Continued Lack of Support from State for Long-Term Care 

Thursday night, New York State passed the budget for the 2024-2025 state fiscal year after three weeks of prolonged negotiations. Portions of the budget have been released, but additional appropriations will continue to print through the weekend. Though I am still reviewing the finer details of the budget we have thus far, the current key points below stand out as flagrant failures to support long-term care communities like Heritage.  

Nursing Homes 

  • A one-year, 4% Medicaid increase with an undisclosed distribution methodology 
  • Does not include authorization of Medication Aides in nursing homes 
  • Includes the Governor’s proposal to cut capital reimbursement by 10%, effective April 1, 2024 
  • Includes the Governor’s proposal to decrease Vital Access Provider Assurance Program (VAPAP) funding from $100M to $25M annually 
  • Includes the Governor’s proposal to use the July 2023 Medicaid rate as the basis for the case mix freeze 
  • Does not include a statutory mandate to rebase and update nursing home rates 

Assisted Living Facilities 

  • A one-year, 4% Medicaid increase with an undisclosed distribution methodology 

So, what does this mean? There will continue to be a shortfall between the cost of care and Medicaid reimbursement rates for a population that relies on Medicaid to provide their care. Other support funding has also been cut, which effectively neutralizes any increase included in the budget. This is less than a drop in the bucket of what our industry needs from the state. We needed industry-wide, significant Medicaid increases and a Medicaid rebasing program to begin to address the funding problems organizations like Heritage face. Without these vital increases, nursing homes across the state will continue to face the same hardships and continue a trend of closing in the places they are needed most. 

However, the budget includes a Managed Care Organization (MCO) Tax that would make $350M available in Fiscal Year 2025 to be used for reimbursing Medicaid MCOs. While this seems promising, in looking at California, which recently added a similar tax, the program is not adding the value and support that had been anticipated. This means we must wait to see how this program plays out – we cannot consider it a win for the industry as of yet. 

The lack of necessary change to financial support for our industry by New York State is negligent. In one fell swoop, Heritage and the seniors we serve, and their needs, were once more neglected, ignored, and disrespected.  

In light of this abysmal support from the state for long-term care, now more than ever it is extremely important that our community supports us financially and in public policy. 

I am frustrated, dismayed, and tired from this continuing pattern of vulnerable populations like our seniors left without the financial support they deserve. But our fight is not over – we will continue to advocate for the rights of our seniors in New York State. But we must call for support from the people who understand the value of our seniors and the people who care for them – we seek support from you, our community. We cannot fix an entire industry, but if you join us, Chautauqua County can solve this for ourselves.  

As a cornerstone organization in our community, I implore you to support Heritage, and join us and our seniors in any way you can. Visit today and donate in support of Heritage, our seniors, our staff, and ultimately you, our community. 

Together, we can create the change the state has failed to enact once more.  

Lisa Haglund
President and CEO of Heritage Ministries