Legislative
Final FY 2023-24 New York State Budget Provisions
The final FY 2023-24 State Budget, as agreed upon by the Governor and Legislative Leaders this weekend, includes/excludes the below provisions that will impact skilled nursing and assisted living providers: SNF Medicaid Rate Increase Provides a uniform Medicaid rate increase of up to 7.5% for the operating component of nursing homes, subject to federal financial participation. ALP Medicaid Rate Increase Provides a uniform Medicaid rate increase of 6.5% for the operating component of assisted living programs, subject to federal financial participation. Medicaid Global Cap Continues the Medicaid Global Cap through 2025. The metric used to set Medicaid Global Cap spending continues to be based on a five-year rolling average of Medicaid spending projections. Cash Receipts Assessment (CRA) Continues the CRA at 6% through March 31, 2024 Statewide Health care Facility Transformation Program (“Statewide V”) Provides $990 million in grant funding for the creation of the Statewide V for the purpose of transforming, redesigning, and strengthening quality health care needs in nursing homes, adult care facilities, assisted living programs, and hospitals. $490 million is reserved for grants to health care providers for capital projects, debt retirement, working capital, or other non-capital projects that, among other things, increase access to care, improve quality of care, and ensure financial stability of health care providers. $500 million is reserved for investments in technological or telehealth projects, projects related to cybersecurity, and unfunded project applications submitted in response to Statewide IV. Temporary Health Care Services Agencies Requires temporary health care services agencies to register annually with DOH and sets forth specific ownership and operational criteria that must be provided by each staffing agency to DOH. Additionally, the law sets forth minimum standards for agencies, that include, among other things, a requirement to maintain a written agreement with every health care entity in which in does business, that sets forth maximum rates that can be billed or charged; minimum license, training, and continuing education requirements for all assigned personnel; and submission to DOH of copies of all contracts and invoices between an agency and a health care entity. Moreover, the law further provides for:- DOH to promulgate regulations to implement the law, including establishing additional minimum standards regarding pricing, fees, administrative costs and business practices;
- Agencies to report quarterly to DOH a full disclosure of charges and compensation, including a schedule of all hourly billing rates for each category of staff, and the names of all health care entities the agency has contracted with in the State;
- DOH to maintain authority to examine the books and records of the agency;
- DOH to be able to suspend, revoke or refuse to renew any staffing agency registration;
- DOH to publish on its website a quarterly report containing aggregated and de-identified staffing agency data;
- DOH and DOL to provide a report to the Governor and the Legislature by January 1, 2024 summarizing the key findings of the staffing agency data collected under the law; and,
- The AG to bring an action for an injunction against any person who violates any provision of the law.
- Merger with a health care entity;
- Acquisition of one or more health care entities;
- Affiliation agreement/contract among health care entities; and,
- Formation of a partnership or joint venture for the purpose of administering contracts with healthcare providers
Gov. Hochul Releases Executive Order 4.20 Continuing Disaster Emergency Due to Staffing Shortages
Gov. Hochul has released the attached Executive Order 4.20, Continuing the Declaration of a Statewide Disaster Emergency Due to Healthcare Staffing Shortages in the State of New York... Read MoreSenate and Assembly One-House Budget Bills
The Senate and the Assembly advanced their One-House Budget bills on March 14th setting forth their respective negotiating positions pertaining to the FY 2023-24 State Budget. The following is a brief summary of some of the provisions either included or excluded in each respective One-House Budget proposal affecting skilled nursing and assisted living providers. Senate One-House Budget Proposal (R.555)- Increases the Governor’s uniform Medicaid rate reimbursement increase from 5% to 10% for skilled nursing and assisted living facilities, adding $157.5 million. Further directs DOH to find solutions to ensure that staffing shortages do not result in underutilized nursing home beds;
- Includes $2 million to support the Long-Term Care Ombudsman Program;
- Adds $200 million to support the Statewide Health Care Facility Transformation Program (“Statewide V”);
- Adds $187 million to support safe staffing for nursing homes;
- Modifies the Governor’s proposal to reform the approval process for health care projects and transactions by accepting increased construction fees for hospitals, nursing homes, and diagnostic and treatment centers construction applications and exempting core public health services from home care licensure when provided by a local health department;
- Modifies the Governor’s proposal requiring assisted living residences to report to DOH on quality measures which the Department will use to grant an advanced standing classification by omitting the provisions related to modified inspection schedules for facilities with advanced standing classification or that obtain accreditation from a nationally-recognized accreditor;
- Does not include the Governor’s proposal to authorize certified nurse aides to administer medication-related tasks in skilled nursing facilities (certified medication aides) via a two-year pilot program;
- Accepts the Governor's proposal to create minimum standards for temporary healthcare staffing agencies;
- Does not include the Governor’s proposal to transfer oversight of healthcare professions from the State Education Department to NYSDOH; and,
- Does not include the Governor’s proposal to expand the scope of practice for medical providers and the introduction of the Interstate Licensure Compact and Nurse Licensure Compact.
