May 3, 2023

New York State lawmakers approved a $229 billion state budget on Tuesday night after completing protracted negotiations with Gov. Kathy Hochul that delayed its passage by over a month.  

For more on ‘The Big Ugly’ – the giant budget bill that served as a vehicle for passage of seemingly unrelated budget proposals – use this link:  https://gothamist.com/news/meet-the-big-ugly-the-ny-state-budget-bill-has-free-buses-a-cannabis-crackdown-and-more

Here’s more on various state budget outcomes:

340B:  Based on a review of the FY ’24 Medicaid Scorecard, provisions in the budget, and conversations we’ve had, it appears that all FQHC providers should be fully funded through the NYRx investment in the new state budget deal.  Previously, a dozen or so FQs were missing and/or underfunded however, it appears this is addressed through ‘legislative adds’ (what we used to call ‘member items’).  

Bail Reform:  The bail reform deal is largely focused on repeat felony offenders.  Our understanding of the significant changes to bail reform laws that are included in the new budget are below: 

• Elimination of least restrictive standard: The change signals to judges that release conditions need to be rational and not excessive, but it doesn’t have to be the least restrictive. It could provide judges with similar discretion they had before 2019 changes to the bail laws when they set bail on more “serious” crimes, such as violent felonies.  
• More supervision: On misdemeanor and low-level felony cases, judges would have more leeway to set non-monetary conditions, such as supervised release. They are still generally restricted from setting bail or sending someone to jail in those cases. 
• Bail and non-monetary conditions: A judge can set bail and order someone to be subject to supervision if they’re released from custody. Under the prior statute they could only choose one. The expectation is that judges may set lower bail amounts if they know a defendant would be supervised upon release.
• Repeat felony offenders: If a person accused of a felony violates their release conditions and is rearrested for another felony they would be subject to bail or pre-trial incarceration for the second felony arrest.
• Mental health and addiction treatment: State officials are hoping to signal to judges that they can use non-monetary conditions for addiction and mental health treatment.  State data show it was rarely used and the Times Union reported recently that drug court enrollment has dropped sharply over the last four years. 
• Increased discretion: Last year, lawmakers agreed to allow judges in cases involving serious crimes to consider a defendant’s charges, criminal record, prior history of showing up to court, ability to afford bail, violation of orders of protection, use or possession of a firearm and whether the offense caused “serious harm” to others. 
• Reporting on pretrial jail population: This would require the Office of Court Administration to report monthly on the number of individuals held in individual jails awaiting trial. 

Minimum Wage:  Gov. Hochul and legislative leaders agreed to index the minimum wage to inflation starting in 2026. They also compromised on a plan to raise the wage before indexing it, settling on an increase to $17 an hour before indexing begins. Although that goes further than the governor’s original proposal, it doesn’t meet the $21.25 wage that many advocates and lawmakers wanted to see. The minimum wage agreement also resulted in tweaks to scheduled increases for home care workers.
And finally, yesterday the CDC released a new Report describing the disproportionate impact that COVID-19 had on overdose rates in Black communities.  The Report is here:  https://www.cdc.gov/nchs/data/vsrr/vsrr027.pdf?source=email
(Following is excerpted from a Politico article on this topic dated 5/3) 

“…White House officials for years warned that opioids were becoming rampant in Black communities. Then came Covid-19.

In 2020, the rate of drug overdose deaths among Black Americans skyrocketed, increasing faster than that of any other racial or ethnic group in the country. Fentanyl, which had become more ubiquitous, drove the rising toll. On Wednesday, the Centers for Disease ontrol and Prevention released a report showing that more Black Americans died from fentanyl overdoses than from any other drug in 2021 and at far higher rates than whites or Hispanics.

“The seesaw was already tipped to the wrong side,” Jerome Adams, who was surgeon general during the Trump administration, said in an interview. “We were barely holding it up prior to the pandemic and then it just completely tipped — particularly for communities of color.”

Between 2016 and 2021, the rate of fentanyl overdose deaths rose 279 percent for all Americans, the new CDC data shows. Even as the total number of overdose deaths in the U.S. held relatively steady last year, the growing fentanyl threat and racial disparity present a stark challenge for the Biden administration, which has made health equity a priority.

“The numbers tell us that we have a lot to do,” said Nora Volkow, director of the National Institute on Drug Abuse.

Access to quality substance abuse treatment, ongoing income inequality, stigma and discrimination all contribute to Black Americans’ overdose deaths, she said, and making medication more readily available for opioid use disorder — naloxone the drug that reverses opioid overdoses — is urgently needed.”