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LeadingAge NY Submits Testimony for Assembly Medicaid Hearing

LeadingAge NY submitted testimony this week to the Assembly Health Committee in anticipation of its hearing on the efficacy and sustainability of the state's Medicaid program. Our testimony focuses on the inadequacy of Medicaid rates, the lack of State support for long term care during the pandemic, and the ensuing workforce crisis. We call for a multi-pronged effort to revitalize the long term care system in the wake of the pandemic, supported by a substantial investment of Medicaid dollars, regulatory reforms, and public and private sector engagement in workforce development and guided by the following principles:

  • Promote Access and Choice: Medicaid beneficiaries should have an array of options suitable to varying levels of acuity and need, lifestyle preferences, and geographies.
  • Maintain a Well-Qualified, Appropriately Compensated, and Ample Workforce: Medicaid rates should support recruitment, retention, and career development of the long term care workforce by enabling payment of competitive wages. Our laws and regulations must also optimize available personnel by allowing them to practice at the top of their scopes and by supporting cross-continuum certifications.
  • Drive Quality and Value: Our policies should incentivize the delivery of high-quality, person-centered care through financial incentives that are reliable, timely, additive, and non-punitive.
  • Strengthen Integration: Our policies should support integration and coordination along the continuum of long-term services and supports and among the primary, acute, post-acute, and long term care sectors so that older adults can transition seamlessly from one setting to another.
  • Target High-Priority Social Determinants of Health for Older Adults: Medicaid should address the social determinants of health (SDH) for older adults through strategies tailored to their unique needs and preferences, including targeted investments to delay the need for higher levels of care; expanded support for unpaid, informal caregivers; and initiatives that forestall reliance on Medicaid coverage for higher-cost services. Affordable senior housing with services is one example of a proven model that accomplishes these goals.

Our testimony also responds to questions posed in the hearing notice regarding the Global Cap and Medicaid Redesign Team (MRT) initiatives. We question the ongoing wisdom of the Global Cap and criticize the elimination of trend factors, the statewide pricing system for nursing homes, and the Managed Long Term Care (MLTC) premium development process. In addition, we express concerns about the impending independent assessor process for personal care services and Consumer Directed Personal Assistance Services (CDPAS).

The hearing was postponed until Nov. 1st due to predictions of severe weather.

Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8838