- Increases the Governor’s uniform Medicaid rate reimbursement increase from 5% to 10% for skilled nursing and assisted living facilities, adding $157.5 million;
- Includes the Governor’s proposal of $2.5 million for the Long-Term Care Ombudsman Program and provides an additional $12.5 million;
- Provides $100 million in additional funding for financially distressed nursing homes;
- Rejects the Governor’s proposal to require ALRs and EALRs to submit an annual report on quality measures to DOH and authorize DOH to grant new classifications based on assisted living quality reporting that would ease inspection requirements by including a description of quality measures and a process for getting consumer and provider input;
- Instructs the Governor to begin the process of rebasing hospital, nursing home, and clinic Medicaid rates in FY 2024-25;
- Modifies the Governor’s proposal to provide $1 billion through the Statewide Health Care Facility Transformation Program V (“Statewide V”) by establishing minimum funding amounts for community-based organizations;
- Modifies the Governor’s proposal to establish a registration process for temporary health care services agencies and create minimum standards for temporary health care service agencies by including maximum rates that an agency can charge a facility;
- Does not include the Governor’s proposal to authorize certain certified nurse aides to administer medication-related tasks in skilled nursing facilities (certified medication aides) via a two-year pilot program;
- Does not include the Governor’s proposal to transfer oversight of healthcare professions from the State Education Department to NYSDOH; and,
- Does not include the Governor’s proposal to allow New York to join the Interstate Medical Licensure and Nurse Licensure Compact.
Stephen B. Hanse, Esq., NYSHFA | NYSCAL President and CEO, Testifies During New York State Joint Legislative Budget Hearing on Health
Stephen Hanse made a compelling request to the Legislature during Tuesday’s joint Legislative Budget Hearing on Health to support a 20% Medicaid reimbursement rate increase – up from the Governor’s Executive Budget proposal of 5% ... Read MoreNYSHFA Legislative Visitation Days – Conference Call
NYSHFA will be holding a conference call for confirmed Legislative Visitation Day participants on Wednesday, February 22, 2023 at 2:00 pm. An email will be sent to participants with a call-in number. If you are not registered for lobby day, please do so by COB Wednesday, February 22! If you still wish to participate in lobby day, send an email to Nancy Knapp at nknapp@nyshfa.org ... Read MoreNYSHFA Legislative Visitation Days
NYSHFA will be conducting our Legislative Visitation Days on Monday, February 27th (12:00 pm – 5:00 pm) and Tuesday, February 28th (9:00 am – 3:00 pm) to advocate for our issues within the FY 2023-24 State Budget ... Read MoreNYSHFA Legislative Visitation Days
NYSHFA will be conducting our Legislative Visitation Days on Monday, February 27th (12:00 pm – 5:00 pm) and Tuesday, February 28th (9:00 am – 3:00 pm) to advocate for our issues within the FY 2023-24 State Budget ... Read MoreFY 2023-24 Executive Budget Update
Following up on today’s NYSHFA|NYSCAL Town Hall Call, please find the following summary of certain initiatives impacting skilled nursing and assisted living providers included within Governor Hochul’s $227 billion FY 2023-24 Executive Budget. Medicaid Rate Increase Effective April 1, 2023 and thereafter, this proposal would amend Part I of Chapter 57 of the laws of 2022 to provide a uniform rate increase of 5% to residential health care facilities and assisted living programs. Provide Transformative Health Care Capital Funding The Public Health Law is amended by adding a new section 2825-h. This provides $1 billion in capital funding for the creation of a new Statewide Health Care Facility Transformation Program (“Statewide V”) for nursing homes, adult care facilities and hospitals, and other providers, for capital projects that, among other things, increase access to care, improve quality of care, ensure financial stability of health care providers; or invest in technological or telehealth projects. Up to $500 million would be awarded to health care providers in support of projects which promote innovative, patient-centered models of care, increased access to care, improved quality of care, and provider financial sustainability. Up to $500 million would also be awarded to health care providers for the implementation or improvement of critical health care information technologies and telehealth capacity. Nursing Home Appeals This proposal would amend Chapter 49 of the Laws of 2017, extending the limit on payment of nursing home appeals of eighty million dollars annually through April 1, 2027. Upper Payment Limit This proposal would amend Chapter 56 of the Laws of 2020, extending the nursing home upper payment limit and intergovernmental transfer provisions through March 31, 2026. Medicare Maximization This proposal would amend Chapter 56 of the Laws of 2020, extending the Nursing Home Medicare Maximization program through February 1, 2026. Trend Factor Elimination This proposal would amend Chapter 57 of the Laws of 2021, extending the elimination of the trend factor for service for general hospital and nursing home reimbursement through March 31, 2025. Cash Receipts Assessment This proposal would amend Chapter 57 of the Laws of 2021, extending the health facility 6% cash receipts assessment program through March 31, 2025. Nurse Staffing Agency Requirements This proposal would make statutory changes to require nurse staffing agencies to register and report key data about their operations with the goal of increasing transparency into the utilization and costs of contract labor. The data would aid the State in exploring options to remedy dependence