New York State Budget

New York State 2017-2018 Budget

Executive budget proposal PHI Position
$255 million for Medicaid providers to cover the increase in the minimum wage PHI strongly supports funding the increase in minimum wage and believes that additional money should be made available to restore home care aide wages to above the minimum wage
Renew Medicaid global spending cap for another year PHI understands the need to keep Medicaid costs in control, but believes there are more effective ways to do so that better accounts for new costs and considerations
Establish the Health Care Regulation Modernization Team to recommend how to update regulations for a variety of health care sectors, including home care PHI strongly supports this proposal, which will allow home care agencies to better situate themselves in a changing health care system

Additional PHI Proposals

In addition to the proposals above, PHI proposes the following items:

  • Create a statewide home care worker advocate – Both workers who want to better understand their rights and providers who want to abide by the law find it complicated, and at times confusing, to do so due to frequent federal, state, and local wage and labor rule changes. A public home care worker advocate, an entity or person who would function as an ombudsman, would ensure that workers and providers can navigate these rapidly changing legal requirements. 
  • Adequately finance the Medicaid system: 
    • Create a high-needs rate cell or stop-loss program –When plans are provided with the same rate for a client no matter their level of care, they are incentivized to enroll clients with low needs in order to maximize their profits. Creating a high-needs rate cell or a stop-loss program would remove this disincentive. 
    • Establish a rate floor for home care services – The state should establish a floor for home care rates, including personal care and consumer-directed services, to ensure providers receive at least the minimum amount required to meet state and federal labor requirements. 
  • Address the home care workforce shortage: 
    • Designate funding for a landscape study on the direct care workforce across the state – The workforce shortage has reached crisis levels but we have mostly anecdotal information. Funding should be allocated to conduct a statewide study of home and community based direct care workers to determine how different areas of the state are affected by this crisis and how to address it. 
    • Establish a direct care workforce data system - The landscape study should be the first step in creating a direct care worker data system that tracks issues such as vacancies, turnover, retention, training, and other workforce measures. This will enable New York to monitor workforce needs and determine when it needs to intervene. 
    • Simultaneously make funds available for pilot programs addressing the workforce shortage – No one solution will completely solve the workforce crisis. One way to begin addressing the crisis is to make funds available for pilot programs that use innovative solutions to recruit and retain home care aides.

Other Executive Budget Proposals

There are a number of other proposals included in the executive budget that may indirectly impact home care workers:

  • Change MLTC eligibility – Reduces MLTC eligibility from needing 120+ days of long-term care services to needing a nursing home level-of-care 
  • Carve transportation out of MLTC benefits – MLTC plans would no longer administer enrollees’ transportation benefits 
  • Prohibit MLTC plan from marketing – Would no longer allow MLTC plans to actively market to potential clients 
  • Continue to fund the Health Care Facility Transformation Program – Provides $500 million, with $30 million earmarked for community-based organizations 
  • Expand Commissioner of Health’s power if changes in federal Medicaid funding – The Commissioner currently has “superpowers” to reduce spending if Medicaid spending exceeds the cap. This provision proposes to expand these “superpowers” in the case that federal Medicaid funding changes.

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