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    <title>fair-access-initiative-inc-150409</title>
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      <title>2026-27 FY Budget Memo</title>
      <link>https://www.fair-access.org/2026-27-fy-budget-memo</link>
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          NYS Budget Passes with Six Legislative Session Days Remaining
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           After eight weeks and 15 extender bills to keep state government funded, the Legislature passed the final New York State (NYS) Fiscal Year (FY) 2026–27 Budget.
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          The Enacted All Funds budget is $268.1 billion for FY 2026-27, $5.4 billion over the Executive’s proposed budget. 
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          The final budget includes significant investments and policy changes across the healthcare continuum, totaling $147.2 billion in All Funds appropriations — an increase of $10.1 billion above the Executive Budget proposal. 
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          The Enacted State Budget prioritizes healthcare system stability, Medicaid sustainability, public health programs, hospital and nursing home support, workforce initiatives, and preservation of essential healthcare services. 
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          The Enacted Budget Includes the Following:
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          Healthcare Stability and Medicaid Investments
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           The budget includes substantial investments to stabilize New York’s healthcare system, particularly hospitals, nursing homes, and safety-net providers.
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          The Legislature allocated:
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           $500 million for financially distressed hospitals;
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           $2.2 billion through the Healthcare Stability Fund (HSF); and
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           $8.5 billion to continue the Essential Plan following federal approval to reactivate the 1331 Basic Health Plan.
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          Healthcare Stability Fund disbursements include:
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           $711 million for hospitals;
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           $500 million to offset Medicaid Global Cap costs, and extends the legal authority for the Medicaid Global Cap through FY 2028.
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           $433 million for nursing homes;
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           $330 million for the Safety Net Transformation Program;
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           $100 million for the Home Care Worker Quality Program;
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           $50 million for the Mainstream Managed Care Quality Pool;
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           $50 million for physician fee schedule enhancements;
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           $40 million for clinics;
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           $18 million for Assisted Living Programs and hospice care; and
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           $15 million for Value Based Payment innovation initiatives.
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          Managed Care Organization (MCO) Provider Tax
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           The FY 2026–27 budget makes permanent a higher tax on Medicaid managed care organizations beginning January 1, 2027, following a temporary federal extension earlier this year. Originally enacted three years ago, the tax has generated more than $3 billion to help offset rising Medicaid costs.
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          The budget restructures the tax into a uniform 0.35 percent assessment on total premium revenue for Medicaid insurers, subject to federal approval. The spending plan also establishes guidelines for how revenues generated from the tax will be invested moving forward.
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          Long-Term Care Support
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          The enacted budget restores and enhances several provider reimbursement streams and support programs. Key provisions include:
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           Restoration of a 10 percent hospital capital rate add-on;
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           A 10 percent restoration of nursing home capital rates;
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           Enhanced reimbursement rates for medically fragile children at Elizabeth Seton through April 1, 2029;
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           Extension of enhanced reimbursement rates under the Medical Indemnity Fund through June 1, 2027; and
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           $7 million for long-term care providers.
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          The Legislature also formally extended the Nursing Home Transition and Diversion (NHTD) waiver program through 2028, as anticipated.
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          Other Related Items
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           The budget also preserves healthcare coverage for vulnerable populations while implementing several federal compliance-related reforms.
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          The enacted budget:
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           Continues Essential Plan coverage for approximately 1.3 million New Yorkers below 200 percent of the Federal Poverty Level;
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           Delays coverage of long-term services and supports under the Essential Plan until 2031;
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           Ensures biomarker testing coverage under Medicaid;
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           Permanently maintains School Based Health services in Medicaid Fee-for-Service; and
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           Preserves benefits for undocumented seniors over age 65 by transitioning coverage to Medicaid Fee-for-Service.
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          Public Health and Community-Based Investments
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          The budget restores or increases funding for numerous public health and community healthcare programs that had faced reductions or elimination under the Executive proposal.
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          Major public health investments include:
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           $39.3 million for Physician’s Excess Medical Malpractice coverage;
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           $28.5 million for the Medical Indemnity Fund;
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           $10 million for maternal health grants;
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           $10.4 million for opioid addiction harm reduction and patient-centered services; and
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           $14.6 million total for Occupational Health Clinics.
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          Additional funding was restored or expanded for programs including:
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           School Based Health Centers;
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           Family Planning Services;
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           Nurse Family Partnership;
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           Rural Health Care Access initiatives;
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           Community Health Advocates;
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           Sickle Cell programs;
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           Alzheimer’s support services;
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           LGBTQ health initiatives;
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           HIV/AIDS community programs; and
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           Various food security and health equity organizations statewide.
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          The Legislature also rejected several Executive proposals to eliminate public health programs.
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          FAIR Access Next Steps
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          During the final days of the Legislative Session, lawmakers are expected to focus on several priority issues, including redistricting legislation, before adjourning later next week ahead of the upcoming primary elections. 
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          This budget cycle has proven to be a Home Care neutral one, as the Governor's office touts its achievements with the PPL implementation and its related declared costs savings. We expect any larger impact items to be back on the table post the 2026 Election season.
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           FAIR Access Initiative continues its push to advance the Home Care Workforce Modernization and Stabilization Pilot Program, as well as legislation that would codify the State’s “13-hour live-in rule" along with our other agenda items- published
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           Over the coming months, we urge providers to monitor the impacts of the MCO tax and report any discrepancies in outcomes.
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          Post-session, the FAIR team will also be on the road, meeting with lawmakers in their districts to continue advocating for home care providers and needed policy improvements. 
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          For questions or concerns about the content of the NYS Budget, please contact our team at Info@fair-access.org.
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      <pubDate>Wed, 03 Jun 2026 00:40:37 GMT</pubDate>
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      <title>2026-27 FY Budget Priorities</title>
      <link>https://www.fair-access.org/2026-27-fy-proposals</link>
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          Strengthen Home Care Workforce Operations -  
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          Streamline training, onboarding, and administrative function
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          Overview
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          New York’s home care system continues to face persistent workforce shortages, high administrative costs, and caregiver retention challenges. Individual agencies are currently responsible for duplicative onboarding, training, credentialing, and compliance functions—creating inefficiencies, inconsistent standards, and unnecessary costs that ultimately affect patient care access.
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          This proposal consists of a pilot program in partnership with the Department of Health (DOH), to serve as a unified workforce infrastructure supporting home care agencies and workers statewide. The model expands on existing DOH-managed systems—such as the Criminal History Record Check (CHRC) and Home Care Registry—by centralizing additional workforce functions through a shared, technology-enabled platform.
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          Policy Problem
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           Agencies duplicate onboarding, training, and credential verification at significant cost
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           Workforce records are fragmented across employers, limiting portability and efficiency
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           Caregivers face inconsistent training pathways and limited professional development
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Administrative burden contributes to agency strain and worker turnover
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          These structural inefficiencies weaken workforce stability and reduce care continuity for patients
         &#xD;
    &lt;/span&gt;&#xD;
    &lt;span&gt;&#xD;
      
