Medicaid reimbursement rates, foundation aid cuts among state budget concerns

Mar. 2—PLATTSBURGH — Local state representatives believe this budget year will be challenging.

State Sen. Dan Stec (R,C-Queensbury) Stec said he believes a lot of it will be related to the “post-COVID hangover.”

“It’s a stone in the pond and the ripples are still making their way to the edge of the pond when it comes to COVID and funding,” Stec said at the North Country Chamber of Commerce’s State Legislative Forum Friday morning.

“Some of the way that that funding was handled, a lot of one-shot money was infused into a lot of state governments by the federal government. That spigot has been turned off. Every state government handled that a little differently, and I think New York’s handled it in a way where there was an expectation or anticipation that this money would continue to flow. So that reality is setting in now.”

Stec was joined by Assemblyman Billy Jones (D-Chateauguay Lake) at the chamber’s annual breakfast to speak and take questions on Albany-related topics, lay out their agendas for the coming year and their strategies for economic growth moving through 2024.

Assemblyman Matt Simpson (R-Horicon), who typically attends as well, was not able to make it.

FOUNDATION AID

Stec said one area the dramatic decrease in state funding may be seen, due to the post-COVID hangover, is in the proposed foundation aid for school districts across the state.

He said Gov. Kathy Hochul went “cold turkey” on the aid cuts by doing it all at once instead of gradually.

He said as it’s proposed currently, half of the 48 school districts in his senate district alone are set to receive cuts to their foundation aid.

“I think that both houses on both sides of the aisle are very concerned about the change to foundation aid that roughly half the Upstate school districts would see less money in that formula,” Stec said.

“I don’t expect that to be the final ‘where we land,’ but anytime an idea is on the table, you have to react to it. You have to be concerned about it.”

Jones, however, said he is confident both houses will “make up” for the aid cuts.

“I think we’re going to make up for the losses and hold our school districts harmless in that,” he said. “I’m pretty confident in that.”

MEDICAID REIMBURSEMENTS

Stec and Jones were both in agreement that the Medicaid reimbursement rates for health care facilities needed to increase in this year’s budget as well.

“The last time that Medicaid rate formula was rebased was in 2007, and except for last year’s modest increase, the Medicaid rates haven’t been touched in a couple of decades,” Stec said.

“You’ve got places that are trying to provide a service to our elderly, and the majority of them in Upstate are covered under Medicaid; they’re not private payers. They’re relying on what the government is going to pay and the government is paying on decades old numbers.”

The result of ignoring increases to Medicaid rates have doomed some facilities in rural areas.

Stec said St. Lawrence County’s last assisted living center just closed a couple weeks ago, which meant the 34 or so residents there had to be relocated 60-70 miles away.

“That’s a burden on families,” he said.

Stec said he doesn’t get a lot of time to speak with the governor, but when he saw her recently, he spent his “nickel” or 30 seconds with Hochul to say Medicaid reimbursement needed to be taken care of.

“Her response to me, generally, was ‘we need to find the money.'”

“Our hospitals need support; they need help,” Jones said in support.

“We see the rising costs of not only health care staffing, everything related to the inflation costs that we’re having; they need help. We need to get more improper Medicaid reimbursement for them.”

INFRASTRUCTURE

Stec also shared his concerns with the proposed reduction in CHIPS (Consolidated Local Street and Highway Improvement Program) funding in the budget.

He said the migration issue in New York City has placed pressure on Albany for assistance and this is impacting the resources that are available. This has resulted in a proposed 10% or $60 million cut to CHIPS, he said.

“We will all fight back, especially those of us that are upstate like Billy and myself. We do it every year. It’s a dance that we do,” Stec said.

“The rising tide that lifts all boats here is what we do for our infrastructure, whether that’s roads and bridges … and broadband, these are all things that affect the value of our homes.”

CHILD CARE

Plattsburgh YMCA CEO Justin Ihne asked Jones and Stec about child care and what can be done to lower the costs of it for families. Ihne said access to child care is an important aspect of attracting workers to the area.

Jones agreed and said improving economic development in the North Country will depend on the quality of child care, transportation, infrastructure and housing in the area.

“Because if you have a company moving into this area — which we always want and the chamber, along with its partners, work very hard to do — if there’s no housing, if there’s no child care and (if) there’s no transportation, you’re not going to have any workers. You know what you have with a company with no workers? You don’t have a company.”

Jones said a fix to child care is especially necessary because it is currently too expensive for families to afford.

“We’ve got to pay our child care providers a great wage, but we have to reduce the cost of the families. It’s not easy,” Jones said.

“The best solution that I can come up with is funneling it into economic development and making it more affordable for our families, whether that be with state subsidies or whatever.”

EASE REGULATIONS

Both Jones and Stec also said that small mom and pop child care businesses are facing too many regulations, which has added to their costs and forced them to raise the price of services.

“They’re very regulated, very restrictive, and those regulations all came (from) a good place … but … they just seem to be pretty stringent,” Jones said.

“We should be helping on easing up those regulations, and not penalizing a child care provider for minor stuff … that adds to their costs as well.”

Stec said his district is facing a child care desert with a ratio of 6:1, meaning the demand for child care seats is six times more than what’s available.

High costs, partly caused by enforcing strict state regulations, are only hurting the situation further, he said.

A solution to the problem, Stec said, could come from providing state funding for an ombudsman or an expert in regulations so child care providers, who may need help getting through those regulatory hurdles, can do so smoother and easier.

“Somebody that knows the system and (can) walk them through it. I thought that was a good idea,” Stec said.

“That could be an opportunity where a relatively small investment moves the needle on supply, and then hopefully that would help control costs.”

HOUSING

Across the state, housing, and the lack of it, continues to be a “major issue” as well, Jones said. This is partly due to the varying needs in different parts of the state, he said.

Because of this, there is no one-size-fits-all solution to fixing housing.

“Talking to a lot of the realtors and developers in the room, it’s a matter of housing stock here … in the North Country and Adirondacks.”

Jones assured a solution is being worked on.

He said Chamber President Garry Douglas, along with other key partners like the Regional Economic Development Councils, is working on a housing plan that will address this issue and get more housing stock locally.

“You talk to anybody in this area, and they’ll say ‘one, we can’t find a house here or an apartment that’s decent, and two, when we do, the cost is up.’ So when your stock is down … the cost is going to be high. So we need to really help out in that situation,” Jones said.

“We’re looking out for the North Country and the Adirondacks and our needs here.”

Email: cnewton@pressrepublican.com

Twitter: CarlySNewton

Leave a Comment