LeadingAge NY Welcomes New Health Commissioner Mary Bassett with Plan for Revitalizing Long Term Care

LeadingAge NY welcomed the State's newly appointed Health Commissioner, Mary Bassett, M.D., with a letter and a policy brief detailing a plan for revitalizing the long term care (LTC) system. The letter urges the Commissioner to take five steps to strengthen LTC and alleviate the workforce shortage in the short term:

Raise Medicaid and State Supplement Program (SSP) Congregate Care Level 3 rates to support competitive wages for personnel and cover COVID-19-related cost increases across the LTC continuum;
Provide an immediate infusion of Medicaid funding for nursing homes to enable them to remain viable through the end of the fiscal year and prevent further erosion of the not-for-profit sector, while drawing down enhanced federal matching funds;
Reduce Health Emergency Response Data System (HERDS) reporting and reconsider other administrative requirements that divert providers from resident and patient care and do not contribute materially to pandemic response or quality;
Exclude capital reimbursement and grants from the nursing home minimum direct care spending calculation to allow homes to invest in more homelike and COVID-19-safe environments; and
Expand training and education opportunities for aides and nurses and eliminate regulatory barriers to obtaining and retaining nursing licenses and aide certifications.

The policy brief details the challenges facing LTC providers as a result of years of underfunding. It calls for a renewed focus on LTC policy through a multi-pronged, interagency effort that includes Medicaid dollars, other state and federal funds, regulatory reforms, and engagement in workforce development. It urges the adoption of LTC policies that prioritize health equity in all dimensions, guided by the following principles:

Promoting access to high-quality providers and choice of setting at all levels of LTC.
Supporting a well-qualified, appropriately compensated workforce to meet the needs of our growing population of older adults.
Driving quality and value across the LTC continuum through reliable, timely, and additive incentives.
Strengthening integration and coordination of services across payers (i.e., Medicare and Medicaid) and along the care continuum.
Targeting high-priority social determinants of health for older adults.

The policy brief advocates for a substantial investment of Medicaid dollars to achieve these goals, including a combination of:

Medicaid rate enhancements and targeted funding pools;
the $17 billion Medicaid 1115 waiver under development; and
the Home and Community-Based Services Enhanced Federal Medical Assistance Percentage (HCBS eFMAP) and federal Build Back Better funds if they become available (note that Build Back Better does not appear to provide a meaningful investment in nursing home care).

It requests that the State’s new 1115 waiver demonstration focus on LTC to address the needs of our growing older adult population that has been so disproportionately affected by the pandemic. It further urges the State to distribute the HCBS eFMAP equitably in a manner that supports choice and access across the state’s diverse communities and various HCBS provider types.

Finally, the brief calls for greater collaboration with the Department of Health (DOH) in policy development, pandemic response, and regulatory oversight. LeadingAge NY is looking forward to a productive relationship with the new Commissioner.

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