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Legislative Bulletin: Budget Negotiations Progressing

Budget Negotiations Between Governor and Legislature Making Significant Progress

Despite a midweek setback that prompted members of the Senate to leave Albany, budget negotiations between Governor Cuomo and legislative leaders have made significant progress. A tentative deal resolving the sticking points of charter school funding, raising the age of criminal responsibility to 18, and 421-a housing subsidies was reached on Thursday, and the Assembly reconvened for what was shaping up to be a “long day” on Friday. Six of the ten budget bills have now passed both houses, with the Revenue and State Operations bills still outstanding. Most of the issues relevant to LeadingAge NY members have been addressed, including several of our priorities:

  • Nursing Home/High Needs Rate Cell: Although statutory language related to a nursing home rate cell was not included in the budget extender bills passed on Monday, we understand that there is an agreement that the Department of Health (DOH) will seek CMS approval of a “high needs rate cell(s)” that will include nursing home residents.
  • Nursing Home Bed Hold: The budget eliminates hospital bed hold payments entirely, while maintaining 10 days of therapeutic leave per 12-month period reimbursable at 95 percent of the Medicaid rate. It makes permanent the bed hold-related cut reflected in current Medicaid rates and requires that it result in $18 million in annual savings. The provision is effective April 1, 2017.
  • MLTC Transportation: The budget rejects the Governor’s proposal to carve transportation out of the MLTC benefit package.
  • Capital and Services Funding for Senior Housing: We are pleased to report that the budget includes $125 million for the development or rehabilitation of 100% senior housing targeted to low income seniors, aged 60 and above. This is an important victory – thank you for your advocacy efforts!
  • Capital for Health Care Transformation: The budget allocates a total of $500 million for the Statewide Health Care Facility Transformation Program, with $75 million going to community based providers (including home care) for capital and non-capital projects.
  • SSI Increase for ACFs: LeadingAge NY has been working hard to obtain an increase in the SSI rate for adult care facility (ACF) residents, with persistent advocacy efforts and joint efforts with other stakeholders. At the moment, this remains an outstanding issue.

In addition to the appropriations and legislation, the health budget agreement includes a “side letter” between the Governor and both houses of the Legislature. While LeadingAge NY has not seen the text of the side letter, we understand that it documents DOH’s agreement to:

  • Explore separate managed care rate cells with CMS covering the nursing home, high cost/high need, and Health and Recovery Plan (HARP) populations.
  • Improve the transparency of managed care rates by sharing with the Legislature:
    • Overview and updates on recent managed care rate packages/adjustments on a quarterly basis;
    • Actuarial memoranda; and
    • Monthly managed care policy and planning meeting materials.
  • Establish a work group on the Uniform Assessment System (UAS) tool that will include representatives of DOH, the Legislature, and health care stakeholders.
  • Delay the transition into managed care of individuals enrolled in the Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) waivers until Jan. 1, 2019.
  • Continue the School Based Health Center carve-out from managed care until July 1, 2018.
  • Maintain the current level of Essential Plan enrollee cost sharing for State Fiscal Year (SFY) 2017-2018.

LeadingAge NY has also learned that while the final budget does not include the proposed statutory change to ensure that Medicare is the primary payer for hospice services, DOH intends to generate the same level of savings by providing guidance to providers and plans on best practices for billing.

Over Spring Break, Please Engage Your Lawmakers on Priority Action Items!

With legislators back in their districts for the next two weeks and the bulk of the budget complete, now is the time to begin engaging them on our other priority issues. Please call your lawmakers and set up meetings in their district offices or on your campus. You may want to consider meeting with them in their offices and then inviting them to visit your organization.

  • CCRC Revitalization Act: Continuing Care Retirement Communities (CCRCs) provide a full range of services, including independent housing, ACF/assisted living, and nursing home care to residents in a campus setting as their needs change. While the number of CCRCs has grown considerably across the nation, only 12 CCRCs are currently operating in New York. Comprehensive statutory and regulatory reforms are needed in order to modernize the state's CCRC laws and eliminate barriers to their development, expansion, and efficient operation. A.6450 (Schimminger)/S.5172 (Hannon) would ensure that this important long term care model is available to seniors in New York. Click here to access LeadingAge NY’s memo of support and here to send a pre-written letter directly to your lawmakers.
  • Role of the Nurse in an ACF: A.2736 (Gottfried)/S.4398 (Hannon) would allow all ACFs and assisted living providers that employ nurses the option to provide nursing services directly. This is vital to prevent unnecessary spending for your facility. Click here for LeadingAge NY’s memo of support and here to connect with your legislators.
  • Integration of Individuals with TBI: A.1425 (Jenne)/S.517 (Young) would allow the integration of individuals with a traumatic brain injury (TBI) sustained after the age of 21 into programs within the developmental disabilities service sector. It would ensure that individuals with a TBI living in urban, underserved, or rural areas, where caregiver shortages and a lack of TBI community resources often lead to placement into nursing homes, receive the support and services they need. LeadingAge NY’s memo of support is available here, and you can reach out to your lawmakers here.
  • Nurse Staffing Ratios: A.1532 (Gunther)/S.3330 (Hannon), known as the Safe Staffing for Quality Care Act, would create specific staffing ratios for nurses and other direct care staff in hospitals and nursing homes at a cost of approximately $1.06B to nursing homes statewide. LeadingAge NY is strongly opposed to this legislation and has developed this cost template to assist you in determining its financial impact on your facility. Click here for LeadingAge NY’s memo of opposition and here to contact your legislators.

Federal Advocacy Alert: Connect With Your Congressional Representatives During April Recess

Like their counterparts in the Assembly and Senate, members of Congress will be back in their districts on recess from April 10th to 21st. This is a great opportunity for you to continue your federal advocacy efforts. LeadingAge National and LeadingAge NY urge you to reach out to your representative, as well as Senators Schumer and Gillibrand, and ask that they:

During the recess, we encourage you to invite your representative to tour your community or schedule an appointment to meet with them in their district office. You can also attend scheduled town hall meetings and voice your priorities or concerns there. LeadingAge National’s “How to Host Your Lawmaker” toolkit, which includes sample letters, issue briefs, and other resources to help you coordinate a successful congressional visit, is available here. In addition, LeadingAge NY’s federal issue brief, which we shared during our visits with the New York congressional delegation at last month’s PEAK Leadership Summit, can be accessed here.

Governor Launches Third Round of New NY Broadband Program

Last week, Governor Cuomo launched the Request for Proposals for the third and final round of the New NY Broadband Program, which aims to provide high-speed Internet access to all New Yorkers by the end of 2018. Per the Governor’s statement, Round III will target “all remaining unserved areas across the state, seeking to provide access to high-speed broadband to even the most rural upstate communities.” Click here for more information.

Senator Latimer Announces Candidacy for Westchester County Executive

Lastly, Senator George Latimer announced on Monday that he will run for Westchester County Executive this fall against two-term incumbent Rob Astorino. His campaign will focus on “issues such as fiscal soundness, infrastructure, environmental protection, fair taxation, long-term planning, and fighting opioid addiction.”

The Senator will first face off against Westchester County Legislator Ken Jenkins for the Democratic nomination at the party's May 10th convention. He has said, however, that he will not force a primary if he falls short in his bid.

Contacts:

Ami Schnauber, aschnauber@leadingageny.org, 518-867-8854

Jeff Diamond, jdiamond@leadingageny.org, 518-867-8821

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