          .
         &#xD;
    &lt;/span&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          Policy Solution
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          The centralized ecosystem would function as a shared service hub, responsible for:
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Standardized Onboarding &amp;amp; Credentialing
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Centralized hiring intake, credential verification, and compliance tracking
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Workforce registry maintaining credentials, training history, and regulatory status
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Training &amp;amp; Professional Development
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           State- and federally compliant standardized training programs
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Technology-Driven Administration
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Centralized HR, compliance, and credential management systems
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Real-time data sharing among agencies, the ecosystem, and DOH
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Modeled after existing CHRC and DOH registry infrastructure
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Caregiver Health Benefit Integration
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Hybrid health coverage model providing primary and limited acute care benefits
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Medicaid remains available for emergency or higher-level care
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;strong&gt;&#xD;
        
           Reduces reliance on Medicaid for routine services and supports preventive care
          &#xD;
      &lt;/strong&gt;&#xD;
      &lt;strong&gt;&#xD;
        &lt;br/&gt;&#xD;
        &lt;br/&gt;&#xD;
      &lt;/strong&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Expected Outcomes
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Workforce Stability: Reduced turnover and improved retention
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Operational Efficiency: Lower administrative costs through shared services and automation
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Improved Job Quality: Clear career pathways, consistent training, and health supports
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Quality of Care: More reliable, well-trained workforce delivering consistent care statewide
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Live-In Home Care Reform -
         &#xD;
    &lt;/strong&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          Aligning DOH and DOL Standards
         &#xD;
    &lt;/strong&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Policy Problem
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          New York’s live-in home care system is governed by conflicting Department of Health (DOH) and Department of Labor (DOL) standards. DOH permits agencies to pay 13 hours of a 24-hour live-in shift when aides receive required sleep and breaks. DOL interpretations and court decisions have nevertheless required payment for all 24 hours—even when agencies comply with DOH rules.
          &#xD;
      &lt;br/&gt;&#xD;
      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          At the same time, unclear DOH supervision rules conflict with federal DOL requirements for duty-free, uninterrupted meal and rest breaks, creating legal exposure and operational confusion.
          &#xD;
      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Current impact on home care providers:
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Widespread litigation and escalating legal costs
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Reduced availability of live-in services
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Increased risk of institutional placement for medically fragile patients
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Provider withdrawal from 24-hour home care
          &#xD;
      &lt;/span&gt;&#xD;
      &lt;strong&gt;&#xD;
        &lt;br/&gt;&#xD;
        &lt;br/&gt;&#xD;
      &lt;/strong&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Policy Solution
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          Create one clear, enforceable statewide standard that aligns DOH and DOL requirements that protects compliant providers from duplicative wage claims and preserves access to 24-hour home-based care.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Codify the 13-Hour Rule: Define live-in care as 13 compensable hours within a 24-hour shift (including required sleep and breaks).
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Preempt Conflicting Interpretations: Statutory clarity that supersedes inconsistent DOL guidance or judicial interpretations.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Safe-Harbor Protections: Liability protection for agencies with verifiable compliance records (e.g., EVV, time logs).
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Curb Abusive Litigation: Direct the Attorney General to address duplicative or bad-faith class actions.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          Required Regulatory Clarification
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          Direct DOH to clarify that supervision requirements do not apply during federally protected, duty-free meal and rest breaks, during which aides are not required to remain on-site or under employer control.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          Fiscal Impact
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Budget neutral
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Potential indirect savings from reduced litigation, administrative burden, and avoidable institutional placements
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Streamline Nursing Assessments
         &#xD;
    &lt;/strong&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          Reducing Duplication, Accelerating Care, and Modernizing Home Care Oversight
         &#xD;
    &lt;/strong&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Overview
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          The FAIR Access Initiative proposes the Universal Nursing Assessment. This proposal is not a new program—it is a structural correction. By aligning existing tools, modernizing data sharing, and eliminating unnecessary duplication, UNA strengthens New York’s home care system while protecting patients, workers, and taxpayers.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          Policy Problem
