2/13/2020 HCP STATEWIDE LEGISLATIVE BRIEFING FOR THE 2020 STATE BUDGET Thursday, February 13, 2020 For HCP members only 1 New York State Association of Health Care Providers, Inc. (HCP) 1
2/13/2020 Kathy Febraio, CAE Kevin Kerwin Robert Reid, Partner HCP President/CEO HCP Vice President of Public Policy Reid, McNally, & Savage 2 New York State Association of Health Care Providers, Inc. (HCP) 2
2/13/2020 Political Landscape in Albany ◦ In the Senate, Democrats, which already have a 40-22 majority(one vacancy), are looking to gain additional seats with Republican retirements across the state but particularly in Upstate New York ◦ Republican Senate Retirements Ken LaValle-1st Senate District Rich Funke-55th Senate District Betty Little-45th Senate District Joseph Robach-56th Senate District George Amedore-46th Senate District Chris Jacobs-60th Senate District Robert Antonacci-50th Senate District Michael Ranzenhofer-61st Senate District James Seward-51st Senate District 3 New York State Association of Health Care Providers, Inc. (HCP) 3
2/13/2020 Political Landscape in Albany ◦ In the Assembly where all 150 members (105 Democrats) are up for re-election in 2020, a large number of Democratic members across the state are increasingly facing a primary election which is set for June 23rd. The focus for many is not the Albany Budget but their district politics! 4 New York State Association of Health Care Providers, Inc. (HCP) 4
2/13/2020 Governor’s Budget ◦ In November 2019, the Governor estimated 2020-21 budget shortfall at $6.9 billion, but higher than expected tax receipts have reduced that number to approximately $4.9 billion. The Governor proposes closing that gap by convening a new Medicaid Redesign Team to identify $2.5 billion in savings, changes to local assistance programs saving $1.8 billion, identifying $400 million in state agency savings, and another $250 million in miscellaneous savings. “Medicaid is the ◦ 1% Medicaid Cut Elephant in the ◦ Other Budget Policies of Interest Room,” ◦ Paid Sick Leave Senate Finance Chairperson ◦ Gig Workers misclassification commission Liz Krueger 5 New York State Association of Health Care Providers, Inc. (HCP) 5
2/13/2020 Medicaid Budget ◦ No details ◦ Creation of Medicaid Redesign Team ◦ Cut $2.5 Billion ◦ No impact on recipients ◦ Need for more revenue ◦ “Spending on Managed Long Term Care has tripled between the 2013 and 2019 fiscal years, a $4.8 billion increase” State Budget Director, Robert Mujica ◦ Target : Long Term Care (Home Care, CDPAS, Nursing Homes) 6 New York State Association of Health Care Providers, Inc. (HCP) 6
2/13/2020 First meeting: February 11 Report by Budget deadline: April 1 MRT II ◦ Membership ◦ T.K. Small, Director of Policy at Concepts of Independence ◦ Co-chair: Michael Dowling, President and CEO of Northwell Donna Colonna, CEO, Services for the ◦ Health UnderServed (S:US) ◦ Co-chair: Dennis Rivera, Former Chair of SEIU Healthcare Todd Scheuermann, Secretary of Finance, NYS Senate ◦ Dr. Steven Corwin, President and CEO, New York Presbyterian ◦ Blake Washington, Secretary of Ways and Means, NYS ◦ Thomas Quatroche, PhD, President and CEO, Erie County Medical ◦ Assembly Center Paul Francis, Deputy Secretary for Health and Human ◦ LaRay Brown, CEO of One Brooklyn Health ◦ Services, Governor's Office ◦ Mario Cilento, President of New York State AFL-CIO ◦ Dr. Howard Zucker, Commissioner of Health Christopher Del Vecchio, President and CEO of MVP Health Care ◦ Dr. Ann Sullivan, Commissioner for the Office of Mental ◦ Pat Wang, President and CEO of Healthfirst ◦ Health ◦ Emma DeVito, President and CEO of VillageCare Arlene González-Sánchez, Commissioner of the Office of ◦ Addiction Services and Supports ◦ Wade Norwood, CEO of Common Ground Health Dr. Theodore Kastner, Commissioner of the Office for ◦ ◦ Steven Bellone, County Executive, Suffolk County People With Developmental Disabilities Robert Megna, Senior Vice Chancellor and COO, SUNY ◦ 7 New York State Association of Health Care Providers, Inc. (HCP) 7
