Legislative Bulletin: State Budget Talks Continue, Marking the Latest Agreement in Over a Decade

April 21, 2023

State Budget Talks Continue, Marking the Latest Agreement in Over a Decade

The state Legislature passed the fourth budget extender of 2023 yesterday, with the spending plan now 21 days late. The $3 billion emergency appropriation is good through Monday April 24^th, when lawmakers will need to either approve a final budget or pass yet another extender as Albany leaders continue to argue over the $227 billion spending plan.

Fortunately and unfortunately, over the last 24 hours additional progress was made on top-priority budget issues that have held up the progression of other budget table conversations. As we have reported the last several weeks, three-way negotiations up until this point have largely been dominated by bail reform and the Executive’s proposed NY Housing Compact. In breaking news yesterday, sources indicated that while the governor appears to have won some of her proposed criminal justice changes, her Housing Compact died when legislators refused to support her plan to allow the state to override local zoning on affordable housing developments. With almost all other housing-related issues now being taken off the table, the controversial proposal known as “Good Cause Eviction,” which would significantly enhance the rights of tenants over property owners, has also fallen out of negotiations. There is already a bill introduced for the 2023-2024 session which would address good cause eviction, indicating that the issue could re-surface in the remaining weeks of this year’s session.

The good news is that progress on these controversial budget topics will mean that negotiations at the health budget table are likely to pick-up at a more earnest pace over the coming days. It is unlikely at this stage that we will see all final budget bills before Monday, however, it is possible that some of the “simpler” final budget bills may begin being printed over the weekend.

This year’s budget is the latest in over a decade, and we thank our members for staying engaged with us through-out this extended process. Your advocacy is critical to obtaining the funding and measures we need to support your work and the needs of older adults! THANK YOU!

ACTION ALERT: Urge Elected Officials to Support LTC in Final 2023-24 Budget!

Now that negotiations on the more controversial state budget issues have begun to resolve, LeadingAge New York expects that health budget talks will ramp-up over the weekend and early next week. This is a critical time to re-ignite our advocacy for our top budget priorities to ensure their inclusion (or omission) in the final state budget agreement!

PLEASE CALL YOUR STATE SENATOR & ASSEMBLY MEMBER AS SOON AS POSSIBLE with the below talking points that are most relevant to your organization. If you are a multi-service provider, we encourage you to discuss all issues with the offices that you call. You can find your legislators’ contact information here. Please call the Albany office and leave a voicemail if someone does not answer the phone.

NH & ADHC MEDICAID TALKING POINTS: Please Provide Meaningful Medicaid Increases to Nursing Homes & Adult Day Health Care!

This year, nursing home families, staff and providers like myself from across the state have been urging for a 20% Medicaid increase for nursing homes.
We have asked for 20% because our nursing home Medicaid rates today are based on 2007 costs. Our rates have not been updated for inflation ever since, despite the fact that costs have risen by 42%, conservatively.
I thank the Legislature for proposing a 10% increase in your one-house budgets, but it’s not enough to make up the Medicaid reimbursement shortfall.
A substantial Medicaid rate increase is a critical first step to enabling us to hire more staff, open more beds, reduce waitlists for care, alleviate hospital gridlock, and ensuring the financial viability of high-quality, non-profit nursing homes like my own.
In addition to this first step, we need a stable, long-term solution. If not, we will find ourselves in this same position again every year.
To solve the root of the problem, the Legislature should require the State to update nursing home Medicaid rates at least every 5 years to better reflect current costs. This can be accomplished with nursing home “rebasing” budget language – as proposed by Assembly Bill A.5905 (Woerner).
Finally, any Medicaid rate increase provided to nursing homes should also be extended to adult day health care programs – the majority of which are sponsored by nursing homes and have struggled to re-open since the start of the COVID-19 pandemic.
Please provide a MEANINGUL Medicaid increase to nursing homes & adult day health care AND include a rebasing measure in the Final NY State Budget!!

