Legislative Bulletin: One Month Remaining of State Legislative Session

May 16, 2025

Summaries of Final State Budget and Thank You to LTC Champions!

At the end of last week, the New York State Legislature approved the final spending plan for State Fiscal Year (SFY) 2025-26. All budget bills have now been passed by the Legislature, and many of the bills have been signed into law by the Executive. LeadingAge New York has issued two quick, high-level summaries of final budget measures most relevant to our membership. Both of those summaries, as well as a press statement from LeadingAge New York are available here.

A comprehensive Final Budget Memo, covering all member service lines, will be shared with members directly via email later today. In addition, once posted, members may find LeadingAge New York’s Final Budget Memo on our website here.

LeadingAge New York is aware that the final budget does not provide the level of funding for older adults and medically vulnerable individuals that is so needed and deserved. Despite our best collective efforts, the outcomes are disappointing. The budget’s Medicaid rate increases for long-term care are better than additional cuts, but the combination of modest new investments, unforeseen payroll tax increases and lingering cuts to capital funding equate to a final budget that maintains the status quo.

Still, the advocacy of LeadingAge New York, our members and our network of advocates over the last several years is having an impact. Two years ago, we were fighting uphill advocating against $1B in long-term care cuts proposed by the Executive. Thanks to consistent member advocacy, this year we started with investments instead of cuts, allowing us to have more productive conversations with legislators about protecting proposed investments and building upon them to create the long-term care sector that aging New Yorkers deserve. Thanks to the engagement of our members, we have acquired stronger advocacy allies within the Legislature and regional communities than ever before, and consumers are increasingly aware of how crucial Medicaid funding is to the availability of quality long-term care services.

The shortcomings in this year’s budget simply signal that we must continue to advocate and educate, to build upon our momentum and strengthen our network of advocates and champions in the Legislature. This is particularly important as we still have one month of this year’s legislative session, and lawmakers are considering the passage of hundreds of proposed bills.

If you have not done so already, please take a moment to thank your legislators and legislative champions for the investments provided in the budget, while also pointing out that more is needed. This is an opportunity to continue to grow member-legislator relationships, while also urging them to reject any bills that would impose additional burdensome and costly requirements.

Please take a moment to thank your State legislators for their support:

Find your legislator's email contact information here.
Use this template thank you email (download) to send your legislators a note of thanks, while urging them to oppose problematic legislation that may arise through the remaining weeks of session.

Please note that this thank you focuses on nursing home budget measures. However, it can be easily tailored to better reflect your organization’s priorities, while still emphasizing the need to reject harmful legislation that might be under consideration.

Thank you, again, for your advocacy throughout this budget cycle! We encourage you to continue to advocate with us on state legislative activity, as well as Federal budget reconciliation measures being considered by Congress. Several areas of advocacy needed are listed below.

BILL ON SENATE HEALTH AGENDA: Oppose Enhanced Penalties on Long-Term Care Providers

A piece of legislation which LeadingAge NY strongly opposes has been added to the Senate Health Agenda for next week. The bill, A.1118 (Paulin)/S.5744 (Cleare), would raise the maximum penalties for violations of the Public Health Law. These enhanced penalties would apply to any individual or organization that violates the Public Health Law. The bill’s memorandum, however, focuses on the impact of the bill on long-term/post-acute care (LTPAC) providers. Unfortunately, the bill has advanced to the Assembly Calendar, which means it could be called up for debate and a vote on the Assembly floor on any session day. Now, the bill is also moving in the Senate.

In short, this bill could increase State and local health fines from the current range per violation of $2,000 to $10,000, raising fines to a range of $3,000 to $20,000.

We must advocate against this bill NOW if we want to stop it from advancing further. Click here to contact your legislators urging them to reject an increase in penalties for nursing homes and other LTC providers!

In addition, if your State Senator sits on the Senate Health Committee, we recommend you call their Albany office to vocalize your concerns, and explain why your organization cannot endure more hefty penalties amidst inadequate reimbursement. Please use the above digital letter content and our memo of opposition to inform your conversations. Reach out to LeadingAge NY policy team if you have any questions.

