State Budget Nears Completion: What We Know So Far 

Situation Report | April 5, 2021

State lawmakers are on the cusp of finalizing a state budget this week after reaching a deal with the Governor over the weekend. Parts of the budget were made available over the past few days. HCA is working on our analysis and will provide members with a comprehensive summary as soon as possible.

It is our understanding that the Legislature and Governor intend to restore some of the major proposed funding cuts, including the 1 percent across-the-board Medicaid cut, the 50 percent workforce recruitment-and-retention cut, and the quality pool funds for Managed Long Term Care. However, we await the appropriations bill language to confirm this status and will follow up with the membership.

Upon reviewing the Health and Mental Hygiene Article VII legislation over the weekend, it appears that the Senate’s home care wage mandate proposal (Fair Pay for Home Care Act) is excluded from the final budget agreement, nor is there an alternative version, as lawmakers had been considering.

Hundreds of HCA members participated in our Legislative Action Center campaigns urging the Senate to reconsider its position on the proposed wage mandate, which offered no guarantee of long-term, equitable appropriations to cover the mandate’s cost for providers across all payors, and to urgently adopt HCA’s proactive and positive plan for health workforce funding and support. We look forward to continuing our work with lawmakers on a productive approach for workforce support post-budget.

The budget includes limited telehealth legislation that defines “distant site” as a site at which a telehealth provider is located while delivering health care services by means of telehealth. Any site within the U.S. or its territories is eligible to be a distant site for delivery and payment purposes.

The telehealth provision also removes limitations to the definition of “originating sites,” and adds certified peer recovery advocate services providers that are certified or credentialed by the commissioners of addiction services and Office of Mental Health. Telehealth is among the areas anticipated for further action post-budget, and HCA will continue to press for the adoption of our telehealth safeguards that avoid duplication of services, improve coordination among health care settings, and provide equitable coverage for home care.

Revisions to the Fiscal Intermediary (FI) contractor provisions are also included in the state budget language but more analysis and information are needed to determine the precise implications. The final budget appears to allow for the selection of some additional FIs who meet certain criteria to continue as FIs in addition to those selected under the recent Requests For Offer (RFO) process. HCA is analyzing the language and will provide more information once we obtain clarification.

With several major and often contentious proposals in the mix throughout this process, lawmakers opted for a stripped-down budget that is focused on fiscal essentials. We anticipate a very active post-budget legislation session, where legislative activity can move more independently without the environment of intense fiscal negotiation with the Governor, as the Legislature intends to take up many priority areas outside of the budget’s timeline constraints.

HCA will now direct our focus toward that arena as we position our platform for the post-budget environment to address critical areas set aside from the budget process, including the need for further investment in home care services and workforce, an equitable framework for the provision of telehealth services, regulatory relief, and our overall push for a New York Home Care First policy.

We are still continuing to review the budget language. We also expect additional information throughout the day and will provide further details as our analysis continues.