HomeTop StoriesMedicaid reimbursement rates, cuts to foundation support are state budget concerns

Medicaid reimbursement rates, cuts to foundation support are state budget concerns

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

State Senator Then 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 Friday morning at the North Country Chamber of Commerce’s State Legislative Forum.

“Part of the way that funding was handled was that there was a lot of one-time money being pumped into a lot of state governments by the federal government. That tap is turned off. Each state government handled that a little differently, and I think New York handled it in a way where there was an expectation or anticipation that this money would continue to flow. So that reality is now setting in.’

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

Assemblyman Matt Simpson (R-Horicon), who usually attends, was unable to attend.


Stec said one of the areas where the dramatic drop in state funding could 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 has gone “cold turkey” with the cuts, doing it all at once instead of gradually.

He said that, as currently proposed, half of the 48 school districts in his Senate district would receive cuts to their foundation support alone.

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

“I don’t expect this to be the last ‘where we end up,’ but every time an idea is on the table you have to respond to it. You have to worry about it.”

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However, Jones 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 the process,” he said. “I have a lot of confidence in that.”


Stec and Jones both agreed that Medicaid reimbursements for health care facilities should also be increased in this year’s budget.

“The last time the Medicaid rate formula was revised was in 2007, and other than last year’s modest increase, Medicaid rates have not changed in a few decades,” Stec said.

“You have places that are trying to provide a service to our elderly, and the majority of them in Upstate are covered by Medicaid; they are not private payers. They rely on what the government will pay and the government pays on decades-old numbers.”

The result of ignoring Medicaid rate increases has doomed some facilities in rural areas to failure.

Stec said the last assisted living center in St. Lawrence County closed a few weeks ago, meaning the approximately 34 residents there had to be moved 60-70 miles away.

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

Stec said he doesn’t get much time to talk to the governor, but when he saw her recently, he spent his “nickel” or 30 seconds with Hochul saying that Medicaid reimbursement should be taken care of.

“Her response to me was generally, ‘We have to find the money.’”

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

“We’re seeing the rising costs of not only the health care workforce, but everything related to the inflationary costs that we have; they need help. We need to get more inappropriate Medicaid reimbursements for them.”


Stec also shared concerns about 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 put pressure on Albany for help and is impacting available resources. This has resulted in a proposed cut to CHIPS of 10% or $60 million, he said.

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“We’ll all fight back, especially those of us who are upstate, like Billy and I. We do it every year. It’s a dance 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 impact the value of our homes.”


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

Jones agreed, saying improving economic development in the North will depend on the quality of childcare, transportation, infrastructure and housing in the area.

‘Because if you have a company moving into this area – which we always want and the chamber, together with its partners, is working very hard to do that – if there is no housing, if there is no childcare and (if) there is no transportation, then ‘We will have no employees. Do you know what happens with a company without employees? You don’t have a business.’

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

“We have to pay our child care providers high wages, but we have to reduce costs for families. That’s not easy,” Jones said.

“The best solution I can think of is to channel it toward economic development and make it more affordable for our families, whether that’s with state subsidies or whatever.”


Both Jones and Stec also said small maternal and child child care businesses face too much regulation, which has increased their costs and forced them to raise the price of services.

“They’re very regulated, very restrictive, and those rules all came from a good place… but… they just seem pretty strict,” Jones said.

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“We should help loosen those regulations, and not penalize a child care provider for little things… which also increases their costs.”

Stec said his district faces a childcare desert with a 6:1 ratio, meaning the demand for childcare slots is six times greater than what is available.

High costs, partly caused by the enforcement of strict government regulations, only further worsen the situation, he said.

A solution to the problem, according to Stec, could come from providing government funding to an ombudsman or regulatory expert so that childcare providers who may need help overcoming these regulatory hurdles can do so. more smoothly and easily.

“Someone who knows the system and can guide through it. I thought that was a good idea,” Stec said.

“That could be an opportunity where a relatively small investment could impact supply, and then that would hopefully help keep costs in check.”


Across the state, housing, and the lack thereof, also remains a “major problem,” Jones said. This is partly due to the varying needs in different parts of the state, he said.

As a result, there is no one-size-fits-all solution for home repairs.

“I talk to a lot of real estate agents and developers in the room, this is about the housing stock…in the North Country and Adirondacks.”

Jones assured that a solution is being worked on.

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

“If you talk to anyone in this neighborhood, they say, ‘First of all, we can’t find a house or a decent apartment here, and second of all, if we do, the costs will go up.’ So if your inventory goes down… the costs will be high. So we really need to help in that situation,” Jones said.

“We look forward to the North Country and the Adirondacks and our needs here.”

Email: cnewton@pressrepublican.com

Twitter: CarlySNewton

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