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6 Budget Asks to Strengthen New York’s Home Care Workforce

January 22, 2019

Funding decisions through the annual state budget can impact the home care workforce in a number of ways. They can influence workers’ wages and benefits through Medicaid payment rates. They can determine the availability of public benefits that many workers depend upon. And they can set the level of funding for home care workforce development programs.

The release of Governor Cuomo’s executive budget on January 15 marked the start of New York State’s budget season. As policymakers begin to debate the state’s funding allocations, PHI offers the following six budget recommendations—based on our recent policy priorities—that aim to strengthen the home care workforce, improve job quality, and address the workforce shortage in this sector.

Establish a workforce shortage taskforce

New York State must recruit and retain more home care workers to meet growing demand, especially in rural areas where the workforce shortage is most acute. This year’s budget should establish a multi-stakeholder taskforce to develop a strategic plan for strengthening the state’s home care workforce.

Create a Home Care Jobs Innovation Fund

As New York’s home care providers struggle to recruit and retain workers, they unfortunately lack the resources to test innovative solutions to this problem. This year’s budget should include funding to support pilot projects throughout the state that boost the number of home care workers that enter and remain in the field. The findings from these projects can help determine statewide solutions.

Fund implementation of the advanced home health aide occupation

New York recently finalized regulations for the advanced home health aide occupation, which will allow certified advanced aides to administer certain medications. To ensure that this new role is successfully established, this year’s budget should include funding to pilot-test implementation of the role in certain parts of the state, covering training, supervision, and evaluation costs, and higher wages for advanced aides.

Build a home care workforce data system

A robust workforce data system will allow the state to more accurately track the size and quality of the workforce. Good data is also essential for monitoring whether recent policy changes, such as increasing the minimum wage and establishing the advanced aide occupation, are having their intended effects. As a starting point, this year’s budget should fund a survey of all state agencies, including (but not limited to) labor, health, and education, to identify data sources and data collection gaps regarding this workforce. This year’s budget should also fund a statewide survey of home care workers to better identify the job experiences and challenges that impact recruitment and retention.

Set baseline Medicaid home care rates

Because the Medicaid Managed Long Term Care (MLTC) program is the largest payer for home care in the state, MLTC rates largely determine provider investment in these workers. To boost funding for workers, this year’s budget should require that the state sets a minimum amount (“baseline rate”) that plans must pay home care providers, accounting for training, wages, benefits, and workforce supports.

Establish a Public Home Care Advocate

Many workers and employers struggle to keep track of their rights and responsibilities under evolving wage and labor laws, such as those regulating minimum wage and overtime requirements. This year’s budget should establish and fund a statewide public home care advocate to help home care workers and employers navigate these complex developments. This advocate could also help connect workers with other supports, such as training, public benefits, and career advancement opportunities, among others.

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