and to make the option of an in-person hearing the default with the opportunity to “opt in” to video rather than requiring they “opt out” of video if they want to appear in person. Advocates also asked SSA to increase the amount of flexibility given to claimants to change their manner of appearance, beyond the 30 days after the notice of the options.

Advocates also submitted comments to requests for information. SSA asked for input on the priority questions to comprise its FY 2022-2026 Learning Agenda. During the comment period that ended March 2, 2023, Empire Justice and UJC asked SSA to study the effects of the reinstatement of reconsideration in the former “prototype” states. New York was one of the ten former prototype states that saw reinstatement of reconsideration in 2019, a change made without any research or data to support it. Since that time, reconsideration has proven to be inefficient and unduly burdensome with minimal benefit. National statistics indicate that the process is beneficial for very few – approximately 13% of claimants see success at that level – while most see their processing time delayed. Comments also urged SSA to add to its Learning Agenda the study of inequities in how disability claims are adjudicated.

In another comment period ending April 17, 2023, advocates again raised their complaints about reconsideration and ISM, this time in response to a request by the Administrative Conference of the United States (ACUS) for comments on how federal agencies can reduce the administrative burden of how the public accesses government programs and services. Comments from UJC, Empire Justice, and LawNY, which focused on SSA specifically, also highlighted more ways in which the agency’s overreliance on online services was sometimes harming underserved communities. In response to ACUS’s request for suggestions for COVID-era policies that should be expanded, advocates suggested that SSA expand and formalize the “good cause” policy enacted during the COVID-19 pandemic. The comments argued that the pandemic revealed how claimants face an array of circumstances that warrant maximum flexibility in how good cause is applied toward those who have missed a deadline or other obligation. The comments also urged SSA to increase its transparency and accessibility to the public.

Please let us know if your program would like to coordinate on future comments.


NYRx Pharmacy Benefit Transition: Info Sheet for Advocates

Posted on April 19th, 2023

 

Read the Info Sheet as a PDF HERE.

NYRx Pharmacy Benefit Transition:
Info Sheet for Advocates

Health Law Unit

Email: health@empirejustice.org

Intake Line: 800-724-0490 x5822

 

April 1, 2023: Prescription drug benefit under MMC is transferring to NYRx

What if client hasn’t received notice of the transition?

What should clients do if they find out their pharmacy benefit has transferred to NYRx?

Where can a client find the Preferred Drug List (PDL) for NYRx?

What if a client already has Prior Authorization approved by their MMC plan?

Is there a transition period after April 1, 2023?

What is the prior authorization process for NYRx?

Is it possible to receive an emergency fill without prior authorization?

What happens if prior authorization is denied?

Prescriber prevails in NYRx

NYRx Medicaid Helpline for members

NYRx issue spotting/case escalation by advocates

Medicaid Matters New York has been asked by the NYS Department of Health to participate in a “command center” to bring issues with the transition of the pharmacy benefit to their attention.

Should you or someone you work with experience any difficulty with accessing prescriptions after the April 1 transition date or if you identify any issues that relate to the NYRx Transition, please complete this form to report:

https://docs.google.com/forms/d/e/1FAIpQLSfqBF_YpnpLb44datSWopCGEfHGmJH-8ipSaD1JMYL2ZqZ0Zw/viewform

 

Resources

Welcome to the NY Medicaid Pharmacy Program (NYRx)

https://www.health.ny.gov/health_care/medicaid/redesign/mrt2/pharmacy_transition/index.htm

Transition of the Pharmacy Benefit from Managed Care (MC) to Medicaid NYRx Pharmacy Program: Frequently Asked Questions (FAQs)

https://www.health.ny.gov/health_care/medicaid/redesign/mrt2/pharmacy_transition/pharmacy_transition_faq.htm

Pharmacy Transition Document Repository

https://www.health.ny.gov/health_care/medicaid/redesign/mrt2/pharmacy_transition/repository/index.htm

NYRx Member Dashboard

https://member.emedny.org/


The End of the COVID-19 Public Health Emergency: What This Means for Medicaid, Child Health Plus, and Essential Plan Beneficiaries

Posted on April 19th, 2023

 

The COVID-19 federal public health emergency is due to expire at the end of the day on May 11, 2023. Recertifications for public health insurance programs are starting soon. Read the PDF to find out what this means for Medicaid, Child Health Plus, and Essential Plan Beneficiaries.

As of August 2023, there is an updated Fact Sheet available. Read the PDF.

Questions? Contact Empire Justice’s Health Law Unit at health@empirejustice.org or 800-724-0490 x5822


Medicaid “Unwinding” Scheduled to Begin

Posted on January 31st, 2023

Under the federal Families First Coronavirus Response Act, existing Medicaid recipients were initially protected from benefits termination after March 18, 2020, through the end of the COVID-19 pandemic public health emergency (PHE).  The PHE was renewed on January 11, 2023, and is now due to expire in mid-April.  Although it is possible the PHE will be extended again, some of the Medicaid protections will be ending soon and will impact many Social Security claimants.

 

Under federal guidelines updated on January 5, 2023, states must initiate a renewal process for all individuals enrolled in Medicaid following the end of the continuous enrollment condition, a process referred to as “unwinding”.  Many recipients will not have returned a renewal for nearly 3 years, if at all, so the process will be unfamiliar.

 

New York State set forth its timeline on January 13, 2023, under which renewals will start in March 2023 in New York City and April 2023 in the rest of the state.  All 7+ million Medicaid recipients will receive renewals over a 12-month period.

This year, there are also significant (positive!) changes to eligibility for Medicaid and the Medicare Savings Program in New York that could affect your clients.  Non-MAGI Medicaid covers people age 65 and over, disabled, and blind.  The increased income and asset limits for non-MAGI Medicaid, and increased income limits for the Medicare Savings Program, are based on percentages of the Federal Poverty Levels (FPLs). While the new FPLs have been released, counties cannot use these levels until the state Department of Health announces them via General Information System (GIS) messaging. As of January 1, 2023, the 2022 FPLs are being used with the increased income limits.

 

Advocates should inform clients or other known Medicaid enrollees to update their address and be on the lookout for important Medicaid notices.  Those enrolled in Medicaid for the Disabled, Aged 65+, Blind through their local district can update their address with the county’s local District Social Services.  For questions about these changes, advocates can email the Health Team at Empire Justice Center at health@empirejustice.org.

 


SSA to Incorporate Inclusive Language in Documents

Posted on January 31st, 2023

The Social Security Administration (SSA) has directed its employees to incorporate inclusive language in all the agency’s written materials as those materials are drafted and updated.  In Emergency Message (EM) 22052, effective September 22, 2022, SSA explains this directive is in keeping with administration and agency priorities to provide a service that reflects the diversity of customers.

 

Inclusive language is defined as language that reflects recognition of diversity and fosters participation by all:

Inclusive language promotes respect by placing individuals first, over characteristics. Inclusive language is particularly important for individuals in underrepresented communities and those who have been historically affected by inequality, including, but not limited to people of color, migrants, women, individuals who identify as LGBTQI+, older individuals, individuals with disabilities and individuals experiencing persistent poverty or homelessness.

 

Authors are directed to a new section of the internal Quality Initiative for Commissioner’s Correspondence (QUICC) Handbook, Incorporating Inclusive Language in Internal & External-Facing Documents and Resources for guidance – a resource not available to the public. The EM indicates that the directive will apply to all internal and external documents, including disability decisions. It does acknowledge, however, that adjudicators may continue to use the term “disabled” when making findings for purposes of disability claims.