Executive Budget: What to Look for – Part I

January 30, 2023

Good evening from Albany where Governor Kathy Hochul will formally present her State Fiscal Year 2024 Executive Budget Proposal on Wednesday, February 1st at 12 pm.  The presentation will be live-streamed here.

Generally, budget bills don’t flow until well after the Governor’s presentation ends.  There have been years when the bills were released in the middle of the night, and other years where we saw a brief flurry of activity, and then the remainder of the bills flowed out over the next 12 -24 hours.  Our commitment to all NYS Council members is to share information about what we are seeing as soon as possible, but we always want to be accurate so being first out of the gate with information is not our primary objective in this instance.  
While we know some of what the Governor is likely to propose in the area of healthcare and behavioral healthcare (see the State of the State ’23 Health review we sent earlier this month), the Governor failed to mention our workforce in her State of the State speech and so, we will be on high alert for language in the budget proposal that answers the question as to whether we were heard on our request for meaningful increases.

The following information was NOT discussed in the State of State:

  1. COLA – We have requested an 8.5% COLA and an additional $500M in funding (for rate increases) to address the many years our field did NOT receive a COLA or another type of increase to address the ever increasing costs associated with operating mental health and substance use disorder programs, and our inability to recruit and retain qualified staff.
  2. Managed Care Organizations (MCO) Competitive Procurement –  As you may recall, the NYS Council took the lead last year, sending a message far and wide that we were in strong support of the Governor’s Competitive Procurement proposal that would have required the state to procure MCOs operating in the State’s Medicaid Managed Care Program.  Ultimately, last year’s proposal from the Governor was scaled way back to a requirement for a report from an outside firm re: consolidation throughout Medicaid Managed Care.  That report was due last October but (to our knowledge) it has yet to be released despite our consistent pushing on DoH to:  1) ensure stakeholders have a voice and are interviewed regarding their perspectives on Medicaid managed care, and 2) to release the Report promptly once it was completed.  The question of how the Chamber will utilize the findings to reorganize managed care— procurement or other consolidation mechanism—in our sector and across the range of special populations carved in to Medicaid managed care, is likely to be a big part of the Budget conversation again this year.   (See our document that we sent to the State Medicaid Director and others in the administration last year, regarding our recommendations for how to reform Medicaid managed care for New Yorkers with mental health and substance use conditions, and the providers that serve them.
  3. Addressing the Addiction & Overdose Crisis – Unfortunately, the Governor’s State of the State proposals (verbal and written) did not focus much on the addiction and overdose crisis that continues to increase in many communities across New York State. The central question is whether the Executive sees the Opioid Settlement Fund dollars as the major source of investment to address this problem this year and next year.  Over the past 5 months as we have met with the Executive and the state agencies to review our budget priorities, we have argued that this must not be the case.  Specific and significant investments of state resources to address woefully inadequate rates and our workforce crisis must be made (with funds that are separate from the Opioid Settlement funds) if we are to increase access to care and ensure that the care is of the quality it should be in order to significantly reduce the suffering and unnecessary deaths associated with the Epidemic.  
  4. Children and Youth – Governor Hochul’s State of the State address focused squarely on the mental health needs of New Yorkers however children’s advocates are concerned that the State of the State did not center on the unique and often complex needs of New York’s children and youth with mental health and related conditions.  Long wait lists for care, inadequate rates for providers, a fragmented continuum of services, and the uncertainty associated with whether a family looking for assistance can find a qualified psychiatrist or other child specialist are just a few of the issues plaguing the children’s system of care.  Proposed investments in school-based mental health services is a great beginning, but investments in a wide range of programs and services across the children’s continuum of care, are also essential. 

Locating proposals that respond to the issues we have prioritized to include issues discussed above will be our focus beginning sometime on Wednesday.  We will stay in touch.