on temporary healthcare services agency staffing. This proposal would add a new Article 29-K to the Public Health Law regarding the registration of temporary health care services agencies with the DOH; establishes staffing agency standards; requires all staffing agency rates to be reported on a quarterly basis; requires disclosure of the maximum rates that can be billed or charged by an agency, as well as the percentage of health care entity dollars that the agency expends in comparison to the agencies profits and other administrative costs; prohibits the imposition of liquidated damages or employment fees if temporary worker is hired by provider; authorizes the DOH to revoke staffing agency licenses; authorizes the DOH to request the Attorney General to bring a cause of action against a staffing agency; requires a report to be drafted by the DOH and the DOL and delivered to the Governor and the Legislature by 3/31/24. Medication Aides This proposal would amend the Education Law and Public Health Law to authorize certified medication aides to administer routine and prefilled 40 medications in residential health care facilities for a duration of two years (a temporary pilot program). Out of State Doctors and Nurses This proposal would amend the Education Law to allow New York to join the Interstate Medical Licensure Compact and the Nurse Licensure Compact, enabling doctors and nurses to relocate to New York and use their existing license to practice in the State. Section 32 of this bill would amend the Education Law to authorize issuance of temporary permits to practice for individuals licensed in another state who seek licensure in New York State. Minimum Wage This proposal would index the state minimum wage to the rate of inflation, subject to a cap and limited exceptions. Amends Section 652 of the Labor Law requiring indexing of the minimum wage regionally for inflation and allocates funds for the cost for State service providers. Such adjusted minimum wage rate shall be determined by increasing the current year’s minimum wage rate by the lesser of 3% and the rate of change in the average of the most recent period between the first of August and the thirty-first of July over the preceding 12 months published by the consumer price index for Northeast region urban wage earners and clerical workers. Public Health & Health Planning Council (“PHHPC”) Reduces from 10 to 7 years the PHHPC character and competence look back review period for certain CON applications; eliminates PHHPC review for transfers of interest of less than 10%; raises the cost threshold for projects that need to file a CON with the DOH; and revises the definition of “public need.” Non-Medical Transportation Establishes a working group to recommend ways to expand access to non-emergency medical transportation. Nurse Scholarships Expands scholarship funding for the ”Nurses For Our Future” program. Healthcare IT Supports the replacement of the State’s healthcare reporting infrastructure with a “nation leading” health monitoring and surveillance system. Wadsworth Center Provides $967 million for the reconstruction and consolidation of the Wadsworth Center. Assisted Living Quality Standards The Governor’s FY 2023-24 Executive Budget proposes two new quality initiatives. The first quality initiative proposal adds a new subdivision to the Public Health Law that applies to ALRs, SNALRs and EALRs and requires these facilities to self-report on an annual basis on quality measures. Adult Homes, Enriched Housing Programs and ALPs are excluded. From this quality reporting, the Department will assign a score to the results based on quality indicators developed by the Department. Under this proposal, assisted living providers will also be required to post their monthly service rates, staffing, the approved admission/residency agreement and a summary of all service fees on the facility’s website and also in a public area within the facility. This information would be made available to the public on forms that will be developed by the Department. The second quality initiative proposal amends the Social Services Law and applies to all Adult Care Facilities. This standard is different than the first proposal and is based on an accreditation by an outside agency. The DOH will not be scoring the ACFs or relying on self-reported data. Those that have obtained accreditation and who meet eligibility criteria may, at the discretion of the Commissioner, be exempt from a Department inspection for the duration the accreditation is in good standing. If a facility accreditation is lost, the facility must report the loss to the Department within 10 business days and will no longer be exempt from inspection. Under this proposal, those facilities with top scores will be classified as “Advanced Standing” on their annual surveillance schedules and will be surveyed every twelve to eighteen months, with those receiving the highest rating being inspected at least once every 18 months. All other facilities not receiving that classification will be surveyed on an unannounced basis, but no less than annually. The Department will post the results of the quality reporting on its website. This proposed initiative will not affect the Department’s present methodology for conducting complaint surveys. NYSHFA|NYSCAL will continue to keep you updated as the FY 2023-24 Executive Budget progresses and negotiations with the Legislature begin. NYSHFA/NYSCAL CONTACTS: Stephen B. Hanse, Esq.` President & CEO 518-462-4800 x11 Read MoreNYSHFA Legislative Visitation Days
NYSHFA will be conducting our Legislative Visitation Days on Monday, February 27th (12:00 pm – 5:00 pm) and Tuesday, February 28th (9:00 am – 3:00 pm) to advocate for our issues within the FY 2023-24 State Budget ... Read MoreNYSHFA | NYSCAL Budget, Legislative, and Legal Town Hall Call