ALP BUDGET TALKING POINTS: Assisted Living Programs Need 10-20% Increase in Final State Budget

After 15 years of no inflation adjustment to our Medicaid rates, 3 years of operating in a pandemic, a health care workforce emergency, and significant increases in worker wages and benefits, we NEED you and your colleagues to provide a 10-20% Medicaid increase for Assisted Living Programs in the Final State Budget!
This 20% Medicaid increase is necessary for us to be able to sustainably compete for staff and raise wages.
The ALP is the only Medicaid funded assisted living option in NY. We MUST ensure that Medicaid eligible older adults have options when they can no longer remain at home.
While we appreciate the Legislature’s proposed 10% increase to the assisted living program Medicaid rate, it is not enough to meaningfully address the chronic underfunding and the strains that are being felt throughout the health care continuum.
Include any specifics for your organization RE: the increase in workforce costs, wages, benefits, bonuses, etc.
Finally, we need to update the base year for ALP Medicaid rates - which are currently based on 1992 Nursing Home rates - to bring the rate closer to current costs.
Please urge your colleagues to provide nothing less than a 20% Medicaid increase to assisted living programs in this year’s budget!!

ALR BUDGET TALKING POINTS: Address Assisted Living Residence Quality Reporting Outside of Budget Process

The Executive Budget included an ambitious proposal to develop quality measures for Assisted Living Residences and public posting of information to begin Jan. 2024. (The proposal can be found in Part Z of the Article VII Health and Mental Hygiene Budget bill).
I urge you to omit this proposal from the final budget agreement, and address this issue outside of the budget process.
This initiative simply cannot be done well in the timeframe allotted and the framework offered.
Sufficient time is needed to identify appropriate measures, develop mechanisms to collect the data consistently—and then collect the data for public reporting.
To date, there has been no engagement with the provider community to develop quality measures.
With significant variation in the services offered among Assisted Living providers, varying acuity of residents and subsequent staffing of the different models, this is a complex task.
Careful thought is necessary to ensure meaningful information is available to the consumer.

MLTC TALKING POINTS: Executive Proposals on MLTC Procurement And Enrollment Thresholds

The Executive Budget proposed enrollment minimums and a procurement process for MLTC plans, with the aim of reducing the number of plans offering MLTC services. This proposal would disadvantage smaller, specialized plans sponsored by non-profit long-term care providers. Moreover, this proposal would limit consumer choice and disrupt established relationships between consumers and providers and between providers and plans.
We appreciate the Legislature’s rejection of the procurement in their one-house bills and urge you to stand firm in rejecting the procurement and other performance standards favoring large insurers that focus on non-elderly and non-disabled populations over more specialized MLTC plans.
We also urge you to restore the MLTC quality pool, which incentivizes the delivery of high-quality LTC services and supports value-based payment (VBP) initiatives with LTC providers.
MLTC plans and PACE programs sponsored by not-for-profit LTC providers play a unique role that combines a mission orientation with a wealth of knowledge and expertise in meeting the needs of Medicaid beneficiaries. I urge you to protect the existence of these plans by rejecting the Executive proposals on MLTC enrollment and procurement.

Thank you for your continued advocacy at this most critical time!

Post Our Social Media Messages of the Week!

Now that we believe more in-depth health budget discissions will begin to take place over the coming days, now is a great time to take to social media to apply public pressure on elected officials as they deliberate over a final budget! Below are a few suggested Twitter messages that can be copied and pasted into your professional or personal Twitter page. These messages can also easily be re-purposed for Facebook.

Please take a moment to copy & paste the below message(s) on Twitter & other social media platforms!

Nursing Homes – download & save this graphic to include it in your social media post.

NYS has not updated nursing home Medicaid rates for inflation since '08. The result? A depleted workforce, 6K beds taken offline since '19, delayed hospital discharges, & long waits in ERs. @GovKathyHochul, @AndreaSCousins, @CarlHeastie Please close the nursing home Medicaid gap!

Assisted Living Programs – download & save this graphic to include it in your social media post.

The Assisted Living Program (ALP) is the only AL option for low-income older adults in NY - but the ALP Medicaid rate has not been updated since 2007, limiting access. @GovKathyHochul, @AndreaSCousins, @CarlHeastie - please provide a meaningful Medicaid increase to the ALP!!

