HCP Testifies at Joint Legislative Budget Committee Hearing on Health


This week the Legislature launched two plus weeks of Joint Legislative Budget Hearings to hear testimony and examine Governor Cuomo’s Fiscal Year 2020-2021 Budget Proposal.  

HCP was invited to testify at the joint hearing on the Health/Medicaid portion of the Governor’s proposal, which was held on Wednesday, January 30. The hearing was well attended by dozens of legislators throughout the day.  Over the course of the nearly twelve hours of testimony there were 40 organizations and 57 witnesses representing the government, public health organizations and all segments of the health care industry.

When it came time for HCP to testify, HCP President/CEO, Kathy Febraio, called on the Legislature to invest in, rather than cut home care services. Highlights of HCP’s testimony are found below, as are a link to the oral testimony presented and a link to HCP’s full written testimony. 

A great deal of testimony focused on the lack of detail available with respect to the Governor’s Medicaid spending plan and the creation of the Medicaid Redesign Team (MRT) II.  Legislators asked nearly every witness if they had yet been invited to participate in the MRT II.  Without exception the answer was no.

There was discussion by many witnesses and legislators that the first round MRT process had begun much earlier in the legislative calendar.  There was also discussion about the lack of adequate representation on the first MRT by witnesses representing a broad range of the health care industry, including home care, HCP and its member providers. 

Many legislators focused on the growth in long term care and what was contributing to that growth. There was wide recognition that aging demographics and increasingly poorer seniors contribute to eligibility and enrollment in Medicaid Long Term Care.  There also was recognition that home care and other long term care providers do not make determinations of eligibility for Medicaid long term care services and that it is either the role of government or managed long term care organizations.

Highlights of HCP’s Testimony follows: 
Providers of home care services have been cut to the bone in recent years and are operating on razor thin margins.  This is all compounded by providers holding accounts receivable from MLTCs far too long, for hundreds of thousands of dollars and more, leaving providers facing personal financial crises and needing to secure personal loans and lines of credit to make payroll. 
Have home care providers had an increase in their basic costs or a trend factor in ten years? No, they have not.
Have State subsidies for the living wage and minimum wage covered all of the costs of paying for these mandatory labor costs? No, they have not. 
The home care industry has been faced with a multi-year licensing moratorium, the prospect of a new Certificate of Need (CON) process as part of licensing, contract limits with managed care organizations, increases in labor costs, and preparations for the implementation of electronic visit verification due at the end of this calendar year, among others.  
The growth in the aging demographic, which has in large measure driven the growth in long term care, is clearly and most definitely beyond the control of the home care industry, a factor we strongly urge policy makers to consider as we all face very difficult fiscal circumstances in the coming fiscal year.
Some have actually said that the growth in the Medicaid program is due to home care. However, the drivers of utilization in the program are not the home care providers, but the managed care organizations that assess and determine the number of hours of care to be provided. Again, something well beyond the control of the home care industry, but firmly in the hands of others not the least of is the managed care organizations.  Likewise, it is not the home care industry making Medicaid eligibility determinations for long term care.  Therefore, while there has been growth in the use of home care services in recent years, that growth is attributable to factors largely beyond the control of the home care industry.
Home care has been shown time and again to be far less costly than hospitals, nursing homes or other care options. Moreover, people overwhelmingly prefer to age in their home. It is critical now more than ever, for New York State to invest in home care! Given the savings associated with home care we are confident that a properly funded home care industry can provide the critical and necessary savings the State needs in light of the massive and unsustainable growth of the Medicaid budget, while at the same time, providing fulfilling employment opportunities for New Yorkers. 
In the last year, the Department of Health has announced grossly inadequate reimbursement rates for FIs providing services in CDPAP, was challenged in court for doing so, rescinded the rates, filed a notice of appeal in the case—which it has failed to prosecute to date—released a request for offers (RFO) late in the year, long after it was expected, which began the procurement process for FIs wishing to continue providing services in CDPAP, and published in the State Register, as the Judge in the Court challenge required, a proposed rule that for all intents and purposes is identical to the proposed rate structure that was successfully challenged and that attempts to change the rate retroactive to September 1, 2019.
The Department of Health’s actions with respect to CDPAP, left unchecked, will undoubtedly result in a self-created and totally avoidable catastrophe that will have severe consequences for consumers, their personal assistants, and the FIs that provide services in the program.

Home care and those who depend on it cannot, should not, and will not be overlooked. 

View HCP’s President/CEO, Kathy Febraio, testimony at this link.

Full written testimony can be found at this link.