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          New York’s home and community-based care system requires multiple duplicative nursing assessments for the same individual across programs—often within days or weeks of one another. Licensed Home Care Services Agencies (LHCSAs), Managed Long Term Care plans (MLTCs), PACE programs, Health Homes, and primary care providers each conduct overlapping assessments using similar data but different formats.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          This fragmentation delays access to care, increases administrative costs, and contributes to nurse and care manager burnout. The delays also frustrate patients with repetitive evaluations. Moreover, duplicative assessments waste substantial state Medicaid resources without improving outcomes.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          Policy Solution: Universal Nursing Assessment (UNA)
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          The FAIR Access Initiative proposes the Universal Nursing Assessment (UNA) as a single, standardized, nurse-led clinical assessment that is completed once at the point of care and shared securely across authorized providers.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          Key Features
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Built on the existing Uniform Assessment System–New York (UAS-NY)
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Completed by a Registered Nurse or qualified care manager
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Shared in real time via SHIN-NY / Qualified Entities
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Serves as the authoritative clinical baseline for a defined validity period (e.g., 90 days)
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Allows targeted program-specific addenda—not full reassessments
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          UNA eliminates duplicative base assessments while preserving clinical oversight, patient choice, and program integrity.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          Fiscal Impact (Public-Info-Based Estimate)
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          Using CMS-reported NY LTSS enrollment (~289,500 users) and conservative RN labor cost proxies:
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Estimated annual gross savings:
           &#xD;
        &lt;br/&gt;&#xD;
        
           $40 million – $175 million per year
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Savings driven by eliminating 1–2 duplicative RN assessments per LTSS user annually
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Does not include downstream savings from faster care initiation or reduced institutional utilization
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Integrated Home Care Ecosystem
         &#xD;
    &lt;/strong&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          A Sustainable Alternative to New York’s Current Home Care System
         &#xD;
    &lt;/strong&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Overview
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          New York’s home care system is facing significant fiscal and workforce pressures that threaten access to care for seniors, people with disabilities, and medically complex patients. Across-the-board reimbursement cuts risk destabilizing providers, worsening workforce shortages, and increasing avoidable hospitalizations and institutional care. The FAIR Access Initiative proposes the Integrated Home Care Ecosystem as a sustainable, cost-effective alternative that achieves savings through coordination and efficiency—not service reductions—while strengthening quality, access, and continuity of care.
         &#xD;
    &lt;/span&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
      &lt;br/&gt;&#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Policy Problem
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Home care agencies operate under Medicaid reimbursement rates that do not adjust to rising labor and operating costs.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Fragmentation across providers, payers, and care managers leads to duplicative services, poor coordination, and higher downstream costs.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Workforce instability and agency closures threaten patient access and continuity of care.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Cuts to home care risk shifting costs to more expensive settings such as hospitals and nursing homes.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          Policy Solution: Integrated Home Care Ecosystem
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          The Integrated Home Care Ecosystem aligns key partners across the care continuum to deliver coordinated, patient-centered home care services. Participating entities include:
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Licensed Home Care Service Agencies (LHCSAs)
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Primary care practices
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Health Homes and care management organizations
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Managed care organizations and other payers
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Community-based and supportive service providers
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          Through formal coordination, shared accountability, and data-driven care planning, the model improves outcomes while controlling costs.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          Fiscal &amp;amp; System Impact
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Reduces avoidable hospital admissions, emergency department use, and institutional placements.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Preserves access to home care while mitigating long-term Medicaid costs.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Strengthens provider viability and protects the home care safety net statewide.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Modernize Home Care Funding
         &#xD;
    &lt;/strong&gt;&#xD;
    &lt;strong&gt;&#xD;
      &lt;br/&gt;&#xD;
      
