Tribal Efforts Safeguard $2.7m Family Support Program
Jan 11, 2017
AKWESASNE — In 2011, the State of New York launched a major effort to redesign the Medicaid Program to curb spending and centralize their care system through a partnership between the New York State Department of Health (DOH) and the New York State Office for Persons with Developmental Disabilities (OPWDD). The proposed plan was submitted to the Federal Center for Medicaid and Medicare Services (CMS) for implementation despite being developed without tribal consultation, as it will eliminate specialized services provided by the Family Support Program of the Saint Regis Mohawk Tribe’s Division of Community and Family Services.
The Tribe first became aware of the State’s Medicaid Redesign through public channels and immediately began strategizing to protect its Family Support Program. Between 2012 to 2015, a series of discussions and meetings were held with State representatives regarding the lack of tribal consultation and the vital services provided by the tribal program. Tribal recommendations went largely ignored by the State, which necessitated the Tribe to reach out to the federal agency CMS, who placed the State’s Medicare Redesign on hold and stipulated the need for sufficient and adequate tribal consultation.
“The State’s effort to centralize their managed care system and eliminate an essential tribal program represents an infringement on our tribal sovereignty due to outside decision making,” said Tribal Chief Eric Thompson on behalf of the Tribal Council. Chief Thompson added, “The State’s Medicaid Redesign directly impacts a vulnerable segment of the Akwesasne community by preventing the Tribe from seeking reimbursements for local services that tribal members with a developmental disability receive through our Family Support Program.”
For the past two years, efforts have been undertaken by the Tribe to provide the State with a thorough understanding of its Family Support Program, which is a “Fee for Service” operation whose work with approximately 89 clients incorporate services that are reimbursable through Medicaid. The tribal program bills Medicaid and receives approximately $2.7 million annually for its trained staff of 70 to provide specialized services to an individual dealing with a developmental disability. The Medicaid Redesign failed to include the Family Support Program as a service provider, which would have jeopardized the program’s funding and ongoing operation.
“The Saint Regis Mohawk Tribe’s disabilities services are amongst the most comprehensive on a rural, local, and tribal level across the entire country,” said Community and Family Services Director Wilfred Bay. He added, “Education, awareness, and protection of our disabled and vulnerable populations are some of our significant priorities and remain so moving into 2017.”
As a result, on Seskéha/August 1, 2016 a New York State delegation visited Akwesasne at the invitation of the Tribe to view the components and services provided by its Family Support Program. It was accompanied with a proposed joint agreement to ensure the tribal program’s ongoing operation through a “Tribal/State Disabilities Compact’ that guarantees the following: rates of reimbursement, listing the Tribe as an “In-Network Service Provider,” maintenance of local Medicaid Service Coordination and Span of Services, local eligibility determination, accommodation of tribal interests in future NYS Waiver Applications, and direct and meaningful tribal consultation.
The two State agencies, DOH and OPWDD, responded in a joint letter on Kentenhkó:wa/November 1, 2016 agreeing to multiple commitment areas, which helps ensure the tribal program’s ongoing delivery of services. It includes an agreement for the continuation of fee for service reimbursements through the State’s new managed care system by recognizing the Tribe as an “In-Network Provider,” as well as a “rural exception” rule that allows for the continuation of in-house case management services for tribal clients. A formalized Tribal/State Disabilities Compact that will address remaining issues is continuing to be sought through ongoing consultation.
“We are very proud of the work that has been done by our Tribal Council, Office of the Executive Director, Legal Department, and our internal working group,” said Bay. He noted, “Their active efforts and support over the past five years has resulted in State commitments that assures protection of our programming and staffing within the State’s redesigned managed care system.”
PHOTO CAPTION: Efforts by the Saint Regis Mohawk Tribe to protect nearly $2.7 Million in Medicaid funding for its Family Support program were successful. Pictured are 11 adult clients of the Family Support Program who received special recognition during Disabilities Awareness Day held at Generations Park on August 19, 2016. They include Mike Montour, Kevin Montour, Darryl Ransom, Chris Herne, Arthur Herne, Frank “Dexter” Herne, Michael Kelley, Kevin Wheeler, Steven Jacobs; and teen clients Sierra Francis and Tim Rourke. Joining them are Executive Director Tsiorasa Barreiro and Assistant Directors Starr Thomas and Gloria Herne.
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The Saint Regis Mohawk Tribal Council is the duly elected and federally recognized government of the Saint Regis Mohawk People.