Multiple scandals involving New York Gov. Andrew Cuomo and a related impeachment investigation will not slow down budget negotiations. That could mean a late night for the state’s home-based care operators, who are following the talks closely due to possible wage hikes on the table.
As of Wednesday afternoon, New York lawmakers were full-speed ahead on meeting their annual budget deadline of April 1. There is wiggle room for finalizing a budget after Thursday, but New York has not missed its normal target since the Cuomo administration took office.
“Everything’s very fluid right now,” Roger Noyes, director of communications at the Home Care Association of New York State (HCA-NYS), told Home Health Care News. “The different conference committees are meeting to basically reconcile all these different proposals, with an eye towards finalizing the budget by the April 1 deadline, which is the statutory deadline for completing the budget and starting the next fiscal year in New York state.”
As it relates to the home-based care workforce, proposals include different plans to ultimately boost wages for caregivers.
Earlier this year, New York Sen. Rachel May sponsored standalone legislation — the Fair Pay for Home Care Act — requiring that home care aides get paid a wage that is 150% of minimum wage or the applicable wage law in any given area. Assembly Member Richard Gottfried sponsored the bill in his chamber.
“New York has been suffering with an austerity funding of human services, particularly health care, particularly home care, for years and years now,” Gottfried said in February. “It’s not just the COVID-19 recession that is causing this downsizing of funding. It’s a long-term problem.”
Now, lawmakers are attempting to boost home-based care workers’ wages through the budget process. Multiple options are being considered, according to Noyes.
One proposal is a scaled-down version of the Fair Pay for Home Care Act that would raise wages to 112% of minimum wage or applicable wage laws. Another proposal is a one-time bonus for in-home workers instead of an ongoing wage mandate.
“Negotiations are pretty feverish right now,” Noyes said. “We should know pretty soon what’s going to happen.”
Generally, New York’s in-home care providers are supportive of a wage hike for workers, many of whom are women, immigrants and people of color. Providers have urged lawmakers, though, to include long-term reimbursement support to help sustain higher wages for caregivers.
The 112% proposal only locks in one year of increased funding to pay workers. That lack of long-term, structural rate support for home-based care employers paired with an ongoing wage mandate could put them in a precarious position down the road.
“HCA has long supported reimbursement for enhanced direct-caregiver compensation,” the advocacy organization noted in a statement. “We appreciate the intent of new proposed state budget legislation to increase aide wages. However, the Senate’s one-house budget proposal would not sufficiently cover the full cost of this new mandate for home care provider employers in New York state, many of whom are operating at negative margins.”
Another downside to that proposal’s one-year funding plan is that it only supports Medicaid-reimbursed providers, leaving Medicare or private-pay employers to fend for themselves.
On its end, HCA has offered alternative budget legislation to the chairs of the state Senate and Assembly budget conference committees. Its proposal would provide a funding mechanism for wages and other supports for in-home care, assisted by federal aid and other sources for coverage of Medicaid and non-Medicaid services alike.
The bonus idea may win some supporters in the hours before the April 1 budget deadline because it meets the objective of getting funds out to caregivers directly without locking the state into a permanent obligation, sources told HHCN. It additionally avoids the potential political complications of implementing a new mandated minimum wage for a single category of worker.
A legal alert from Poricanin Law sent Wednesday afternoon reported that the Fair Pay for Home Care legislation “seems almost certain to become law.” If that proposal is enacted, providers would have to immediately raise pay for workers, as its provisions take effect on April 1.
“Such a quick effective date simply does not provide sufficient time for covered providers to actually come into compliance with the wage and benefit requirements of this legislation,” Poricanin Law’s alert stated.
Budget negotiations did not reach a conclusion at the time this story was published.
Broadly, home care is one of the fastest-growing sectors of the New York economy. In New York City, two out of every five new private-sector jobs in 2017 were in home care, according to state statistics.