New York State’s Care Coordination Organizations (CCOs) are the foundation of the care system for people with intellectual and/or developmental disabilities (I/DD).
For individuals and families navigating complex Medicaid and service delivery systems, care managers — provided through CCOs — are their primary point of contact. Care managers connect individuals and families to healthcare, behavioral health services, housing, employment services, and long-term supports.
By coordinating access to preventive services, CCOs and care managers help keep individuals with I/DD out of hospitals, shelters, and other crisis centers.
CCOs are the only entities in the State that provide this critical coordination function for people with I/DD and are required for people to access the Medicaid waiver. This role is not duplicated elsewhere in the system.
For the first two years of the Targeted Inflationary Increase (TII, previously known as COLA), CCOs and their care managers were included. In the current New York State FY 2026–2027 Executive Budget proposal, CCOs are excluded.
If this funding is not restored, providers will struggle to retain staff, manage increasing costs, and continue delivering high‑quality care to people with I/DD.
We are asking the Legislature to restore CCOs to the TII so that care management agencies can:
- Maintain a stable workforce.
- Address rising operational costs.
- Continue providing essential coordination services to 135,000 New Yorkers with I/DD.
CCOs are workforce-driven organizations with minimal property or transportation overheads. That means their rising costs are overwhelmingly tied to retaining qualified care management staff.
Without the TII restoration, workforce pressures and service instability will continue to grow. This will directly impact individuals and families who rely on care managers as their primary system navigators.
Key Legislative Priorities
In addition to restoring CCOs to the TII, we are asking lawmakers to advance key legislation that will strengthen workforce capacity and continuity of care for people with I/DD.
Expand Medication Administration by Trained DSPs (A.7284 McMahon / S.6334 Fahy)
This legislation will:
- Clarify and expand existing authority so trained direct support professionals (DSPs) can administer medications, tube feeding, and diabetic care when individuals cannot safely self-administer.
- Include strong safety guardrails, including Office for People With Developmental Disabilities (OPWDD) clinical protocols, annual certification, and limits consistent with nursing scope of practice.
- Improve continuity of care, reduce service disruptions, and help address workforce shortages without compromising safety.
When medication administration is unavailable, individuals with I/DD risk losing services or experiencing unnecessary hospitalizations. This legislation will help people with I/DD remain safe, stable, and supported in their communities.
Expand Medicaid Coverage for Family Caregiver Services
This proposal:
- Authorizes Medicaid reimbursement for eligible family caregivers of children with I/DD who provide specified in-home services.
- Recognizes the essential role families play in sustaining community-based care.
- Helps prevent institutionalization while supporting family stability.
