LeadingAge NY to Health Care Commission: Funding Needed for Robust Continuum of Care

(Aug. 13, 2024) "A robust, financially viable continuum of long-term care that enables older adults to age with dignity and thrive will require investment", LeadingAge New York wrote in a letter to the New York State Commission on the Future of Health Care.  The letter, which followed remarks to the Commission provided by CEO Jim Clyne, detailed the challenges facing New York's long-term care continuum after years of under-payment by Medicaid.  It also highlighted the ripple effects being felt throughout the health care system and by consumers and families in the form of inability to access post-acute care close to home, prolonged hospital stays, and logjams in hospital emergency departments.

The letter provided detailed recommendations and data for the Commission, aimed at providing access to high-quality long-term care (LTC) and housing with services for older adults and people with disabilities, with varying levels of need, at all income levels, in all geographies.  At a high level, the recommendations expanded on the following key steps:

• Update Medicaid rates for LTC providers to align with the costs of care (including appropriate compensation of the workforce), to incentivize desired outcomes, and to support innovation in residential environments and care delivery. Nursing home rates, for example, fall short of costs by $1.6 billion on a statewide basis, resulting in 70 percent of nursing homes having negative operating margins in 2022.
• Support community-based congregate LTC settings, including ACFs, ALPs, and ADHC programs, in order to expand options for older adults.
• Build upon the platform of existing affordable senior housing by funding a Resident Assistant Program to offer social supports that prolong independence and improve health outcomes.
• Prioritize LTC for workforce development programs and funding, including Nurses Across New York, the waiver Career Pathways Program, Department of Labor apprenticeship programs, and training/employee grants for financial relief.
• Promote alternatives to Medicaid-funded LTC by expanding the Special Needs Assisted Living Residence (SNALR) Voucher Program, expanding options for State Office for the Aging (SOFA)-funded home care programs that include cost sharing, and facilitating the expansion of Continuing Care Retirement Communities (CCRCs).

The Commission was launched in November 2023 with the appointment of 13 members.  It is charged with providing "ongoing strategic recommendations to transform the health care system in New York State, with a goal of ensuring that the limited resources of the State and other health care payers are optimized to enable the delivery of accessible, equitable, high-quality care for all New Yorkers, through a resilient health care ecosystem and a strong health care workforce."

A copy of the letter is available here.

LeadingAge NY will continue to update members as the Commission's work progresses.

Contact:  Karen Lipson, klipson@leadingageny.org.