On January 5, Governor Hochul presented the State of the State Message, and for the first time in recent memory, there was a specific section dedicated to issues of importance to older residents. The State of the State is available for your review in an online book, and can be found at this link.
StateWide Executive Director Maria Alvarez expressed appreciation that she listened to advocates who had been urging a focus on concerns of older residents. StateWide is looking forward to working with the Administration to improve aging, quality of care, home care shortage & ending the Medicaid cliff by increasing income to 138% FPL & eliminating resource test for aged, blind & disabled, in addition to other priorities in our legislative agenda.
We applaud Goveror Hochul’s proposal to expand Medicaid eligibility so that low income New Yorkers age 65 and up, as well as those with disabilities, are able to maintain Medicaid eligibility after they become eligible for Medicare. This coverage expansion will eliminate the resource eligibility test and raise the income level to 138 percent of the federal poverty level (FPL) for all who apply for or recertify for Medicaid. StateWide counselors have heard about this problem from callers asking for help enrolling in Medicare coverage when they have been thrown off the Exchange Medicaid expansion coverage due to becoming eligible for Medicare. Those that were receiving services for long term care, home care, dental, hearing and vision lost their benefits as a result! Many, living very close to poverty, but above the discriminatory lower threshold for Medicaid coverage if they were eligible for Medicare, found the costs of health care unafforable. As a result, we (along with other advocacy partners) proposed a systemic fix to end the different eligibility requirements for Medicaid based on whether or not someone is eligible for Medicare and the cliff that occurs when someone on Medicaid loses their benefits when they become Medicare eligible. Currently, when they turn 65 or when they obtain Medicare due to a disability, they become subject to different (lower) income eligibility requirements at 84% of the FPL and a resource test.
StateWide is also pleased that the Governor spoke to a comprehensive plan to ensure the health and well-being of aging New Yorkers, anchored by a State Master Plan for Aging. StateWide was part of a group of advocates that wrote to the Governor asking that she adopt the concept of a Master Plan that would impact future decisions on budgeting and policies to improve the lives of older residents. The Governor will issue an Executive Order to implement the State Master Plan for Aging. It will coordinate all State policy and programs to create a blueprint of strategies to ensure that older New Yorkers can live fulfilling lives, in good health, with the freedom and independence to age in place for as long as possible. This plan will also address challenges related to communication, coordination, caregiving, long-term financing, and innovative care models — all furthering the ability for more New Yorkers to age with dignity and independence.
The Governor also raised issues regarding long term care. She will seek certification criteria for “memory care” — a form of long-term care focusing on helping residents with memory issues or dementia. Those facilities that advertise that they provide memory care will need to be certified to do so. Additionally, the Governor will support innovations (but not defined yet) in nursing homes. With specificity, she has endorsed nursing home conversions to the Green House model that is resident focused while improving worker recruitment and retention. You can read more about this model here. The Governor mentioned without specificity the need for future reforms in the LTC Ombudsman program. She references an audit conducted by State Comptroller DiNapoli that found the program failed to meet national standards.
The Governor did not mention quality of care or staffing in nursing homes. At the end of 2021, she did delay by Executive Order any penalties against nursing home operators under the new law effective January 1 that requires minimum staffing hours (3.5 hours per resident per day.) The law is now in effect, but penalties/enforcement will not occur sooner than February 1.
The Governor did address the need to invest in the recruitment and retention of health care staff. A significant portion of the Message focused on growing the healthcare workforce by 20% by improving the career pipeline, expanding access to healthcare training and education, recruiting care workers to underserved areas, and strengthening home care. She will propose a $10 billion commitment to healthcare, supporting higher wages, bonuses, and investments in care. This includes a $500 million for Cost of Living Adjustments (COLAs) to help raise wages for human services workers that would help aging services providers.
We’ll be monitoring these policy developments and will seek further clarification after the Governor’s proposed budget is released in the weeks to come.