Several measures to solve New York’s home care crisis were part of the budget proposed by Governor Cuomo and passed by both houses of the New York State legislature early this morning. It was a significant victory for home care consumers, their caregivers and responsible providers.
Wage Parity for Home Care Workers
The law now requires parity between the wages of home care workers working under Medicaid subcontracts and those covered by local living wage laws in New York City, Nassau, Suffolk and Westchester. Over the next four years, tens of thousands of invisible workers will be lifted from poverty, reducing high rates of industry turnover and improving the quality of care provided.
In New York City, the law requires the following:
- 3/1/12 - 2/28/13: $9.00 per hour, plus $1.35 without health benefits.
- 3/1/13 - 2/28/14: $9.50 per hour, plus $1.43 without health benefits.
- Beginning 3/1/14: $10.00 per hour, plus $1.50 without health benefits.
After 3/1/14, agencies must also offer the paid time off and modest pension currently provided under the collective bargaining agreements covering workers in the New York City home attendant program.
In Nassau, Suffolk and Westchester, the living wage requirements will begin in March of 2013, and may rise up to 115% of the New York City living wage law standard of $10.00 plus $1.50 without benefits.
You can read the full text of the new law here.
The law will rein in Medicaid spending by Certified Home Health Agencies, a small group of whom have been responsible for almost doubling per-recipient spending over the last six years. It will do so in two ways:
- This year, the law sets ceilings on spending by individual CHHAs, saving up to $200 million by cutting rates if those who have seen the highest rates of growth fail to reduce utilization.
- Beginning in 2013, there will be a new Medicaid payment system for CHHAs, matching Medicare’s system by funding 60-day episodes of care, with rates varying by the diagnosis of the patient. This will end once and for all the fee-for-service incentive to inflate hours of service.