2/13/2020 MRT II Areas where Medicaid Course Correction may be needed ◦ Long Term care and CDPAS: ◦ 13% enrollment growth in MLTC is much faster than demographic trends would indicate; ◦ 75% of MLTC costs reflects personal care – and personal care costs are growing in Mainstream Managed care as well; ◦ CDPAP is a key driver of growth – projected to grow by over 800% from CY 2016 to CY 2021. ◦ Distressed Hospitals and other Supplemental Payments ◦ Prescription Drugs: Pharmacy Benefits were moved into Managed Care following MRT I, but unfortunately costs have increased again due to high cost drugs, PBM spending, and other factors. ◦ Transportation ◦ Care management including health homes ◦ Few Dual Eligibles are Enrolled in Integrated Plans 8 New York State Association of Health Care Providers, Inc. (HCP) 8
2/13/2020 MRT II Long Term Care Advisory Group The MRT indicated an Advisory Group would be created to generate ideas and proposals on long term care. The Advisory Group will present a summary of proposals to the MRT II at its second meeting (March 4). The members of the Long Term Care Advisory Group have not yet been announced. ◦ Proposals for the LTC Advisory Group are due no later than 12:00 PM on or about February 21st 9 New York State Association of Health Care Providers, Inc. (HCP) 9
2/13/2020 HCP Testimony ◦ Highlights ◦ Invest in home care. ◦ Rollback budget cuts. ◦ Growth in the long term care sector is inevitable, beyond the control of providers. ◦ Rates provided for state funded programs do not cover living wage or minimum wage requirements. ◦ Home care is less costly than other forms of care. ◦ Concern over the impending CDPAP catastrophe. ◦ Licensing moratorium and contracting limits are adversely affecting providers ability to do business. ◦ No trend factor increase in 10 years. 10 New York State Association of Health Care Providers, Inc. (HCP) 10
2/13/2020 HCP Leadership Advocacy Day ◦ HCP leadership was able to meet with legislators days after the Governor’s Budget Proposals. ◦ Message: Invest in Home Care! ◦ Discussions surrounded the MRT II and growth in long term care – particularly personal care services. ◦ HCP met with over 10 legislative leaders in Health and Finance policy areas. ◦ Leaders recognized the critical importance of the Home Care Industry. ◦ Foundation laid by HCP Leadership and continuing efforts by HCP’s Public Policy Team will allow HCP’s Advocacy Day to drive home the message that the State needs to Invest in Home Care! 11 New York State Association of Health Care Providers, Inc. (HCP) 11
2/13/2020 HCP Advocacy Day: February 25 ◦ Home Care Saves Money Home care in New York is significantly less costly than alternatives. ◦ Monthly cost of a Semi-Private Room in Nursing Home: $11,756 Home Health Aide monthly cost: $4,957 ◦ ◦ Usage Rates 265,214 individuals 21 years old and over receive Home and Community Based Care through New York's Medicaid Program. ◦ ◦ Turnover in Home Care Turnover in Home Care Alarmingly, recent data on turnover rates among care givers has been reported as high as 82%. ◦ ◦ Need for In-Home Care is Critical ◦ The number of adults age 65 and over is expected to increase by 50 percent between 2015 and 2040 in New York; that number is expected to double for adults over the age of 85 during the same time frame. ◦ Inadequate Reimbursement In a recent HCP member survey, 55% of respondents reported having been offered contract amendments with rates that do not cover the cost of minimum ◦ wage. ◦ Care at Home is the Preferred Option 90% of people 65 and older say they would prefer to receive care in their own homes as long as possible. ◦ 12 New York State Association of Health Care Providers, Inc. (HCP) 12
2/13/2020 HCP Advocacy Day : Bring Your Data! ◦ How many patients do you serve? ◦ How many people do you employ? ◦ What programs do you provide services in? ◦ What’s your rate of turnover? ◦ What is your turn-away rate for new referrals? ◦ How long has your agency been in business? ◦ How long have you been in the industry? This information is important to legislators! This Photo by Unknown Author is licensed under CC BY-SA 13 New York State Association of Health Care Providers, Inc. (HCP) 13
2/13/2020 Before Advocacy Day ◦ Call your legislators and share your story! ◦ Use HCP’s Find Your Legislators tool in the Advocacy Action Center under the Public Policy section on the HCP website. ◦ https://www.nyshcp.org/NYSHCP/Public_Poli cy_Tab/Find_Your_Legislator_Widget.aspx 14 New York State Association of Health Care Providers, Inc. (HCP) 14
2/13/2020 Questions? 15 New York State Association of Health Care Providers, Inc. (HCP) 15
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