FY 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.

70/40 Law Amendments

Amends the definition of “revenue” in the 70/40 law to exclude the cash receipts assessment for all providers. Also amends the definition of “revenue” to exclude the capital per diem portion of the Medicaid rate for nursing homes that have a 4-Star or 5-Star CMS rating. Also allows for the Commissioner of Health, on a case by case basis, to exclude from the definition of “revenue” the capital per diem portion of the Medicaid rate for nursing homes that have a 3-Star CMS rating.

Scope Of Practice: CertifiedMedication Aides

Amends the Education Law and the Public Health Law to expand the Nurse Aide’s scope of practice to include the administration of medication in a skilled nursing facility. Specifically, the Education and Public Health Laws will be amended to allow Certified Nurse Aides to administer routine and prefilled medications (insulin, low weight molecular heparin, naloxone, and epinephrine) once trained and able to demonstrate competency. The Certified Medication Aide will be supervised by a Registered Professional Nurse employed by the skilled nursing facility. Facilities must have a systemic approach to address drug diversion.

Financially Distressed Facilities

Amends the Public Health Law to include residential healthcare facilities and adult care facilities among the providers that are eligible for Vital Access Provider Assurance Program (“VAPAP”) funds.

Medicaid Global Cap

Extends the Medicaid Global Cap for two years (through FY 2024). Modifies the metric for year-to-year growth allowed for Medicaid spending by adopting the five-year rolling average of Medicaid spending projections, based on the CMS Office of Actuarial Services (replaces the 10-year rolling average of the Medical component of the CPI index). The Executive Budget calls for a 4.7% increase in the Global Cap for FY 2022-23.

Nurses Across New York

Amends the Public Health Law to implement workforce initiatives to rebuild and grow the healthcare workforce, including establishing the Nurses Across New York (“NANY”) loan repayment program.  Specifically, Public Health Law will be amended to establish the NANY program which would reimburse nurses working in underserved communities for loan repayment over three years. A work group would be appointed from associations representing nurses, hospitals, and other healthcare providers to streamline the application process.

Interstate Medical Licensure Compact

Authorizes New York to join the Interstate Medical and Nurse Licensure Compact to allow doctors and nurses to easily relocate and practice in their profession using their existing license to practice in New York. Joining the Compact recognizes the expanded mobility of nurses and the need for coordination and cooperation among states to ensure the health and safety of residents and the benefits to public health through the effective use of advanced communication technologies.

Also authorizes the issuance of a temporary permit for up to six months to practice while a licensing application in a qualified high need healthcare profession is pending for individuals licensed in another state who seeks licensure in New York while under the supervision of a New York licensee.

Assisted Living Needs Methodology

Extends the deadline that determines the need methodology for the Assisted Living Program through April 1, 2025. ACF regional and ALP occupancy rates will factor into the need methodology. Existing ALP Providers in good standing with the Department of Health will be afforded an expedited review when applying for an additional nine beds not requiring renovation or construction. Based on a complete and satisfactory application, a determination of the application will be made within 90 days of submission.

Transfer of Oversight for Licensed Healthcare Professions

Amends the Education Law and the Public Health Law in relation to the transfer of oversight of certain licensed professions from the State Education Department to the Department of Health. Provides that all functions, powers, duties and obligations of the Education Department concerning the healthcare professions listed in the bill which includes medicine, physicians, pharmacy, nursing, OT, PT, speech, social work, dietary and mental health among other healthcare professions will be transferred to NYS DOH.

NYSHFA/NYSCAL CONTACTS:

Stephen B. Hanse, Esq.
President & CEO
518-462-4800 x11