The home care minimum wage increase established by the 2022-23 New York State budget became effective Oct. 1, 2022. All home care agencies are required to pay home health aides and personal care aides at least $2 above the current minimum wage, with another $1 added to wages on Oct. 1, 2023. Home care provided in all settings with all payor types are subject to the wage mandate, including Medicaid, Medicare, private pay, Expanded In-Home Services for the Elderly Program (EISEP), and other payors of home care.

As LeadingAge NY has previously reported, the Department of Health (DOH) has communicated little with providers of home care about the requirement. We have asked for more detail regarding provider and plan obligations relating to the mandate.

The Department did present a framework for its adjustment of Medicaid rates to account for the mandate through Managed Long Term Care (MLTC) and Medicaid Advantage Plus (MAP) plans, which account for almost 90 percent of the Medicaid home care in the state. The State Plan Amendment seeking approval for this change from the Centers for Medicare and Medicaid Services (CMS) was posted on Sept. 30, 2022. LeadingAge NY has posed questions to DOH on the document, including its reference to minimum wage reconciliation, which the Department has communicated will not be carried out with this rate adjustment.

The Department has made it clear that negotiations between plans and providers may result in providers receiving varying adjustments based on these negotiations and contractual agreements. The published rate amounts are based on regional averages. While DOH is setting no floor, ceiling, or benchmark, providers should receive sufficient funding to meet their wage obligations.

Home care minimum wage rates for services delivered through Medicaid fee-for-service (FFS), mainstream managed care, Health and Recovery Plans (HARPs), Programs of All-Inclusive Care for the Elderly (PACE programs), and Licensed Home Care Services Agencies (LHCSAs) serving Assisted Living Programs (ALPs) are currently being developed by the Department.

The Department has already started a survey process to assist with developing the rate increase for ALPs. More information is provided in this Intelligence article.

Members should feel free to reach out with questions on the wage mandate and/or communicate their progress on rate increases per their provider/plan negotiations. We will keep you abreast of further developments.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871