Situation Report | March 29, 2021
In the lead-up to this week’s state budget finale, on April 1, HCA continues pressing for our “Home Care First” agenda. This includes:
- The restoration of Medicaid funds slated for cuts.
- An alternative package of home care and hospice workforce supports (to replace the Senate’s underfunded wage mandate).
- Our proposed telehealth language.
- A process to reactivate Fiscal Intermediaries that the state Department of Health (DOH) excluded in the Request for Offers process, and to guard against a similar handling of the pending Request for Proposals (RFP) for Licensed Home Care Services Agencies.
Cuomo Administration officials this week stated for the first time that they intend to drop proposed funding reductions in the budget, having “identified over $5 billion in resources available that could be used to restore all of the reductions,” said the state’s Budget Director Robert Mujica early last week.
This ostensibly includes the proposed 50 percent reduction in workforce recruitment-and-retention funds. It also includes the 1 percent across-the-board Medicaid cut that would fall on top of last year’s 1.5 percent cuts — a total impact of 2.5 percent — as well as anticipated restoration of Managed Long Term Care (MLTC) quality funding.
HCA has called for full restoration of the cumulative cuts (i.e., all 2.5 percent in the case of the across-the-board reductions), although reports indicate that the administration is only looking to restore the new amounts (at 1 percent going forward). HCA is urging the Governor and Legislature to hold firm against the proposed cuts and will continue to condemn the persistent erosion of the home care, MLTC, and hospice financial base at a time when more investment is needed to sustain services.
Workforce proposal and aide wages
Other major risks remain, including the Senate’s proposal for a new mandate of home care aide compensation at 112 percent of minimum wage, plus increases in mandatory fringe benefits. HCA appreciates and has called for funding for higher wages and benefits in home care. However, HCA asserts that the Senate bill is a new and underfunded wage mandate, with no provision for sufficient or long-term structural rate support to cover this obligation.
In addition, the Senate’s proposed funding for wages would apply only to Medicaid services, neglecting cost coverage for aide compensation for services under other payors (i.e., Medicare, commercial insurance, and private pay).
HCA has proposed an alternative funding mechanism for wage and non-wage supports in home care, assisted by federal aid and other sources for coverage of Medicaid and non-Medicaid services.
We are also pushing hard for changes to the Governor’s telehealth proposals that open settings, including the home, to virtually any telehealth provider class, which risks overlap, duplication, and conflict in services. The Governor’s proposal also fails to include appropriate updates allowing equitable flexibility and payment for home care telehealth, as compared to other sectors.
HCA has advanced language to mitigate all of these concerns in the Governor’s telehealth proposals and we continue to press for our amendments in the final budget.
Now is your last chance to reach legislative representatives and ask them to: hold firm against the proposed Medicaid cuts; replace the Senate’s home care wage proposal with a more sustainable solution as advanced by HCA; and include appropriate guardrails and equity standards for telehealth.
Please contact your state lawmakers and make an appointment to meet with them this week. All the advocacy instructions you need are on our state advocacy webpage, including the following links and resources:
- Take our Virtual Advocacy Challenge and meet with your Senate and Assembly representatives this week using our legislator look-up tool.
- Watch and share our Home Care First video advocacy campaign. Encourage everyone you know (patients, colleagues, the public) to participate in our Home Care First action campaign, which accompanies the video. Written from the perspective of a “concerned citizen” in the general public, this campaign tells Governor Cuomo and state lawmakers to restore funding and invest in home care.
- Complete our online advocacy campaign on home care workforce supports urging legislators to adopt HCA’s amendments offering a more methodical rate structure for worker supports in place of the Senate’s proposal.
- Please also take our action campaign, written from the perspective of a home care provider representative, calling for the restoration of funds to home and community-based care and dedicated investments for home care’s long term resiliency.