Thousands of disabled and aging New Yorkers rely on Medicaid home care to live full lives in the community and avoid institutionalized placement. The newly proposed policy profoundly restricts access to home care by making the eligibility criteria for services much stricter than that of nursing homes. This means that home care will only be granted to those with significant disabilities, leaving most either in more costly and restrictive nursing home settings or left with no support. This will violate federal mandates, leave the state with a loss of significant federal funding, increase Medicaid spending long term since nursing homes are more costly, decrease public health, and strip people of their right to live independently.
The stricter rules for home care eligibility, which will probably go into effect in 2024, will cut eligibility for home care and personal care services for all but those facing the most significant disabilities, preventing access to lower-cost services that help avoid health deterioration, hospitalization, or other institutional placement. Under the new rules, individuals will become eligible for nursing home care well before they are able to receive home care services. The cuts are equivalent to telling people they are no longer able to go to the doctor for a cold but must instead wait until it turns into pneumonia before receiving care.
Making the eligibility criteria for home care stricter than that of nursing home placement would upend federal mandates and policies, leaving the State vulnerable to lawsuits and a significant loss of critical federal funds. The new rules completely disregard the Olmstead ruling, a United States Supreme Court mandate that requires home care be available to all who need it. Advocates contend that implementing these cuts will not only waste money but also worsen the institutional bias in New York State, which encourages nursing home placement above services in your home.
Nina Bakoyiannis, a past co-coordinator of Downstate New York ADAPT, said of the new rules, “These proposals are the definition of penny-wise and pound foolish. They are using draconian cuts to eligibility in a misguided attempt to save money, refusing to recognize that the only way in which these cuts would actually save the state money is that they will result in the early and unnecessary death of thousands of aging and disabled New Yorkers who need them for basic needs like showering, going to the bathroom, and even getting out of bed. We are giving the Senate and the Assembly a clear and swift way to save thousands of lives. If they ignore us, we will remember.”
In response to the home care eligibility changes, the members from Downstate New York ADAPT and Capital District ADAPT have worked with Assemblywoman Amy Paulin and Senator Gustavo Rivera to draft bills that would restore broader access to those in need of services. The bills are S. 328/A. 6346. We need this to be law, NOW!
Assembly Bill A. 6346: https://nyassembly.gov/leg/?bn=A06346&term=2023
Senate Bill S. 328: https://nyassembly.gov/leg/?term=2023&bn=S00328