I am writing to express my deep concern regarding proposals contained in the 2009-10 Executive Budget, which, if left unchanged, will take a severe toll on people with developmental disabilities. I recognize that difficult choices must be made in allocating funds across the many budget priorities this year. At the same time, the federal stimulus plan will generate a projected $11billion in additional Medicaid revenue for New York State. OMRDD programs operated by voluntary agencies will generate approximately $675 million of this additional stimulus Medicaid funding. However, there is currently no proposal to use any portion of this additional federal funding for OMRDD programs and services. Among the proposals contained in the 2009-10 Executive Budget, several will put OMRDD consumers and providers at undue risk and should be madea priority for restoration. The most damaging of these are the following: The Executive Budget does not include funds to continue residential development for individuals on waiting lists. New York State must continue to provide development resources sufficient to honor the commitment that has been made to families to provide residential supports when their adult children can no longer be taken care of at home. Projects have been delayed, cancelled, or put on indefinite hold for lack of adequate resources. This has given rise to growing alarm that New York State's commitment to families caring for our most vulnerable citizens is at great risk. Many of these families include elderly, sometimes infirm parents caring for aging adult children with severe developmental disabilities. For more than 10 years, New York has kept faith with the thousands of families relying on our system of services and supports to provide the appropriate residential supports for those needing them; this is not the time to break that faith. On Long Island, 51 new group homes for 282 Long Island consumers (from a waiting list of over 1,700) were authorized for development 2-3 years ago. Now these homes are ready to open in the upcoming year. However, each has been placed on hold and the previous placement commmitment given to these families in immediate need is in jeopardy. The Legislative's budget proposal must include funds to continue some level of residential program development for consumers identified as needing homes. The Executive Budget includes a 3% across-the-board cut to Intermediate Care Facilities (ICFs). Community based ICFs serve people with severe disabilities, often with multiple disabilities. Many of these individuals are medically frail and their lives depend on the unique and intensive 24 hour care provided by the ICF. The program serves a total of 5,500 people who are the neediest and most vulnerable of people with developmental disabities. While the Governor proposes to cut $9 million in state funding to the ICF/MR program, the actual cut for providers would be $18 million with the federal match. Staffing and the quality of services provided will be jeopardized by such a cut. The Legislature's budget proposal needs to restore the funding for ICFs. The Executive Budget includes no OMRDD Trend Factor. A trent factor is the lynchpin to progam fiscal health, safety, quality and is critical for meeting wage commitments to recruit and retain quality staff. State employees, who perform exactly the same work as their voluntary counterparts in the same settings and for the same consumers, have a 3% wage increase scheduled as part of their current contract; this is an inequity. Direct care workers employed by these programs quickly spend their earnings on daily requirements, injecting these funds directly into the economy. The Legislature's budget proposal needs to include a trend factor for providers of OMRDD services. The Executive Budget includes a 4% cut to Day Habilitation funding. Coupled with the federal match, this amounts to an annualized reduction of $28 million. In addition, the proposed restructuring of the fee system would dismantle the extremely successful current person-centured, individualized model that serves almost 37,000 New Yorkers with developmental disabilities daily. WIth 85% of Day Habilitation costs supporting direct care personnel and fixed expenses, a cut here will result in increased unemployment, and will inevitably lead to one or more declines in service, such as fewer days per week, fewer hours per day, a re-focus on segregated services rather than the current community-based programming, or a reduction in access for individuals with greater needs for support. These outcomes are in direct conflict with OMRDD's long established mission and core principles. The Legislature's budget proposal needs to restore the funding for Day Habilitation services and reject the proposed rate restructuring.