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Home care supporters remain up in arms following last month’s release of New York Gov. Kathy Hochul’s executive budget for fiscal year 2025 that included more than $1 billion worth of cuts to home care programs statewide.

“The governor’s plan for home care is death by a thousand cuts,” Bryan O’Malley, executive director of the Consumer Directed Personal Assistance Association of New York State, said Tuesday in a statement. “In the midst of the worst home care shortage in the nation, Hochul’s proposal to cut home care from over 100,000 disabled children and older adults with dementia and Alzheimer’s is both irresponsible and cruel.”

The budget, released Jan. 16, proposed $800 million in unspecified home care cuts and a wage reduction for the state’s 175,000 home care workers by $2.54 per hour. The latter totals an additional $800 million, according to home care advocacy coalition New York Caring Majority. In the governor’s “30-day amendments,” which can be put forth up to 30 days after submitting an executive budget, Hochul also proposed sweeping changes to New York’s Consumer Directed Personal Assistance Program (CDPAP). This would place tough restrictions on home care workers and their patients’ access to care.

Under new rules set by the 30-day amendments, New Yorkers would be banned from using third parties to manage their care, potentially preventing thousands of older adults with chronic conditions or dementia from receiving care through CDPAP, according to New York Caring Majority. Home care workers would also be subjected to yet-unspecified maximum care hours and training mandates, and agencies would be prohibited from providing both traditional home care workers and CDPAP workers — a greater hurdle for both patients and providers.

Meanwhile, New York’s senior population has continued to grow rapidly. By 2025, a quarter of New Yorkers will be 60 years and older, increasing the need for home care in the state, New York Caring Majority noted in a release. And as providers struggle to keep up with demand, critics have pointed out the growing share of healthcare dollars eaten up by managed care organizations in the state.

“If Hochul is truly concerned with growing costs of CDPAP and other home care programs, she should stop handing private insurance companies billions a year to mis-manage home care — saving New York over $3 billion annually,” O’Malley said. “Instead of cutting out these expensive middle men, the Governor is proposing over a billion in cuts … which will force tens of thousands of older adults and disabled New Yorkers into nursing homes and institutions.”

New York has not yet passed its state budget for fiscal year 2025. Home care advocates have voiced strong opposition to the cuts set by the executive budget proposal.

“This budget puts New York’s Medicaid program at a crossroads,” O’Malley testified during a Jan. 23 budget hearing. “We can make decisions that will move the system forward or break it. Let’s choose the former.”

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