Please note there will be a NYSHFA|NYSCAL Town Hall call Thursday, February 9th at 2:00 pm. On the call we will discuss Governor Hochul’s FY 2023-24 Executive Budget proposal, and other regulatory and legal issues affecting providers ... Read MoreStephen B. Hanse, Esq., President & CEO of the New York State Health Facilities Association and the New York State Center for Assisted Living is Pleased to Announce the Appointment of Kristin A. DeVries as Director of Government Relations
Kristin A. DeVries, MA, MPP will join NYSHFA | NYSCAL on February 21, 2023, as Director of Government Relations... Read MoreStephen B. Hanse, Esq., President & CEO of the New York State Health Facilities Association and the New York State Center for Assisted Living is Pleased to Announce the Appointment of Kristin A. DeVries as Director of Government Relations
Kristin A. DeVries, MA, MPP will join NYSHFA | NYSCAL on February 21, 2023, as Director of Government Relations... Read MoreNYSHFA | NYSCAL Budget, Legislative, and Legal Town Hall Call
Please note there will be a NYSHFA|NYSCAL Town Hall call Thursday, February 9th at 2:00 pm. On the call we will discuss Governor Hochul’s FY 2023-24 Executive Budget proposal, and other regulatory and legal issues affecting providers ... Read MoreNYSHFA Legislative Visitation Days
NYSHFA will be conducting our Legislative Visitation Days on Monday, February 27th (12:00 pm – 5:00 pm) and Tuesday, February 28th (9:00 am – 3:00 pm) to advocate for our issues within the FY 2023-24 State Budget ... Read MoreGovernor Hochul’s FY 2023-24 Executive Budget Proposal
On Wednesday, February 1st, Governor Hochul released her $227 billion FY 2023-24 Executive Budget proposal. As presented, the FY 2023-24 Executive Budget increases “All Funds” State spending by an estimated 2.4% and continues the Medicaid Global Cap through 2025. The metric used to set the Medicaid Global Cap spending continues to be based on a 5-year rolling average of Medicaid spending projections. The Governor’s Executive Budget reflects $11 billion in additional Medicaid spending growth between FY 2023 and FY 2027. In presenting the Executive Budget, Governor Hochul emphasized that last year’s Executive Budget included the largest investment in healthcare in the State’s history and that she is “doubling down” on that investment with her FY 2023-24 Executive Budget. Specifically, in FY 2024, the State funded portion of the Medicaid program will be the largest in State history at $34.7 billion with 7.9 million expected enrollees by June 2023. The following is a brief summary of certain initiatives included within Governor Hochul’s FY 2023-24 Executive Budget:- Medicaid Rate Increase: Provides a 5% increase ($157.5 M State Share) in the operating component of a nursing home’s Medicaid rate effective April 1, 2023. Provides a 5% increase in the Medicaid rate for assisted living providers as well;
- Capital Funding: Provides $1 billion in capital funding for the creation of a new Statewide Health Care Facility Transformation Program (“Statewide V”) for nursing homes, adult care facilities and hospitals, and other providers, for capital projects that, among other things, increase access to care, improve quality of care, ensure financial stability of health care providers; or invest in technological or telehealth projects;
- Nurse Staffing Agency Requirements: Requires health care staffing agencies to register with the DOH; establishes staffing agency standards; requires all staffing agency rates to be reported on a quarterly basis; prohibits the imposition of liquidated damages or employment fees if temporary worker is hired by provider; authorizes the DOH to revoke staffing agency licenses; authorizes the DOH to request the Attorney General to bring a cause of action against a staffing agency; requires a report to be drafted by the DOH and the DOL and delivered to the Governor and the Legislature by 3/31/24;
- Medication Aides: Allows for nursing homes to utilize medication aides;
- Out of State Nurses: Allows New York to join the Interstate Licensure Compact so nurses and physicians licensed in other states may practice, either physically or virtually, in New York;
- Assisted Living Survey Requirements: Requires assisted living facilities to report annually on quality measures; post monthly services rates, staffing, residency agreements and summaries of fees; authorizes DOH to post results of assisted living facility quality reporting; top rated facilities would be granted the classification of advanced standing on their annual surveillance schedules; advanced standing facilities would be surveyed every 12 to 18 months, while all other assisted living facilities would be surveyed on an unannounced basis annually; assisted living facilities that receive national accreditation may be exempted by the DOH from surveys during the duration of their accreditation;
- Minimum Wage: Indexes the minimum wage regionally for inflation and allocates funds for the cost for State service providers.
- Public Health & Health Planning Council (“PHHPC”): Reduces from 10 to 7 years the PHHPC character and competence look back review period for certain CON applications; eliminates PHHPC review for transfers of interest of less than 10%; raises the cost threshold for projects that need to file a CON with the DOH; and revises the definition of “public need;”
- Non-Medical Transportation: Establishes a working group to recommend ways to expand access to non-emergency medical transportation;
- Nurse Scholarships: Expands scholarship funding for the ”Nurses For Our Future” program;
- Healthcare IT: Supports the replacement of the State’s healthcare reporting infrastructure with a “nation leading” health monitoring and surveillance system; and
- Wadsworth Center: Provides $967 million for the reconstruction and consolidation of the Wadsworth Center.
