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New York State Budget 2009-10:
Results and Implications for Long-Term Care
On April 3rd, the New York State Legislature
passed the 2009-10 state budget. Although the
infusion of federal Medicaid stimulus money
from President Obama’s economic recovery plan would
have been more than enough to restore all of Governor
Paterson’s proposed Medicaid cuts to long-term healthcare,
only about 40% of those funds are being invested in health
care in the budget.
The budget will create pilot Long Term Care
Assessment Centers, authorize 6,000 assisted living
program beds and decertify 6,000 nursing home beds over
five years and create workgroups to inform new payment
methodologies for nursing homes and home care. Some
of the major cuts include elimination of 2008 and 2009
“cost of living” increases for all providers, as assessment
tax on home care providers and alterations to Medicaid
reimbursement for nursing home services.
Thankfully, there was restoration of $173 million of
nursing home cuts and $121 million of home care cuts
originally proposed by the Governor. While there is still
a substantial reduction in revenues from 2008-09, the
magnitude is much less. Given the challenging economic
and fiscal environment, these results are an achievement.
These results would not have been achieved without
the strong and sustained advocacy efforts of the long-term
care industry and the families and caregivers who depend
on them. Legislative advocacy is critical in ensuring that
providers can deliver the best quality care to their residents,
patients and clients. Throughout the budget process,
trustees, staff, residents, patients, volunteers, students as
well as family members and caregivers should all be part
of advocacy efforts. Legislators need to hear from their
constituents and your voice does make a difference. The
next time—and there will be a next time—the organization
that cares for your family member reaches out and asks you to participate in an advocacy campaign, jump at the
chance!
Once again, long-term care facilities will examine their
programs and operations and assess ways in which they can
work more efficiently and economically in the face of this
loss of revenue. Many facilities anticipated these cuts and
reforms and were very conservative when planning for
2009-10. But if the economic situation does not improve,
Governor Paterson may call the State Legislature back to
Albany this summer to review the budget and possibly
enact more cost-cutting measures.
If this occurs, more advocacy will be needed so please
respond to your long-term care facility’s request for phone
calls, emails and letters.
The effect of the budget cuts on people with dementia
and their families will be significant. Even though our
patients are heavy users of long-term care services, they
don’t usually require complex skilled nursing tasks such
as ostomy or wound care. Our patients need supervision,
engagement and assistance with personal care. These
cuts make people with dementia even less attractive to
nursing homes, which will receive reduced payments
for “lower acuity” care. If the reduction in rates for
the “Home Attendant” program and other Medicaid
home care programs persist, it might very well threaten
the existence of the very programs that so many of our
families depend on.
We are well aware of the need to reduce spending.
However, it is imperative that the budget not be balanced
on the backs of people with Alzheimer’s disease and other
dementias: a heavily Medicaid dependent population that
is projected to grow in the next decades.
— Pat Beilman
Jewish Home Lifecare
Pat Beilman is Vice President for Public Affairs at Jewish Home Lifecare where she has been coordinating advocacy efforts for the
past 10 years.
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