          Aligning Fair Pay with Sustainable Medicaid Funding
         &#xD;
    &lt;/strong&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Overview
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          New York State has long championed fair wages, workers’ rights, and equitable access to care. Home care agencies and caregivers support efforts to raise the minimum wage and establish a livable wage for the workforce serving the State’s most vulnerable residents.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          However, unlike other industries, home care agencies cannot adjust prices or negotiate reimbursement to absorb rising labor costs. Caregiver wages are funded entirely through Medicaid reimbursement rates set by Managed Care Organizations (MCOs) under State oversight.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          When wage mandates increase without corresponding reimbursement adjustments, agencies face an untenable choice: comply and risk insolvency, or reduce services and quality to remain operational. The FAIR Access Initiative calls for aligning wage policy with reimbursement policy to ensure fair pay for workers and sustainable access to care for patients.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Policy Problem
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
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           Wage mandates rise without funding alignment: State minimum wage increases are not automatically reflected in Medicaid reimbursement rates.
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           Agencies lack rate-setting authority: Licensed Home Care Services Agencies (LHCSAs) rely on MCO-negotiated rates that often fall below the true cost of care.
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           Inconsistent and inequitable MCO practices: Some MCO incentives favor volume or referrals, disadvantaging smaller and independent agencies regardless of quality outcomes.
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           Data-driven methodologies are underutilized: MCO rates frequently fail to reflect Department of Health (DOH) Cost Reports and regional cost data used by the State in rate-setting.
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          Absent reform, these structural imbalances will continue to drive agency closures, workforce attrition, and reduced patient access—particularly in rural and underserved communities.
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          Fiscal Reality
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          A $1.00/hour wage increase results in $1.64/hour in total employer cost once mandated payroll taxes, benefits, and administrative expenses are included—representing a 64% increase beyond the wage itself.
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           Per caregiver (30 hours/week): ≈ $2,560 annually
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           750 caregivers: ≈ $1.92 million annually
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           1,000 caregivers: ≈ $2.56 million annually
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          With approximately 250,000 caregivers statewide, even modest wage increases create substantial unfunded liabilities when reimbursement is not adjusted proportionally, threatening agency solvency and continuity of care.
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          Policy Solution
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          The FAIR Access Initiative proposes aligning wage policy and Medicaid reimbursement through the following reforms:
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           Automatic Rate Adjustment
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           Statutorily require Medicaid reimbursement rates to automatically adjust with any State-mandated wage increase.
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           Apply a standardized multiplier (e.g., 1.64×) to reflect the full employer cost of wage increases.
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           Review and update the multiplier biennially.
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           Cost-of-Living Adjustment (COLA) Indexing
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           Incorporate regular COLAs into home care reimbursement rates to prevent recurring inflation-driven funding gaps.
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           Transparency and Pass-Through Enforcement
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           Require MCOs to demonstrate compliance with State-directed rate increases through provider-level reporting and auditable verification that funds reach direct care staff.
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           Data-Driven Base Rate Methodology
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           Mandate use of DOH Cost Reports and regional cost data in MCO rate negotiations to ensure consistent, evidence-based reimbursement.
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           Administrative Transition Support
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           Provide temporary implementation funding to support necessary updates to billing, payroll, and contract systems.
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          Policy Impact
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           Advances New York’s livable wage goals in a fiscally responsible manner.
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           Protects patient access to Medicaid-funded home care statewide.
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           Stabilizes the caregiving workforce and prevents provider attrition.
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           Promotes transparency, accountability, and data-driven oversight.
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           Strengthens collaboration among providers, MCOs, and the State.
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&lt;/div&gt;</content:encoded>
      <pubDate>Sun, 08 Feb 2026 02:52:58 GMT</pubDate>
      <guid>https://www.fair-access.org/2026-27-fy-proposals</guid>
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    <item>
      <title>Health Budget Testimony</title>
      <link>https://www.fair-access.org/health-budget-testimony</link>
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           February 8, 2026 
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          FAIR Access Initiative, Inc. 
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          51 Maryland Street 
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          Dix Hills, NY 11746 
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          Chairpersons, Ranking Members, and Members of the Legislature, 
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          My name is Sasha Guillaume, and I am the Founder and President of the FAIR Access Initiative, a provider-led association representing home care agencies across New York State. It is an honor to represent our members and to submit this testimony to the Members of the Legislature on their behalf. 
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          The mission of FAIR Access Initiative is to strengthen the home care industry by working in partnership with the Legislature, the Executive, and the Department of Health as responsible stewards of the Medicaid program. Our focus is on identifying inefficiencies, reducing waste, and improving long-term sustainability, not expanding programs or increasing spending. 
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          FAIR Access was formed in the wake of the CDPAP transition, which exposed the risks created by a fragmented and disunified industry response. When cost growth, operational complexity, and oversight concerns reached a tipping point in the Consumer Directed Personal Assistance Program, the resulting policy response was sweeping and centralized. Regardless of one’s perspective on that outcome, it demonstrated that when provider-led solutions are absent, corrective action can be broad and disruptive. 