Call Assembly Members: Oppose Requiring Written Consent for Antipsychotic Medications

Another piece of legislation which LeadingAge NY opposes advanced out of the Assembly Codes Committee this week and has been added to the Assembly Floor Calendar. This means the bill could be called up for a vote, and passed, on any upcoming session day. The bill, A.1461-A (Paulin)/S.893-A (Sepulveda), would require an enhanced level of informed consent before antipsychotic medications can be prescribed for residents of skilled nursing facilities (SNFs). The legislation makes two major changes to state laws in an effort to reduce the use of antipsychotic medications:

Requires health care professionals to receive written consent from the resident or the resident’s “lawful representative” before initiating an antipsychotic medication; and
Requires that written consent be renewed every 12 months.

LeadingAge New York supports the goal of this legislation – to further reduce the inappropriate use of antipsychotic medications in nursing homes. However, the strategy this bill would deploy – enhanced consent in writing – is misguided and could negatively impact residents and families.

It is reasonable and appropriate to require oral consent; however, written consent poses barriers to care for residents of nursing homes and their families. In addition, there are already ample federal and state guardrails in place to safeguard against the unnecessary use of antipsychotics.

TAKE ACTION NOW: Please click here to email elected officials in opposition to this legislation!

In addition, we encourage members to call your Assembly Member’s Albany office to vocalize your opposition to this bill – especially if your State Assembly Member sits on the Assembly Codes Committee! LeadingAge NY memo of opposition is available here.

Please call your Assembly Member with the below talking points on the antipsychotic bill.

I am calling you today to oppose A.1461-A, a bill that requires nursing homes to obtain written consent prior to prescribing and administering antipsychotic medications.
I am with XXX organization, serving the XXX region of New York.
To be clear, it is important for residents and families to provide informed consent for the use of these medications.
However, requiring written consent would impede nursing home residents’ access to necessary medications and cause distress for residents and their families.
Generally, nursing home residents or their authorized representatives provide oral consent to treatment, after discussing treatment options with the nursing home’s clinical team. Their oral consent is then documented by the clinical team in the medical record.
There are ample state and federal regulations that deter the use of unnecessary antipsychotics and ensure informed consent, while ensuring access to effective treatment for individuals who need them.
However, requiring residents or their representatives to sign a written consent document, as this bill proposes, will create unnecessary barriers to care for residents whose representatives do not visit the facility frequently or are unable to manage digital signature documents, as is often the case for the family members who make health care decisions for nursing home residents.
Please oppose this bill in its current form (Version A). Request the bill be amended to remove the requirement that consent be provided in writing and renewed every 12 months.

Please make phone calls to Assembly offices as soon as possible!

Threats Re-emerge as Congressional Budget Reconciliation Process Continues

Over the course of the last seven days, Federal budget reconciliation bills have been printed, marked up, and debated at length. Speaker Mike Johnson (R-LA) held meetings May 15 with multiple factions within the Republican caucus trying to iron out final details. One unfinished item, changes to the state and local tax (SALT) deduction cap (SALT cap), which is of particular importance to House Republicans in New York, New Jersey, and California. How the SALT cap will be addressed by the reconciliation bill is still under debate. Since raising the SALT cap will cost money, others in the Caucus are demanding more savings. Those that want more deficit reduction in the bill also feel from an ideological perspective that the Medicaid cuts are not deep enough.

One path forward that is under consideration is more Medicaid cuts than were passed out of Energy and Commerce earlier this week, on May 14. Some have suggested that work requirements could take effect sooner than the bill’s current January 1, 2029 implementation date, providing for additional savings. There are also still congressmembers who want more provider tax restrictions and even FMAP cuts, but the change in the implementation date of work requirements and perhaps a few other policies in the existing bill are the most likely.