NYSHFA Legislative Visitation Days
NYSHFA will be conducting our Legislative Visitation Days on Monday, February 27th (12:00 pm – 5:00 pm) and Tuesday, February 28th (9:00 am – 3:00 pm) to advocate for our issues within the FY 2023-24 State Budget ... Read MoreNYSHFA Legislative Visitation Days
NYSHFA will be conducting our Legislative Visitation Days on Monday, February 27th (12:00 pm – 5:00 pm) and Tuesday, February 28th (9:00 am – 3:00 pm) to advocate for our issues within the FY 2023-24 State Budget. These meetings will be in-person this year. We will provide additional meeting details as time gets closer. Please send an email to Nancy Knapp at nknapp@nyshfa.org if you will be attending this year’s Legislative Visitation Days. Also, if you have specific legislators you would like to meet with during these dates, please include that in your email to Nancy. For overnight accommodations, please call the Hilton Hotel, 40 Lodge Street, Albany, NY at 518-462-6611. The current rates start at $219 for the evening of February 27. Unfortunately, we do not have a block of rooms, so please book your accommodations quickly! NYSHFA/NYSCAL CONTACTS: Stephen B. Hanse, Esq.` President & CEO 518-462-4800 x11 Nancy Knapp Administrative Assistant 518-462-4800 x26 Read MoreGovernor Hochul’s 2023 State of the State Address
Governor Hochul delivered her second State of the State today before a joint Session of the Legislature in the Assembly Chamber in the State Capitol in Albany. In her remarks, which lasted for roughly one hour, Governor Hochul highlighted six issue areas:- Crime and gun violence;
- Mental health issues;
- Access to affordable housing;
- Energy costs and climate change;
- Access to childcare services; and
- Indexing the State’s regional minimum wages to inflation with a cap and an “off ramp” in the event of certain economic conditions.
- Establish quality reporting and accreditation for assisted living residences and implement quality improvement initiatives in nursing homes “to promote transparency and make it easier for New Yorker’s to make informed choices;”
- Establish a Commission on the Future of Health Care to, among other things, shape the allocation strategy of subsidies for financially distressed nursing homes and hospitals and health care capital;
- Require the DOH to launch an initiative to automate data reporting, reduce the administrative burden on providers, and provide greater flexibility to the DOH on the types and frequency of data collection;
- Advance legislation to require staffing agencies to register and report key data about their operations in an effort to increase transparency into the utilization and costs of contract labor;
- Expand existing transformative capital funding and establish a new capital grant fund to enable technological upgrades;
- Advance legislation to allow New York to join the Interstate Licensure Compact and the Nurse Licensure Compact;
- Require the DOH to review and amend the CON process, including raising the cost threshold for projects that need to file a CON, and revisiting the definition of “public need” used in the application process;
- Create a comprehensive plan to address excessive medical debt for patients, including (1) amending the Consumer Credit Fairness Act to cover medical debt; (2) launching an industry and consumer education campaign; and (3) requiring hospitals to use a uniform application form; and
- Establish a working group to recommend ways to expand access to non-emergency medical transportation.
Executive Order 23
Governor Issues Executive Order – Establishing the New York State Master Plan for Aging. See attached for details ... Read MoreReminder: Early Voting Begins October 29th
This is a reminder that early voting for the General Election will take place October 29 through November 6, 2022. All registered voters are eligible to participate in the General Election. You can also vote on November 8th which is General Election Day... Read MorePublic Health and Health Planning Council
On Friday, September 30th, of the Public Health and Health Planning Council (“PHHPC”) released its respective agendas for the October 6th PHHPC Codes Committee meeting and the full October 6th PHHPC meeting. Absent from both agendas were the proposed regulations drafted by the DOH to implement the provisions of Public Health Law §§ 2828 and 2895-b, which ... Read MoreIMPORTANT REMINDER: Comments to the Public Health and Health Planning Council (PHHPC)
Attached is a revised PHHPC comment letter prepared by NYSHFA regarding the draft 70/40/5 Spending and 3.5 Staffing Mandate regulations. This revised draft letter does not require facility specific financial data. If you haven't done so already, please take the time to complete the letter and submit to PHHPC. Also, below is a link to NYSHFA’s VoterVoice where you can electronically submit your comments to PHHPC. If you are sending a hard copy letter, it is imperative that a copy of your PHHPC comment letter also be emailed to Comments@nyshfa.org. It is imperative that you complete this letter ASAP and e-mail it to PHHPC. Click the link below to log in and send your message: https://www.votervoice.net/NYSHFA/Campaigns/97171/Respond NYSHFA/NYSCAL CONTACTS: Stephen B. Hanse, Esq. President & CEO 518-462-4800 x11 Read MoreComments to the Public Health and Health Planning Council (PHHPC)
