It’s Time to Invest in Our Seniors: Heritage Ministries Urges New York State to Increase Medicaid Rates by 20% in 2023-2024 Budget, Take Other Steps to Support Seniors and the Senior Care Workforce.
The 2023 state legislative session is the most important one yet in determining the future of not-for-profit assisted living facilities and nursing homes in New York. If critical steps aren’t taken, it’s virtually certain that the crisis in the state’s not-for-profit senior living industry will get significantly worse. It’s a crisis that has steadily worsened for more than a decade and was accelerated over the past three years.
Heritage Ministries joins Leading Age New York, which represents more than 600 not-for-profit, mission-driven and public continuing care providers serving seniors, in urging the governor and legislature to take a number of necessary actions this year, including:
- Provide a 20 percent increase Medicaid rates for nursing homes in the state fiscal year 2024 budget. The five percent increase proposed by the Governor is insufficient; a 20 percent increase is needed to maintain the viability of nursing homes, enable them to recruit and retain staff, and deliver high-quality care residents. Medicaid rates in New York are among the worst in the nation and have not been increased for inflation in 15 years, resulting in an average shortfall between costs and reimbursement of $74 per resident per day. At a time when more than 75 percent of nursing home care is paid by Medicaid, a 20 percent increase is essential in helping quality, mission-driven nursing homes continue to serve New York’s seniors.
- Increase the state portion of the Supplemental Security Income (SSI) Rate for adult care facility (ACF) residents by at least $20 per day and build in an annual cost of living adjustment thereafter. SSI, together with the State Supplement Program (SSP), pays ACFs $44.94 per day, which is entirely inadequate for ACFs to provide residents with regulatorily required services including housing, meals, personal care, case management, and more. While approximately 12,000 ACF residents rely on SSI statewide, there has not been an increase to the SSP per day reimbursement amount since 2007.
- Authorize specially-trained nurse aides (CNAs) to work as medication aides in nursing homes. The Governor’s budget would authorize specially-trained CNAs to administer routine medication to residents under the supervision of a registered nurse. This proposal would provide a career ladder for CNAs—serving as a no-cost strategy to address the staffing crisis—and enable nurses to focus on higher level tasks.
- Expand the direct care roles that qualify for meeting minimum staffing requirements. Currently, only registered nurses and CNAs are included when calculating nursing home staffing ratios. Expanding the positions to include others involved in the daily care of residents, such as therapists, nurse practitioners, and directors of nursing, would more accurately represent the staff that provide care on a daily basis and help nursing homes avoid daily fines associated with not meeting staffing ratios. Like the proposal above, this regulatory adjustment would cost the state nothing but would make an immediate positive impact on nursing homes.
Not-for-profit nursing homes and assisted living communities in New York have been in constant survival mode for far too long. Seniors in New York and the people who care for them deserve better. We urge Governor Hochul and the New York State Legislature to take the steps outlined above. Whether by providing desperately-needed funding or making policy adjustments, it’s time for New York state to invest in our seniors of today and tomorrow.