FY 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
