HCP STATEWIDE LEGISLATIVE BRIEFING FOR THE 2020 STATE BUDGET - - PDF document

2/13/2020 New York State Association of Health Care Providers, Inc. (HCP) 1

HCP STATEWIDE LEGISLATIVE BRIEFING FOR THE 2020 STATE BUDGET

Thursday, February 13, 2020 For HCP members only

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Kathy Febraio, CAE HCP President/CEO Kevin Kerwin HCP Vice President of Public Policy Robert Reid, Partner Reid, McNally, & Savage

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Political Landscape in Albany

• In the Senate, Democrats, which already have a 40-22 majority(one

vacancy), are looking to gain additional seats with Republican retirements across the state but particularly in Upstate New York

• Republican Senate Retirements

Ken LaValle-1st Senate District Rich Funke-55th Senate District Betty Little-45th Senate District Joseph Robach-56th Senate District George Amedore-46th Senate District Chris Jacobs-60th Senate District Robert Antonacci-50th Senate District Michael Ranzenhofer-61st Senate District James Seward-51st Senate District

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Political Landscape in Albany

• In the Assembly where all 150 members (105 Democrats) are up for re-election in

2020, a large number of Democratic members across the state are increasingly facing a primary election which is set for June 23rd. The focus for many is not the Albany Budget but their district politics!

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Governor’s Budget

• In November 2019, the Governor estimated

2020-21 budget shortfall at $6.9 billion, but higher than expected tax receipts have reduced that number to approximately $4.9 billion. The Governor proposes closing that gap by convening a new Medicaid Redesign Team to identify $2.5 billion in savings, changes to local assistance programs saving $1.8 billion, identifying $400 million in state agency savings, and another $250 million in miscellaneous savings.

• 1% Medicaid Cut
• Other Budget Policies of Interest
• Paid Sick Leave
• Gig Workers misclassification commission

“Medicaid is the Elephant in the Room,”

Senate Finance Chairperson Liz Krueger

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Medicaid Budget

• No details
• Creation of Medicaid Redesign Team
• Cut $2.5 Billion
• No impact on recipients
• Need for more revenue
• “Spending on Managed Long Term Care has tripled between

the 2013 and 2019 fiscal years, a $4.8 billion increase” State Budget Director, Robert Mujica

• Target : Long Term Care

(Home Care, CDPAS, Nursing Homes)

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MRT II

• Membership
• Co-chair: Michael Dowling, President and CEO of Northwell

Health

• Co-chair: Dennis Rivera, Former Chair of SEIU Healthcare
• Dr. Steven Corwin, President and CEO, New York Presbyterian
• Thomas Quatroche, PhD, President and CEO, Erie County Medical

Center

• LaRay Brown, CEO of One Brooklyn Health
• Mario Cilento, President of New York State AFL-CIO
• Christopher Del Vecchio, President and CEO of MVP Health Care
• Pat Wang, President and CEO of Healthfirst
• Emma DeVito, President and CEO of VillageCare
• Wade Norwood, CEO of Common Ground Health
• Steven Bellone, County Executive, Suffolk County

First meeting: February 11 Report by Budget deadline: April 1

• T.K. Small, Director of Policy at Concepts of Independence
• Donna Colonna, CEO, Services for the

UnderServed (S:US)

• Todd Scheuermann, Secretary of Finance, NYS Senate
• Blake Washington, Secretary of Ways and Means, NYS

Assembly

• Paul Francis, Deputy Secretary for Health and Human

Services, Governor's Office

• Dr. Howard Zucker, Commissioner of Health
• Dr. Ann Sullivan, Commissioner for the Office of Mental

Health

• Arlene González-Sánchez, Commissioner of the Office of

Addiction Services and Supports

• Dr. Theodore Kastner, Commissioner of the Office for

People With Developmental Disabilities

• Robert Megna, Senior Vice Chancellor and COO, SUNY

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MRT II

Areas where Medicaid Course Correction may be needed

• Long Term care and CDPAS:
• 13% enrollment growth in MLTC is much faster than demographic trends would indicate;
• 75% of MLTC costs reflects personal care – and personal care costs are growing in Mainstream Managed care as well;
• CDPAP is a key driver of growth – projected to grow by over 800% from CY 2016 to CY 2021.
• Distressed Hospitals and other Supplemental Payments
• Prescription Drugs: Pharmacy Benefits were moved into Managed Care following MRT I, but unfortunately

costs have increased again due to high cost drugs, PBM spending, and other factors.

• Transportation
• Care management including health homes
• Few Dual Eligibles are Enrolled in Integrated Plans

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MRT II

Long Term Care Advisory Group The MRT indicated an Advisory Group would be created to generate ideas and proposals on long term care. The Advisory Group will present a summary of proposals to the MRT II at its second meeting (March 4). The members of the Long Term Care Advisory Group have not yet been announced.

• Proposals for the LTC Advisory Group are due no later than 12:00 PM on or about February 21st

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HCP Testimony

• Highlights
• Invest in home care.
• Rollback budget cuts.
• Growth in the long term care sector is inevitable, beyond the control
• f providers.
• Rates provided for state funded programs do not cover living wage or

minimum wage requirements.

• Home care is less costly than other forms of care.
• Concern over the impending CDPAP catastrophe.
• Licensing moratorium and contracting limits are adversely affecting

providers ability to do business.

• No trend factor increase in 10 years.

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HCP Leadership Advocacy Day

• HCP leadership was able to meet with legislators days after the Governor’s

Budget Proposals.

• Message: Invest in Home Care!
• Discussions surrounded the MRT II and growth in long term care – particularly

personal care services.

• HCP met with over 10 legislative leaders in Health and Finance policy areas.
• Leaders recognized the critical importance of the Home Care Industry.
• Foundation laid by HCP Leadership and continuing efforts by HCP’s Public

Policy Team will allow HCP’s Advocacy Day to drive home the message that the State needs to Invest in Home Care!

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HCP Advocacy Day: February 25

• Home Care Saves Money
• Home care in New York is significantly less costly than alternatives.
• Monthly cost of a Semi-Private Room in Nursing Home: $11,756 Home Health Aide monthly cost: $4,957
• Usage Rates
• 265,214 individuals 21 years old and over receive Home and Community Based Care through New York's Medicaid Program.
• Turnover in Home Care
• Turnover in Home Care Alarmingly, recent data on turnover rates among care givers has been reported as high as 82%.
• Need for In-Home Care is Critical
• The number of adults age 65 and over is expected to increase by 50 percent between 2015 and 2040 in New York; that number is expected to double for

adults over the age of 85 during the same time frame.

• Inadequate Reimbursement
• In a recent HCP member survey, 55% of respondents reported having been offered contract amendments with rates that do not cover the cost of minimum

wage.

• Care at Home is the Preferred Option
• 90% of people 65 and older say they would prefer to receive care in their own homes as long as possible.

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HCP Advocacy Day : Bring Your Data!

• How many patients do you serve?
• How many people do you employ?
• What programs do you provide services in?
• What’s your rate of turnover?
• What is your turn-away rate for new referrals?
• How long has your agency been in business?
• How long have you been in the industry?

This information is important to legislators!

This Photo by Unknown Author is licensed under CC BY-SA

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Before Advocacy Day

• Call your legislators and share your story!
• Use HCP’s Find Your Legislators tool in the

Advocacy Action Center under the Public Policy section on the HCP website.

• https://www.nyshcp.org/NYSHCP/Public_Poli

cy_Tab/Find_Your_Legislator_Widget.aspx

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Questions?

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