Attached is a revised PHHPC comment letter prepared by NYSHFA regarding the draft 70/40/5 Spending and 3.5 Staffing Mandate regulations. This revised draft letter does not require facility specific financial data ... Read MoreComments to the Public Health and Health Planning Council (PHHPC)
NYSHFA hosted an Town Hall Call today regarding the submission of public comments by all NYSHFA members to the Public Health and Health Planning Council (“PHHPC”) opposing both the revised proposed 70/40/5 spending mandate and 3.5 hours staffing mandate regulations. Attached is an updated draft PHHPC comment letter prepared by NYSHFA that was discussed during the Town Hall Call. Also, below is a link to NYSHFA's VoterVoice where you can electronically submit your comments to PHHPC. If you are send a hard copy letter, it is imperative that a copy pfyour PHHPC comment letter also be emailed to Comments@nyshfa.org. Click the link below to log in and send your message: https://www.votervoice.net/NYSHFA/Campaigns/97171/Respond NYSHFA/NYSCAL CONTACTS: Stephen B. Hanse, Esq.` President & CEO 518-462-4800 x11 Read MoreUrgent NYSHFA - Town Hall Call
On Tuesday, August 23rd at 3:00 PM, NYSHFA will be hosting an important Town Hall Call regarding the submission of public comments by all NYSHFA members to the Public Health and Health Planning Council (“PHHPC”) opposing both the revised proposed 70/40/5 spending mandate and 3.5 hrs staffing mandate regulations... Read MoreUrgent NYSHFA - Town Hall Call
On Tuesday, August 23rd at 3:00 PM, NYSHFA will be hosting an important Town Hall Call regarding the submission of public comments by all NYSHFA members to the Public Health and Health Planning Council (“PHHPC”) opposing both the revised proposed 70/40/5 spending mandate and 3.5 hrs staffing mandate regulations. Call In # 1-800-220-9875 Participant Code: 14227658 Please make every effort to participate on this important NYSHFA Town Hall Call. Thank you! NYSHFA/NYSCAL CONTACTS: Stephen B. Hanse, Esq.` President & CEO 518-462-4800 x11 Read MoreAHCA/NCAL: Deadline Approaching – Registration for Congressional Briefing today
Get the latest news about what’s happening on the Hill, network with colleagues, hear from exciting speakers, and earn CEs at this event. It’s more important than ever to make sure that your Members of Congress understand the challenges you face on a daily basis. The registration deadline is April 29, 2022. See attached for more information ... Read MoreRegister now for the AHCA/NCAL Congressional Briefing
Get the latest news about what’s happening on the Hill, network with colleagues, hear from exciting speakers, and earn CEs at this event. It’s more important than ever to make sure that your Members of Congress understand the challenges you face on a daily basis. The registration deadline is April 29, 2022 ... Read MoreThe AHCA/NCAL Congressional Briefing is back for 2022!
Come to Washington, D.C. June 6-7, to present and discuss your needs and concerns with people in a position to make changes. See attached for details ... Read MoreFY 2022-23 Executive Budget Overview
1.5% Medicaid Cut Restoration Restores the prior administration’s 1.5% reduction to FFS Medicaid revenue in order to provide additional funding and recognize growth in provider service costs. 1% ATB Medicaid Rate Increase Provides for a payment increase of 1% across all DOH Medicaid fee-for-service rates. Healthcare Workforce Bonuses Amends the Social Services Law to make statutory changes necessary to implement healthcare workforce bonuses. Specifically, the law will be amended to provide health and mental hygiene workers earning up to $100,000 annually with a one-time bonus up to $3,000. The bill requires Medicaid providers to identify, claim, and pass through healthcare worker bonuses, and establishes monetary penalties for such providers for failure to properly do so. The bill further establishes that the maximum bonus per employee will be $3,000 and shall not be subject to state and local income tax. Statewide Facility Transformation Program IV Allocates $1.6B for the purpose of transforming, redesigning and strengthening health care needs. Supports capital projects that facilitates advancing these transformational goals.- Authorizes use of $450M to finance existing Program III eligible capital projects. This includes funds for residential health care facilities.
- Invests an additional $50M to support implementation of a Green House Nursing Home Initiative.
- Invests an additional $150M for IT infrastructure and telehealth capabilities for providers.
- Allocates $61M additional funding for minimum staffing requirements.
