A raw deal for home care workers?

Good morning and welcome to the Weekly New York Health Care newsletter, where we keep you posted on what’s coming up this week in health care news, and offer a look back at the important news from last week.

Beat Memo

Home care workers and those who rely on them have long rallied to raise workers’ pay to 150 percent of the regional minimum wage, arguing that seniors and people with disabilities are struggling to find home health aides to help them continue living independently.

Gov. Kathy Hochul’s budget is expected to leave them far short of that.

Draft language that has been circulating among lawmakers, lobbyists and advocates indicates a tentative deal to raise workers’ wages each year through 2027, when their pay rate would be indexed to rise with inflation.

However, there are caveats that have raised at least a few eyebrows.

The first is that an hourly wage increase of $1 planned to start in October — a relic of last year’s budget that approved a phased-in $3 hourly increase — would not happen as planned.

Instead, downstate home care workers would get a $1.55 per hour raise come January, while workers in the rest of the state would see another $1.35 per hour. The next two years would bring 55-cent annual increases.

But there’s a catch: Home care workers downstate currently make an hourly base wage of $17, but their employers are also required to pay supplemental wages in cash or in benefits under a 2012 wage parity law.

The supplemental wage rate is currently $4.09 an hour for New York City workers and $3.22 on Long Island and in Westchester.

Under the tentative budget deal, home care workers in those regions would see their base pay rise from $17 to $18.55 an hour but their total rate of compensation would stay the same. In other words, the size of the supplemental portion would shrink.

That means home care workers who receive the supplemental portion in cash, not benefits, would not necessarily see higher pay next year — and that applies to a sizable portion of home care workers across the state, most of whom are on Medicaid or subsidized health plans through the state’s exchange rather than employer health plans.

However, it would benefit home care workers who belong to the union 1199SEIU United Healthcare Workers East.

That’s because the tentative deal includes a gross increase of about $112 million for a little-known state program called the Quality Incentive/Vital Access Provider Pool, which already receives a base allocation of $70 million, according to 1199SEIU political director Helen Schaub.

The funding is doled out to home care providers that comply with the wage parity statute and participate in a health benefits fund — like the one that 1199 SEIU runs for its union members — or provide comprehensive health insurance to their employees, among other requirements.

Schaub said the increase to the pool would enable home care agencies that pay the supplemental wage in benefits to afford to continue providing those benefits while paying workers $1.55 more per hour in cash.

The setup would incentivize more home care employers to provide their workers with insurance coverage and other benefits, Schaub said.

In practice the primary beneficiaries would be unionized home care agencies that already pay into 1199SEIU’s benefits fund, since only 41 percent of New York’s home care workers get insurance through their job, according to data from the research and advocacy group PHI.

Half of the state’s home care workers are enrolled in Medicaid, Medicare or other public insurance coverage, compared to 26 percent of nursing home staff, according to PHI.

And because the budget proposal would narrow the supplemental wage instead of increasing total compensation for downstate home care workers, the state would save hundreds of millions of dollars in Medicaid funds — at least on paper — that would have supported the planned $1 hourly increase in the upcoming fiscal year.

ON THE AGENDA THIS WEEK:

— Tuesday at 5 p.m. NYC Health + Hospitals’ board of directors hosts a meeting of the community relations committee.

— Thursday at 10 a.m. The City Council Committee on Mental Health, Disabilities and Addiction introduces the legislative package for its mental health roadmap.

— Thursday at 4 p.m. The Public Health and Health Planning Council’s Health Planning Committee will convene an educational workgroup to discuss reducing emergency department boarders.

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What you may have missed

— The tentative state budget agreement is slated to raise Medicaid reimbursement rates by 7.5 percent for inpatient hospital care and 6.5 percent for outpatient services, according to Assemblymember Amy Paulin, who chairs the health committee. Nursing homes and assisted living facilities would also see a 6.5 percent rate hike. Meanwhile, the state’s carveout of the Medicaid pharmacy benefit is primed to continue, which providers said will negate most of the Medicaid rate increase’s impact.

But Paulin said health care providers will benefit from higher reimbursement rates under the state’s Essential Plan, which provides low-cost health insurance for low-income New Yorkers who do not qualify for Medicaid.

Odds and Ends

NOW WE KNOW — A federal law that went into full effect Friday entitles nursing parents to a private space in their workplace and adequate break time to express breastmilk.

TODAY’S TIP — Never mind what they say about working out five days a week! Exercising just on the weekend is perfectly fine as long as it’s intense enough.

STUDY THIS — Adolescents with strong parental relationships have better long-term health outcomes, according to a longitudinal study of more than 15,000 young Americans.

What We're Reading

— One Brooklyn Health cyberattack prompts class action lawsuit, THE CITY reports.

— Community organizations rethink public health efforts as Covid relief dries up, Crain’s New York Business reports.

— Covid-19 deaths and hospitalizations are nearing new lows, although some states are reporting data less frequently, The Wall Street Journal reports.

— Error and confusion are plaguing the Medicaid recertification process, The Associated Press reports.

— Via The Washington Post: “His sickle cell disease brought agony. Gene therapy is bringing hope.”

— To prevent preeclampsia, experts push for broader blood pressure testing at home, STAT reports.

Around POLITICO

— Via POLITICO’s Anna Gronewold and Joe Spector: “Hochul brings back an Albany tradition: The late, late budget.”

— Telehealth bill would permanently extend eased Medicare rules, Ben Leonard reports.

— Via POLITICO’s Daniel Han: “Why a New Jersey employee didn’t work for over a year — and was still paid $80k.”

MISSED A ROUNDUP? Get caught up on the New York Health Care Newsletter.