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          FAIR Access exists to prevent that pattern from repeating elsewhere in home care. 
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          Today, fragmentation continues to drive unnecessary Medicaid spending. Multiple entities often assess, document, supervise, and manage care for the same patient. These overlapping assessments and care planning functions can be streamlined to eliminate repetitive services that result in Medicaid paying multiple times for the same work. 
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          FAIR Access proposes a Universal Nursing Assessment, built on the existing UAS-NY, completed once and securely shared across authorized providers. This is not a new program. It is a structural efficiency that recognizes work already being performed and eliminates redundancy. 
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          We also support an Integrated Home Care Ecosystem that aligns plans, providers, and care managers around shared assessments, reconciled care plans, and interoperable data. Better alignment improves continuity of care while reducing administrative duplication and unnecessary cost. 
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          FAIR Access Initiative also sees significant opportunities to reduce redundancy through greater workforce regulatory alignment. While workforce stability is at its core a care issue, it is also a critical fiscal issue. We can build upon existing Department of Health eligibility and credentialing infrastructure to centrally manage in-service and continuing education requirements through a secure registry accessible to providers. This would eliminate repetitive training requirements for staff working across multiple agencies, while maintaining consistent standards and compliance. 
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          Additionally, FAIR Access seeks to work collaboratively with Albany to address the unintended consequences of misaligned mandates that have led to unnecessary litigation and destabilization of provider networks. Conflicting regulatory standards, particularly in live-in care, have reduced participation in one of the most cost-effective alternatives to institutional placement. 
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          FAIR Access Initiative is not here to ask for new funding. We are here to partner with the State to identify waste, improve transparency, and ensure that legislative mandates align with operational and fiscal realities. 
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           ﻿
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          Our goal is to offer provider-led solutions that protect Medicaid dollars and to work collaboratively as trusted stewards of a program that New York’s most vulnerable residents depend on. 
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          Thank you for the opportunity to submit this testimony. 
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          Regards, 
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          Sasha Guillaume, President 
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          FAIR Access Initiative, Inc.
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      <pubDate>Sun, 08 Feb 2026 02:49:35 GMT</pubDate>
      <guid>https://www.fair-access.org/health-budget-testimony</guid>
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    <item>
      <title>Executive Budget Released and FAIR Advocacy Day</title>
      <link>https://www.fair-access.org/state-of-the-state-and-fair-advocacy-day</link>
      <description />
      <content:encoded>&lt;div data-rss-type="text"&gt;&#xD;
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          Join FAIR for Home Care Advocacy Day on Tuesday, February 3!
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           To RSVP for FAIR’s Advocacy Day, please contact Alyssa Lovelace at 
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           alyssa@hgmlobby.com
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           .
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            To review FAIR’s budget requests in detail, members are encouraged to click
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           here
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           .
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          2026 Executive Budget Highlights
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           ﻿
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           Lawmakers officially convened for the 2026 Legislative Session on
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          Tuesday, January 7
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           . Breaking with recent tradition, Governor Kathy Hochul delivered her
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          State of the State Address on January 13
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           , followed by the release of the
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          Executive Budget on January 20
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          .
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           The Governor introduced a
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          $260
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          billion
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           balanced budget that includes no new income tax increases and maintains more than
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          $14.6 billion
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           in reserves. Her agenda this year is anchored in the theme of affordability, with a strong focus on improving quality of life for all New Yorkers—particularly older adults and those relying on long‑term care services.
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          Key Budget Proposals Affecting Health Care &amp;amp; Aging Services
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          Medicaid Investments
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           The Executive Budget proposes
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          $38.2 billion
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          for New York’s Medicaid program, including
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          $1.2 billion
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           in new federal funding generated through an assessment on Managed Care Organizations (MCOs). These funds will be distributed to health care providers and related programs.
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          Support for New York’s Growing Older Adult Population
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           New York is now the fourth-oldest state in the country, with 4.6 million residents aged 60 and older—a number expected to climb to 5.4 million by 2030. Many older adults face mobility limitations, challenges with daily living activities, and the growing burden of chronic conditions.
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          Recognizing these trends, the Governor’s budget advances several initiatives aimed at strengthening care access and enhancing economic stability for older New Yorkers.
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          Specifically, the Governor’s budget includes:
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           Hospital at Home:
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      &lt;/strong&gt;&#xD;
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           General hospitals could provide acute medical services in a patient’s home without needing a home care agency license. Under the proposal Participating hospitals must submit annual operating cost data to the Department of Health. The DOH would establish Medicaid reimbursement rates for services provided under this model. This initiative would significantly expand the amount of acute care delivered in patients’ homes.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
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      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;strong&gt;&#xD;
        