Governor Hochul’s FY 2022-23 Executive Budget Proposal
On Tuesday, January 18th, Governor Hochul released her $216.3 billion FY 2022-23 Executive Budget proposal entitled “A New Era for New York.” As presented, the FY 2022-23 Executive Budget increases overall State spending by an estimated 3.1%, increases the Medicaid Global Cap ceiling to 4.7%, and changes the metric used to set the Medicaid Global Cap spending from the 10-year rolling average of the medical component of the CPI to a 5-year rolling average based on Medicaid spending projections. Total Federal, State and local Medicaid spending is expected to be $92 billion in FY 2023, an increase of 6.3%. In presenting the Executive Budget, Governor Hochul emphasized the critical need to invest in healthcare and rebuild New York’s healthcare workforce, highlighting that the FY 2022-23 Executive Budget includes $10 billion for healthcare – “the largest investment in healthcare in State history.” The following is a brief summary of certain initiatives included within Governor Hochul’s FY 2022-23 Executive Budget:- Restores the prior administration’s 1.5% Medicaid cut;
- Increases the Medicaid base rate by 1% ATB;
- Invests $1.2 billion (state share) for healthcare worker retention and recruitment by providing up to $3,000 per frontline healthcare worker earning up to $100k annually. Workers must have been employed a minimum of 6 months to be eligible. These funds will flow through the employer via Medicaid;
- Allows for nursing homes to utilize medication aides;
- Establishes a $1.6 billion capital program for financing capital improvements to nursing homes and other eligible healthcare facilities;
- Allocates $450 million for other capital improvements, with $50 million guaranteed for nursing homes;
- Invests $150 million to build out IT infrastructure and telehealth capabilities for various providers;
- Allocates $61 million (state share) for minimum staffing requirements;
- Invests $50 million to support the implementation of a Green House Nursing Home initiative; and
- Allocates $750 million to construct a new laboratory on the Harriman campus in Albany.
Governor Hochul’s State of the State Address
Governor Hochul delivered her first State of the State address today in the Assembly Chamber in the State Capitol in Albany. In speaking for just under an hour, Governor Hochul opened her speech by directly addressing the critical role of healthcare workers in hospitals and long-term care facilities and the healthcare workforce crisis New York is facing. Building upon these remarks, Governor Hochul set forth several proposals to rebuild and grow the State’s healthcare workforce by 20% over the next 5 years and invest $10 billion in healthcare. Key components of the Governor’s multi-year investment proposal include the following: $2 billion for healthcare worker wages; $2 billion for healthcare worker retention bonuses, including $3,000 bonuses going to certain full-time workers; $2 billion for healthcare capital infrastructure and improved lab capacity; and $500 million for certain COLAs. In addition, Governor Hochul also proposed the following long-term care initiatives in her State of the State: Allowing certain long-term care workers to administer medications in nursing homes; Establishing certification criteria for “memory care” that will require long-term care facilities to include specific training requirements for staff and administrators; Offering free tuition, cover instructional costs and provide stipends for high demand healthcare occupations; Developing career pathways for long-term care workers by investing in mentorship and transition tools; Supporting conversions of nursing homes to the Green House model for long-term care; Initiating a study of the impacts of COVID on the Long-Term Care Ombudsman Program; Establishing a State Master Plan for Aging through an Executive Order to address challenges related to communication, caregiving and financing; and Creating a Center for Medicaid Innovation to lower costs and improve care. As always, NYSHFA|NYSCAL will be sure to provide updates on these and other initiatives as the FY 2022-23 State Budget process moves forward. NYSHFA/NYSCAL CONTACTS: Stephen B. Hanse, Esq. President & CEO 518-462-4800 x11 Read MoreNew E.O. 4.4 regarding Nursing Homes
On December 31, 2021 Governor Kathy Hochul issued Executive Order 4.4 suspending until January 31, 2022 any enforcement of parts of two controversial laws enacted last year that directly affect nursing homes ... Read MoreGovernor Hochul Announces Administration Appointments
Governor Kathy Hochul today announced new appointments to her administration ... Read MoreNYSHFA | NYSCAL Town Hall Call – April 15th at 11:00 am
Please note the NYSHFA | NYSCAL Town Hall call has been scheduled for Thursday, April 15th at 11:00 am ... Read MoreClarification: Executive Order 202.100
Governor Andrew Cuomo signed Executive Order (EO) 202.100 which is effective through April 30, 2021. This EO continues the suspensions and modifications of law made by EO 202, with the exception to temporarily suspend or modify any statute, local law, ordinance, order, rule, or regulation, or parts thereof, of any agency during a State disaster emergency, if compliance with such would prevent, hinder, or delay action necessary to assist or aid in coping with such disaster. In addition to requiring the nursing home operators or administrators to certify that they are able to properly care for a patient and obtain a negative COVID-19 diagnostic test result prior to discharge from the hospital, it further requires that no Article 28 general hospital shall discharge a patient to a nursing home, without first offering to medically eligible patients, and if the patient consents, providing a COVID-19 vaccine to such patient. Please see attached Executive Order and Guidance that was sent to hospitals regarding Vaccinating Long-Term Care Patients Before Discharge to a Long-Term Care Facility. NYSHFA/NYSCAL CONTACTS: Stephen B. Hanse, Esq. President & CEO 518-462-4800 x11 Lisa Volk, RN, B.P.S., LNHA Director, Clinical & Quality Services 518-462-4800 x15 Read More70/40 Spending Ratio - Executive Budget Summary
Included within the Health & Mental Hygiene State Budget bill (S.2507-C/A.3007-C), which is anticipated to be passed by the Legislature today, are the following provisions pertaining to the 70/40 nursing home spending ratio. As previously noted, O’Connell and Aronowitz, NYSHFAs General Counsel, anticipates filing suit to challenge these and other provisions in either or both state and federal court in order to invalidate the terms. NYSHFA will continue to provide updates as these issues progress.- Establishes minimum direct resident care spending thresholds effective on 1/1/22 where every RHCF must spend a minimum of 70 percent of revenue on direct resident care and 40 percent of revenue on resident facing staffing. Resident facing staffing is included within the amounts spent on direct resident care.
