While New York state nursing homes are hoping to make up Medicaid funding shortfalls 16 years in the making, senior living providers are hopeful that a comparable Medicaid increase for the Medicaid-funded assisted living program also makes it into the final budget.
The state Medicaid Assisted Living Program, or ALP, is New York’s only Medicaid-funded assisted living option.
When originally enacted, the ALP rate was supposed to be calculated at 50% of the regional average skilled nursing facility reimbursement rate. But the Empire State Association of Assisted Living, or ESAAL, noted that ALP rates have lagged far behind and remain “woefully inadequate.”
S 7248 / A 7553 would update assisted living Medicaid rates based on current costs and require periodic updates of those rates moving forward. The state’s senior living provider groups are encouraged by the proposals to support the ALP.
“We appreciate the much-needed proposed increase to Medicaid reimbursement rates from both houses, and we hope that they stand firm in their support during negotiations with the executive,” ESAAL Executive Director Lisa Newcomb told McKnight’s Senior Living. “As importantly, we hope that the assembly and the executive (governor) will join the Senate and include ALP rate rebasing.”
Unlike other care sectors, the ALP’s base rate must be updated in law, from 1992 rates to 2023 rates, “to adequately reflect program costs and prevent additional facility closures, which over the past year have accelerated,” Newcomb said.
As demand for assisted living options for low-income older adults climbs, providing more consistent ALP rate increases would help ensure the viability of the program, said LeadingAge New York. President and CEO James Clyne said the ALP program has been “chronically underfunded” for more than a decade.
“Additional funding for this program should help keep some Medicaid-funded residents out of nursing homes and in a more appropriate level of care,” Clyne told McKnight’s Senior Living on Tuesday.
In January testimony on the 20240-2025 Executive Budget from Gov. Kathy Hochul (D), Clyne noted the need for ALP services is growing, particularly as nursing homes close or take beds offline and individuals in need of around-the-clock services seek more homelike alternatives to nursing homes.