           Personal Care Administrative Fees: 
          &#xD;
      &lt;/strong&gt;&#xD;
      &lt;span&gt;&#xD;
        
           The Executive Budget proposes to cap personal care fee‑for‑service administrative reimbursement at 15% of total costs.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
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  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;strong&gt;&#xD;
        
           Increased investments in Naturally Occurring Retirement Communities (NORCs):
          &#xD;
      &lt;/strong&gt;&#xD;
      &lt;span&gt;&#xD;
        &lt;span&gt;&#xD;
          
            These community-based programs provide older adults with support and resources to help them age in place, reducing the need for institutional care.
           &#xD;
        &lt;/span&gt;&#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
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      &lt;br/&gt;&#xD;
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  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;strong&gt;&#xD;
        
           Renewed funding of $35 million
          &#xD;
      &lt;/strong&gt;&#xD;
      &lt;span&gt;&#xD;
        &lt;span&gt;&#xD;
          
            to reduce waitlists for non-medical in-home services such as personal care, case management, home-delivered meals, congregate meals, and transportation services. This investment will help address immediate service gaps that many seniors face.
           &#xD;
        &lt;/span&gt;&#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
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      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;strong&gt;&#xD;
        
           An educational initiative
          &#xD;
      &lt;/strong&gt;&#xD;
      &lt;span&gt;&#xD;
        &lt;span&gt;&#xD;
          
            aimed at increasing awareness among clinical providers and their staff about options for community-based
           &#xD;
        &lt;/span&gt;&#xD;
      &lt;/span&gt;&#xD;
      &lt;strong&gt;&#xD;
        
           palliative care, hospice care, and the importance of advance care planning
          &#xD;
      &lt;/strong&gt;&#xD;
      &lt;span&gt;&#xD;
        
           . This will help ensure older adults have access to care that meets their needs in a timely manner.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
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  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;strong&gt;&#xD;
        
           A short-term, multi-agency council
          &#xD;
      &lt;/strong&gt;&#xD;
      &lt;span&gt;&#xD;
        &lt;span&gt;&#xD;
          
            to identify all available benefits for older adults across various state and federal programs. This initiative will
           &#xD;
        &lt;/span&gt;&#xD;
      &lt;/span&gt;&#xD;
      &lt;strong&gt;&#xD;
        
           assist seniors in accessing benefits
          &#xD;
      &lt;/strong&gt;&#xD;
      &lt;span&gt;&#xD;
        &lt;span&gt;&#xD;
          
            related to Veteran’s services, tax reductions, nutrition assistance, prescription drug support, and medical care.
           &#xD;
        &lt;/span&gt;&#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
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      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;strong&gt;&#xD;
        
           Expansion of eligibility for the Senior Citizen Rent Increase Exemption (SCRIE) and Disability Rent Increase Exemption (DRIE) programs:
          &#xD;
      &lt;/strong&gt;&#xD;
      &lt;span&gt;&#xD;
        &lt;span&gt;&#xD;
          