Adult Day Health Care – download & save this graphic to include it in your social media post.

ADHC offers older adults the health care & social opportunities that enable them to live at home. It's a great option for many, but lack of resources is preventing dozens of programs from reopening after pandemic closures @GovKathyHochul, @AndreaSCousins, @CarlHeastie #nybudget

Thank You to 2023 National Lobby Day Participants!

On Wednesday, LeadingAge National held its in-person coordinated lobby day effort in Washington, D.C. As part of the national effort, LeadingAge New York and a group of NY member providers and advocates met with 11 U.S. Senate and Congressional offices in just one afternoon.

Key topics discussed in meetings were workforce, under-funding, staffing mandates, the CNA training lockout, and the elimination of 3-day hospital stay requirements. Great discussions were had and connections made during Wednesday’s lobby day which will help inform and support LeadingAge National’s year-round advocacy on our behalf.

If you were not able to attend the leadership summit and lobby day this year, we hope you’ll consider joining us next year! In addition, you can easily take action on several of the issues mentioned above via LeadingAge National’s advocacy action alert website.

Thank you again to the LeadingAge New York members (not all of whom are pictured) that committed their afternoon to advocating with us on capitol hill! Your work and stories are inspiring, and will help drive the change and funding actions we hope to see in Washington, D.C.

Additional Grassroots Advocacy Tools for Final Days of Budget

With budget discussions continuing well into April, it is critical that we work together to keep long-term care and aging services top-of-mind for legislators. We have worked hard since January to educate the entire Legislature and the Governor on our budget priorities, and why the proper funding of long-term care is critical to ensuring the quality care of our most vulnerable. Your advocacy has been incredibly impactful. However, we need to keep the pressure on to ensure these issues remain at the forefront as final budget decisions begin to be made.

LeadingAge New York has created the below service-line specific digital advocacy letters to help us keep the pressure on legislators for the remainder of 2023-24 budget discussions. Each letter takes only a minute or two to send. Simply enter your information to automatically send an email to the Governor and your State Senator and Assembly Member! The letters can also be edited via the text box, to reflect any organization specific information or reflect the perspective of families and staff that wish to use them.

Please use the below links to send messages to your legislators and the Governor TODAY!

Nursing Home Budget Letters – several letters available for family members, staff, residents, etc.
ACF/ALP & Low-Income Seniors Budget Letter
Home & Community-Based Services Budget Letter
Managed Long-Term Care Budget Letter
Adult Day Health Care Budget Letter
CCRC Budget Letter
Affordable Senior Housing Budget Letter

After you send your letters, we strongly encourage members to share these links with residents, families, staff, board members and volunteers. This is a simple and easy way to amplify our message!

Additionally, LeadingAge New York has created a new set of social media messages and graphics! These messages have been crafted for a general public, family member, resident, consumer audience, and are aimed at raising awareness of long-term care underfunding. If members choose, the messages can easily be tailored to capture the attention of the Governor & State Legislators OR they can be used to enlist your social media following in budget advocacy.

The NEW social media messages, graphics, and instructions for how we recommend members use these tools are available here. The messages themselves are crafted so you can simply copy & paste into your Twitter, Facebook and LinkedIn. To add an image to your message, simply download & save the graphic and add it to your post. Please reach out to Sarah Daly at sdaly@leadingageny.org with any questions.

LeadingAge & LeadingAge New York Coronavirus Resources

LeadingAge NY continues to closely follow all COVID-19 news and we are doing our best to keep members informed of updates, recommendations and guidelines from the Department of Health (DOH).

LeadingAge NY and LeadingAge National Member resources are linked below.

LeadingAge NY Coronavirus Resources

LeadingAge NY COVID-19 Weekly Update calls – Mondays at 11 a.m. Click here to join the call from your computer, android or apple device. Or you can join the call by dialing in: 877 853 5257 (Toll Free); Webinar ID: 852 964 255.

LeadingAge National Coronavirus Policy Updates – Mondays and Wednesdays at 3:30 p.m. Past call recordings are available here and you can register here for future calls.

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