Procedurally, the House Budget Committee met this morning to package all of the reconciliation pieces together and vote for the whole bill to move forward, but the reconciliation bill failed to pass out of committee on the first vote and discussions are expected to continue over the weekend with another meeting set for Monday, May 19. While more changes are being discussed in order to attain further spending reductions, none of the bills are expected to be changed in the Budget Committee. However, the Budget Committee members from the House Freedom Caucus are saying they will not vote for the bills without concessions (more deficit reduction, including in Medicaid as outlined above). The actual text changes to the bill would happen in the House Rules Committee, which was preliminarily going to meet on Monday, but that meeting may be moved back due to delays in the Budget Committee today.

The timeline of this process, as well as what will be in the final House budget reconciliation bill, remain very much in flux. However, one thing is very clear: we need LeadingAge New York members to continue to advocate with your members of Congress! Please click here to send your representatives a message, reminding them that cuts to Medicaid are unacceptable!

In addition, if you live or work in a Republican congressional district of New York, we urge you to call/contact their office today, over the weekend, or on Monday morning, and remind them of what is at stake if there are any additional cuts to Medicaid. In light of the above recent developments, some Republican Congressmembers need to be reminded that:

the budget reconciliation bill is already harmful for long-term care providers in New York and will likely result in exacerbated challenges for older adults and individuals with disabilities accessing critical services;
changes to retroactive Medicaid eligibility from 90 to 30 days (as proposed by the current bill) will hurt nursing homes. Currently the application process is long, complicated, and occasionally needs to be restarted. A new or re-started application means a new date of application, which is the time to which an approval back-dates eligibility. Reducing the period of retroactive coverage before the date of application will hurt already financially distressed nursing homes in New York as they will have no ability to get paid for more than thirty days before an application is submitted;
Seventy percent of New York’s nursing homes are already experiencing negative operating margins, and New York’s long-term care system is already ill-prepared for the number of aging New Yorkers who will need services. Additional changes of any kind will impact care for older adults;
I urge you – DO NOT concede to more cuts to Medicaid to facilitate SALT relief;
Please don’t vote for this bill that will decimate care for older adults;
Can we count on a no vote on the House floor from the Congress person?

Finally, please join LeadingAge National’s Weekly Policy Pulse Calls to hear about all the latest on the ever-evolving landscape of aging services national policy. The calls are on Mondays at 3:30 p.m. ET. This week’s call covered budget reconciliation bills in depth, and it is likely the May 19^th call will do so as well. If you’re interested in signing up for these members-only calls, please sign up using the link on the National Policy Pulse webpage. Calls are also recorded.

Please Continue to Oppose New Unfunded Mandates on Nursing Homes!

Another bill which LeadingAge NY strongly opposes was recently approved by the Senate Health Committee and was reported to the Senate Finance Committee. The legislation, A.1365-A (Paulin)/S.15-A (Skoufis), would require nursing homes to develop and submit to the Department of Health (DOH) a plan for a designated location for the storage of bodies of deceased persons who pass while living in a nursing home, in the event of a declared disaster emergency. While the bill has been amended to require a plan for emergency response, this legislation will ultimately impose new, costly requirements on most nursing home providers, many of which are already experiencing financial distress.

First and foremost, LeadingAge NY and our members believe that the remains of all individuals deserve the utmost respect and courtesy upon passing, even in an emergency. However, under current and normal circumstances, there is no need for this kind of designated storage in nursing homes. The issues with securing decedents that arose during the COVID-19 pandemic were largely due to insufficient capacity in funeral homes and municipal morgues. As a response to that tragic circumstance, this bill would impose on nursing homes alone, a new and costly responsibility that should instead be borne by state and municipal authorities.

Bill A.1365-A (Paulin)/S.15-A (Skoufis) is now in Senate Finance Committee and has already been passed by the Assembly. Therefore, we must strengthen our advocacy against this new, unfunded mandate on nursing home providers!

Take Action Now: Please click here to email your State Senators and the Governor against this legislation!

In addition, if your State Senator sits on the Senate Finance Committee we strongly recommend you call their Albany office to vocalize your opposition to this bill! You can share our LeadingAge NY memo of opposition to this bill, available here. Talking points on this bill are available in recent editions of Legislative Bulletin.

Contact: Sarah Daly; 518.867.8845; sdaly@leadingageny.org