            The Governor proposes raising the income eligibility threshold from $50,000 to $75,000 for seniors in New York City, with similar provisions for other local jurisdictions opting into the program.
           &#xD;
        &lt;/span&gt;&#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
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      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;strong&gt;&#xD;
        
           $250 million in new capital funding
          &#xD;
      &lt;/strong&gt;&#xD;
      &lt;span&gt;&#xD;
        &lt;span&gt;&#xD;
          
            to accelerate and expand the development of affordable housing for seniors. This funding will produce thousands of affordable homes, ensuring that older New Yorkers have access to safe, affordable living environments.
           &#xD;
        &lt;/span&gt;&#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;span&gt;&#xD;
        
           ﻿
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;strong&gt;&#xD;
        
           CDPAP: 
          &#xD;
      &lt;/strong&gt;&#xD;
      &lt;span&gt;&#xD;
        
           While the Executive Budget does not include new CDPAP provisions, the Governor highlighted the savings realized from last year’s CDPAP reforms.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
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      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;strong&gt;&#xD;
        
           Expanded efforts to protect older adults from abuse, scams, and fraud,
          &#xD;
      &lt;/strong&gt;&#xD;
      &lt;span&gt;&#xD;
        &lt;span&gt;&#xD;
          
            which have become increasingly prevalent as seniors spend more time online and are targeted by bad actors.
           &#xD;
        &lt;/span&gt;&#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
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      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          These proposals align with the Governor’s broader vision for making New York more affordable for its residents, particularly seniors, who often face financial and logistical barriers as they age.
          &#xD;
      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;h2&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          FAIR Access Initiative Policy Platform
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/h2&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          We’ve published a clear, accessible policy overview outlining the key reforms needed to stabilize the workforce, streamline patient assessments, clarify regulations, and ensure fair reimbursement for providers.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;span&gt;&#xD;
        
           These reforms strengthen access to care, reduce waste, and promote financial stability across the system.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;br/&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          Our platform highlights six core policy priorities:
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;br/&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Fair Wage Reimbursement
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Universal Nursing Assessment
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        &lt;span&gt;&#xD;
          
            Repeal of the LHCSA RFO
           &#xD;
        &lt;/span&gt;&#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        &lt;span&gt;&#xD;
          
            Integrated Home Care Ecosystem
           &#xD;
        &lt;/span&gt;&#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        &lt;span&gt;&#xD;
          
            Live‑In Care Clarity
           &#xD;
        &lt;/span&gt;&#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Workforce Ecosystem
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          Our policy Agenda
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div&gt;&#xD;
  &lt;img src="https://irp.cdn-website.com/md/dmtmpl/aea76736-c28b-4cc5-abee-d56810e08d14/dms3rep/multi/vikorion_Hyperrealistic_photograph_of_modern_minimalist_fashion_861260bf-bea6-4bcd-bc2f-c555b72b5901.png" alt=""/&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;h2&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          What Has FAIR Been Up To?
         &#xD;
    &lt;/strong&gt;&#xD;
  &lt;/h2&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          The FAIR team has been actively engaged with Senate and Assembly lawmakers and their staff on the Health and Aging Committees, introducing the new Association and discussing its proposals for the budget season and Legislative Session.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;br/&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          These meetings have involved representatives and staff from the offices of Senators Jake Ashby, Samra Brouk, Kristen Gonzalez, Patrick Ryan, and Robert Ortt, as well as Assembly Members Jeff Dinowitz, Demond Meeks, and Phil Steck.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;span&gt;&#xD;
        
           The FAIR Access Team was also present at the Home Care Show! We extend our gratitude to the offices of
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/span&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Senate Majority Leader Andrea Stewart-Cousins
         &#xD;
    &lt;/strong&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;span&gt;&#xD;
        
           and
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/span&gt;&#xD;
    &lt;strong&gt;&#xD;
      
          Assembly Member Amy Paulin
         &#xD;
    &lt;/strong&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;span&gt;&#xD;
        
           for sending representatives to join us for our live podcast.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Click
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/span&gt;&#xD;
    &lt;a href="https://youtu.be/FnzWT3hKDAg?si=a0IxuSO4ghc4Oo_V" target="_blank"&gt;&#xD;
      
          here
         &#xD;
    &lt;/a&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;span&gt;&#xD;
        
