State Budget Proposes Medicaid, Workforce Recruitment Cuts Amid Ongoing COVID-19 Siege

Capitol Report | January 2021

Governor Cuomo this month issued a state budget proposal amid an unprecedented fiscal deficit of $15 billion.

The Governor’s plan is based on assumptions that New York will receive at least $6 billion in federal aid to partly cover that gap. But even with such a large infusion of funds, which is far from given, the budget still nevertheless calls for cuts.

These include across-the-board Medicaid spending cuts and reductions in workforce recruitment-and-retention investments that home care and hospice programs have long relied upon — and now more so at a time of continuing crisis-level staffing challenges which have only worsened in the COVID-19 pandemic.

Indeed, according to our most recent surveys, 65% of home care agencies have experienced an increase in referrals to home care as hospitals seek help with decompression or as patients look for an alternative to nursing home care. Yet 76% of these home care agencies say that the lack of workforce fundamentally challenges their ability to meet referral demands.

What’s more, almost half of home care agencies report a decrease of 11% or more in their home health or personal care aide workforce capacity since the start of the public health emergency, exacerbating prior workforce challenges.

These emergent conditions demand state and federal action as part of the COVID-19 response: namely, an immediate infusion of home care workforce and provider support to serve patients during the public health emergency.

While the severity of the budget crisis understandably necessitates unprecedented actions — like calls for billions in federal aid or dramatic revenue and spending‐containment measures — HCA will look to work with state officials to shape constructive budget solutions.

We are prepared and eager to brief your office further on the specific budget provisions for home and community-based care, their impact, and some of HCA’s solutions for cost-savings that leverage home care as an opportunity area for reform.