LeadingAge New York State Budget Review April 2017 | Page 14

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SFY 2017-18 Final State Budget
Home Care and Hospice Services
The final budget reflects the continuation of the implementation of Medicaid Redesign Team (MRT)
recommendations, which began in SFY 2011-12. As a result of these reforms, especially MRT #90 which mandates
managed care enrollment of Medicaid recipients who need more that 120 days of community-based long term
care services, the provision of home care services has changed significantly.
In addition, the budget extends ongoing cost containment initiatives, such as Medicare maximization,
administrative and general cost caps, past trend factor cuts and others. Specific proposals affecting home care and
hospice services include:
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Hospice Services: The final budget includes an agreement to achieve $9 million in savings administratively
(without legislation) through billing guidance to ensure that Medicare is the primary payer for hospice
services.
Extending Elimination of Trend Factors: The final budget continues the elimination of the Medicaid trend
factor. It appears the elimination continues until March 31, 2019 for CHHAs, LTHHCPs, AIDS home care
programs, and personal care provider services; however, we are awaiting confirmation on the language.
CHHA and LTHHCP Administrative and General Caps: The final budget continues, through March 31,
2020, the existing caps on CHHA and LTHHCP reimbursable administrative and general costs, which limits
reimbursement to the statewide averages.
CHHA Episodic Payments: Last year’s final budget extended the authority for CHHA episodic rates of
payment for sixty-day episodes of care until March 31, 2019. The episodic payment methodology does not
apply to services provided to children under eighteen years of age and other discrete groups.
Home Care Appropriations
The final budget reflects the following funding amounts:
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Consumer Directed Personal Assistance Program (CDPAP) – Wage Parity: The final budget expands the
Wage Parity law to cover personal assistants or aides working under CDPAP. Wage Parity requires specified
hourly wages for aides working in New York City, Westchester, Nassau and Suffolk Counties. The budget
appropriates $18 million to support this expansion; howev er, the Department of Health has indicated that it
believes existing rates are sufficient to cover the expansion.
Personal Care Worker Recruitment and Retention (R&R): The final budget accepts the Executive proposal
to level-fund $272 million for New York City and $22.4 million for other areas of the State for Medicaid
adjustments supporting R&R of workers with direct patient care responsibility.
LeadingAge New York/April 2017
Page 13