           to view the recording.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div&gt;&#xD;
  &lt;img src="https://irp.cdn-website.com/6434d0c9/dms3rep/multi/Image+%281%29.jpg" alt=""/&gt;&#xD;
&lt;/div&gt;</content:encoded>
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      <pubDate>Sun, 25 Jan 2026 05:04:42 GMT</pubDate>
      <guid>https://www.fair-access.org/state-of-the-state-and-fair-advocacy-day</guid>
      <g-custom:tags type="string" />
      <media:content medium="image" url="https://irp.cdn-website.com/6434d0c9/dms3rep/multi/a0e740e4-d019-4814-8d2a-093b8fb7423b.jpg">
        <media:description>thumbnail</media:description>
      </media:content>
      <media:content medium="image" url="https://irp.cdn-website.com/6434d0c9/dms3rep/multi/a0e740e4-d019-4814-8d2a-093b8fb7423b.jpg">
        <media:description>main image</media:description>
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    <item>
      <title>A New Era for Home Care</title>
      <link>https://www.fair-access.org/10-17-newsletter</link>
      <description>In this month’s update, we detail our progress on the immediate priorities necessary to stabilize the market</description>
      <content:encoded>&lt;div data-rss-type="text"&gt;&#xD;
  &lt;h3&gt;&#xD;
    &lt;span&gt;&#xD;
      
          FAIR Vision 2026
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/h3&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;span&gt;&#xD;
        
           "IN A TIME MARKED BY LIMITED RESOURCES AND FIERCE COMPETITION, OUR MISSION IS TO ENSURE THAT THE NEEDS OF PROVIDERS AND PATIENTS ARE EFFECTIVELY ADDRESSED."
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          - Sasha Guillaume, FAIR President
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;span&gt;&#xD;
        
           The FAIR Access Initiative recognizes New York's urgent need to protect—rather than weaken—the home care sector within an overall challenging fiscal outlook.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;span&gt;&#xD;
        
           While the community's needs are only increasing and there is a rising demand for more and better care, providers and payors face severe workforce shortages, increasing costs, and stagnant reimbursement.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Further reductions are expected and would only destabilize essential services and jeopardize the ability of seniors and people with disabilities to remain safely at home.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;span&gt;&#xD;
        
           To address these systemic challenges, FAIR is working proactively with lawmakers and regulators to develop and advocate for innovative as well as cost-saving programs that will strengthen the entire home care ecosystem.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          Our focus is on clear, specific action to stabilize our future.
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          Fair Compensation and Financial Equity
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Tackling financial inequities faced by home care providers outside of NYC - specifically in Long Island, who are currently reimbursed $2 to $3 less per hour than those in other regions, which creates a detrimental two-tiered system. Addressing this disparity is crucial for the recruitment and retention of workers, ensuring stable access to care.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Requiring transparency by mandating managed care organizations (MCOs) to disclose their payment rate calculations to enhance oversight and ensure fairness for home care workers.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          1
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Developing Unified Systems to eliminate duplicative evaluations by Managed Long Term Care Plans, ensuring a single, consistent plan of care.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Creating a Continuum of Care by streamlining services and adopting a hybrid PACE model to both reduce redundancy and improve outcomes while saving costs.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Centralizing Aide Training through a unified system for tracking aide training hours to reduce redundancy and costs across the industry.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;br/&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          2
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          Systemic Efficiency and Quality
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;ul&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Eliminating the LHCSA RFO: Requesting the elimination of the current Licensed Home Care Services Agency Request for Offers.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
    &lt;li&gt;&#xD;
      &lt;span&gt;&#xD;
        
           Addressing the NHTD Cap: Raising concerns over the NHTD enrollment cap, which limits services to 9,400 individuals without establishing a waitlist, thereby restricting access to care.
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/li&gt;&#xD;
  &lt;/ul&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;br/&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          3
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          Regulatory Reform and Access Preservation
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;&#xD;
&lt;div data-rss-type="text"&gt;&#xD;
  &lt;h3&gt;&#xD;
    &lt;span&gt;&#xD;
      &lt;span&gt;&#xD;
        
           FAIR's Legislative Agenda:
          &#xD;
      &lt;/span&gt;&#xD;
    &lt;/span&gt;&#xD;
  &lt;/h3&gt;&#xD;
  &lt;p&gt;&#xD;
    &lt;span&gt;&#xD;
      
          As we schedule meetings with the Division of Budget and the Governor's office, FAIR will discuss the following crucial priorities for the upcoming fiscal year:
         &#xD;
    &lt;/span&gt;&#xD;
  &lt;/p&gt;&#xD;
&lt;/div&gt;</content:encoded>
      <pubDate>Fri, 17 Oct 2025 19:06:37 GMT</pubDate>
      <guid>https://www.fair-access.org/10-17-newsletter</guid>
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