Recommendations with far-reaching consequences are speeded for state budget adoption without vetting, without transparency, at a time when providers are asked to take on overwhelming roles in the crushing global health crisis
$2.5 billion in proposed state-share funding cuts to Medicaid ($5 billion when federal shares are considered) were swiftly advanced by the state’s Medicaid Redesign Team (MRT) on March 19, within days of the President declaring a federal emergency as COVID-19 reached pandemic levels.
And now, these proposals — seemingly oblivious of the state, national and global emergency — are just as swiftly being queued for adoption in the state budget, just days away from completion.
“We know that time is short to pass a state budget. But that is no reason to advance these proposals heedless of the consequences,” said HCA President Al Cardillo in a statement to the media, noting that COVID-19 “has impaired home care’s workforce capabilities, created new vulnerabilities for patients at home, and brought enormous, unprecedented stresses on the entire health care support system.”
In short, now is not the time to be cutting long term care for elderly and chronically ill New Yorkers who are most at risk.
The MRT proposals, adopted with very little advance notice on March 19, also included several items that were not previously shared or discussed publicly at prior MRT public meetings, including an increase in the current across-the-board Medicaid cuts from 1 percent to 1.875 percent, a request-for-proposals process to limit the number of Licensed Home Care Services Agencies, enrollment caps on Managed Long Term Care, the proposed elimination of MLTCs that are not part of fully integrated models, an independent assessor process for all of home care that could completely reshape the care planning process of home and community-based services, an array of structural changes to the Consumer Directed Personal Assistance Program, $45 million in cuts to worker recruitment and retention funds, and others too numerous to mention.
Many of these would have devastating consequences with dubious cost-savings at a time when HCA has advanced alternative proposals — declined by the MRT — to meet the goals of saving Medicaid dollars and safeguarding the infrastructure necessary to support Medicaid programs and services.
We acknowledge the state’s very serious fiscal imbalances; and forecasts say it will only worsen due to the COVID-19 economic impact. But given that very crisis, and the alternatives already offered, the Legislature should reject MRT proposals which pose long-lasting damage to the home care infrastructure.
HCA appeals to the Legislature to take a stand against this backdoor process of Medicaid budgeting, and against these proposals which would set back New York’s system of long term and community-based care at the very time that elder care needs are growing, and as this national emergency is escalating to potentially unspeakable levels.