- 15 percent of costs associated with resident facing staffing shall be deducted for contracted services provided by RNs, LPNs and CNAs.
- RHCFs whose total operating revenue exceeds total operating and non-operating expenses by 5% or that fail to spend the minimum amount necessary to comply with the minimum spending standards for resident facing staffing or direct resident care, calculated on an annual basis, shall remit the difference to the State by 11/1 in the year following the year in which the expenses are incurred. Such funds shall be deposited into the Nursing Home Quality Pool.
- “Revenue” is defined as total operating revenue from or on behalf of residents, government payers or third-party payers.
- The definition of “Revenue” excludes the average increase in the capital portion of the Medicaid reimbursement rate from the prior 3 years.
- “Expenses” are defined as including all operating and non-operating expenses before extraordinary gains. Third party transactions or compensation that is greater than the fair market value for such transactions and the payment of compensation for employees not actively engaged in or providing services at the facility are excluded from expenses.
- “Direct Resident Care” is defined very broadly but excludes administrative costs (other than nurse administration), capital costs, debt service, taxes (other than sales taxes and payroll taxes), capital depreciation, rent and leases and fiscal services.
- “Resident facing staffing” is defined as including all staffing expenses in the ancillary and program services categories on Exhibit H of the cost report as of 2/15/21.
- Authorizes the Commissioner of Health to waive the requirements on a case-by-case basis, upon successful demonstration of unexpected or exceptional circumstances which prevent compliance.
- Authorizes the Commissioner of Health to seek a State Plan Amendment and promulgate regulations to implement the law.
Senate and Assembly One-House Budget Bills
The Senate and the Assembly advanced their One-House Budget bills setting forth their respective negotiating positions pertaining to the FY 2021-22 State Budget. The following is a summary of some of the provisions either included or excluded in each respective One-House Budget proposal affecting skilled nursing and assisted living providers. It is important to note that while the Senate and Assembly both rejected the Governor’s nursing home and adult care reforms, these initiatives are being advanced in legislation outside of the State Budget process by both the Senate and Assembly and could also be included in the final FY 2021-22 State Budget. Senate One-House Budget Proposal- Does not include the Governor’s proposed nursing home and adult care reforms stating that the Senate has already passed a package of nursing home reform legislation;
- Does not include the Governor’s 1 percent Across the Board Medicaid reimbursement cut;
- Does not include the Governor’s extension of the Medicaid Global Cap through FY 2023 and calls on the DOH to seek alternatives that factor in reductions in federal reimbursement rates, adjustments in utilization and enrollment increases;
- Provides $200 million for services and expenses for acute care facilities and nursing homes to increase nurse staffing levels;
- Does not include the Governor’s transfer of $455 million of Medicaid funds to the General Fund;
- Does not include the Governor’s elimination of EQUAL subsidy program;
- Expands the definition of ‘distant site’ to allow telehealth providers to provide services anywhere in the United States;
- Repeals the transition of the Medicaid pharmacy benefit from Medicaid Managed Care; and
- Adds language to require the DOH to reoffer contracts to ensure there are at least two fiscal intermediaries for CDPAP in each county with a population of 200,000 or more.
- Does not include the Governor’s proposal related to nursing homes and adult care facilities;
- Does not include the Governor’s 1 percent Across the Board Medicaid reimbursement cut;
- Transfers $250 million for distressed hospitals and nursing homes to the Medicaid general fund;
- Provides $20 million for workforce recruitment and retention of nursing home CNAs and home care personal aides;
- Does not include the Governor’s proposal to eliminate exemptions for mandatory electronic prescribing requirements;
- Does not include the Governor’s elimination of EQUAL subsidy program;
- Includes a proposal to establish the eligibility of individuals being discharged from a nursing home or adult home to the community for Special Standard for Housing Expenses which exempts an amount of income for the purpose of assisting with housing costs;
- Restores funding for the Adult Home advocacy Program to support legal service providers assisting adult home residents;
- Includes an additional $1 million in funding for the Long Term Care Ombudsman Program;
- Carves out services for Medicaid enrollees with traumatic brain injuries or that qualify for nursing home diversion from Medicaid managed care and into Medicaid FFS;
- Includes a proposal to require the DOH to conduct a study on ambulette Medicaid reimbursement rates;
- Delays the Medicaid pharmacy transition from managed care to FFS for three years; and
- Does not include the Governor’s proposal to eliminate Prescriber Prevails.
