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HCA President Al Cardillo Testifies at Senate Workforce Hearing 

HCA calls for provider and worker investments, regulatory relief, and actions to stop dislocations caused by LHCSA/FI RFO process 

HCA President Al Cardillo testified yesterday at a daylong state Senate hearing on long term care workforce challenges, offering solutions drawn from HCA’s extensive legislative proposals and new recommendations for home care provider and worker investments.

“The pandemic has left home care in a dire worker shortage,” said Cardillo in his prepared remarks. “Immediate support is needed. We ask your urgent action to help these agencies and workers who provide for New York’s medically needy and vulnerable individuals every day.”

Witnesses at yesterday’s hearing included nearly 40 individuals or groups representing associations, providers, workers, unions, families, and coalitions concerned with chronic workforce shortages in home care, assisted living, and nursing homes.

Cardillo cited the well-documented need for home care services in New York State based on demographic data as well as HCA reports showing chronic workforce recruitment-and-retention challenges, lost workforce capacity in the COVID-19 pandemic, increased patient care referral demands, and trailing levels of state reimbursement.

“The need for both immediate and progressive structural solutions is critical,” he said. “It will require a commitment to developing and maintaining the structural capacity of the system,” including rates and compensation for worker salaries, benefits, and agency operations, recruitment-and-training investments, professional supports, and regulatory relief from “procedures that are counterproductive to the workforce and to worker and agency efficiency.”

FMAP Investments 

Cardillo specifically noted the importance of $1.6 billion in enhanced Federal Medical Assistance Percentage (FMAP) share dollars to New York State that could rise as high as $5 billion, calling for direct state investment in agency capabilities to provide: increases in compensation and benefits, hiring incentives, longevity bonuses, COVID-19 service recognition, and enabling agencies to provide for workers’ essential occupational supports.

However, he also cautioned that these investments and objectives must be recurring, beyond the one-time infusion of FMAP funds, with a long-term state commitment of dedicated resources.

Also, these investments should cover home care’s systemic needs as broadly as possible, without regard to payor silos; and under no circumstances should they assume the form of a wage mandate, Cardillo said, given that such mandates often become permanent statutory obligations without a promise of permanent funding support.

Please see HCA’s prepared testimony here for bullets outlining our recommendations in further detail.


Cardillo also warned lawmakers about the dangers of the state Department of Health’s (DOH) Licensed Home Care Services Agency (LHCSA) Request for Offers (RFO) process and the need for reforms of the Fiscal Intermediary (FI) RFO for quality FIs who were excluded by DOH. As HCA did repeatedly throughout the state legislative session this year, Cardillo again called for repeal of the pending LHCSA RFO that “risks massive workforce and service dislocation” as well as modifications to the FI RFO “to preserve current, quality FIs that are supporting workers and patients.”

HCA has already advanced these proposals in various forms throughout the recent state legislative session. However, yesterday’s hearing provided an important platform for focus and public attention on these critical issues and recommendations that we will continue to advance with key legislative offices.

Please stay tuned for further information on how you can help HCA advocate for these critical areas of need.