As New York State’s budgeting season is underway, concerns about a shortfall in nursing home funding have surfaced — especially when it comes to long-term care in Black and Brown communities.
Drastic cuts to Medicaid funding at the federal level are expected in 2026, in accordance with the Trump administration’s big bill. More than 6.8 million New Yorkers are currently covered by Medicaid, according to the governor’s office.
In an effort to offset healthcare costs, the state’s preliminary executive budget (2026–2027) proposal is dedicating $38.2 billion to its own Medicaid program. Of that, the budget allotted $750 million to provide hospital and nursing home services, such as Managed Long Term Care (MLTC). This program allows nurses and home health aides to care for chronically ill, disabled, or elderly patients in their homes.
State Sen. Cordell Cleare, who chairs the Aging Committee, introduced a bill to establish a $50 million High Acuity Stabilization Pool to ensure that the MLTC can continue to serve its most vulnerable.
“The State’s newly released MLTC rates make an already serious problem worse by underfunding the plans that care for New Yorkers with the most complex needs,” said Cleare in a statement. “Those plans, such as VNS, who are willing to care for the most vulnerable need our steadfast support, and the budget and policy we pass must reflect this reality. The MLTC High-Acuity Stabilization Pool is a targeted step we can take in this year’s budget to protect care for vulnerable seniors and people with disabilities.”
Just as important to this industry are the workers themselves.
According to the city comptroller’s office 2023 report, the home health care industry has grown exponentially since 2006. This includes the state’s Consumer Directed Personal Assistance Program (CDPAP), which allows adult relatives to work as assistants for the elderly. These workers are most likely to be Black or Hispanic, and immigrant women, said the report.
Esther Conteh, the vice president for Care Management for VNS Health, started out as a home health aide and went on to be a nurse practitioner for over 25 years in Harlem.
“It really is going into people’s homes and addressing the day-to-day that support them, maybe with hands-on care. Just the basic necessities of life. Bathing, dressing, making sure that they have a meal. And, you know, undressing and going out, performing activities of daily living,” said Conteh.
She added that nursing care revolves around medication management if they were hospitalized, environmental safety, food insecurity, housing, family dynamics, and complex chronic health issues like diabetes, hypertension, and heart disease.
“These are our community. These are our people. And we know the challenges. We know the cultural challenges that come with our population health,” said Conteh. “So this program, this manage long-term care program, MLTC, is a crucial program in making sure that we do exactly that. Members benefit a whole lot by these external supports that we wrap around our members to keep them safe and well in the community. This is why it’s such a very passionate topic for me.”