January 9, 2024

The Governor’s Office is planning another mystery event (location to be revealed upon RSVP to the invite) on Thursday where she will make a ‘special announcement’ regarding mental health in New York State (just two days after her State of the State address, scheduled for later today).   The invite says, “Last year Governor Hochul prioritized addressing the mental health crisis with a $1 billion investment to transform the continuum of care and mental health will continue to be a main focus for us in 2024.”    Stand by for more. 

Federal Budget Negotiations to Avert a Shutdown

Congressional leaders reached a bipartisan deal on Sunday setting a roughly $1.6 trillion federal spending level for the year, but the pact drew quick criticism from some conservatives, and it remains unclear whether lawmakers will be able to quickly pass legislation averting a government shutdown. The House and Senate now have less than two weeks to craft underlying bills funding the government, with several federal agencies set to run out of money later this month and the rest to follow in February, a tall order in a Congress that has struggled to pass major legislation on time.

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Politico article on Medicaid Rate Increase Push and Coming Executive Budget Proposal

Budget deficit has Hochul cool on big Medicaid raise

NEW YORK — Health care leaders are riding the momentum of last year’s historic Medicaid rate increases to push Gov. Kathy Hochul for even higher hikes in the upcoming budget.

But a projected $4.3 billion will make it difficult for the governor to greenlight any increase in payment to providers. Instead, the Legislature is homing in on inexpensive ideas for alleviating the health care system’s ongoing struggles, such as making it easier to recruit out-of-state doctors and nurses.

The Medicaid program, which enrolls about 8 million New Yorkers, is projected to cost more than $100 billion by the end of the fiscal year on March 31, according to the Division of the Budget’s mid-year financial report. Of that, the state picks up about one-third and the federal government pays the rest.

The governor last week said she is open to discussing Medicaid rate hikes but suggested that last year’s 6.5 to 7.5 percent increases for hospitals and long-term care facilities are off the table.

“There’s a shortfall, and the disinvestment has led to many problems. I’m trying to fix that,” Hochul said. “But I’ve never said I can keep doing those amounts year after year after year. It’s just not sustainable.”

Nonetheless, 1199SEIU and the Greater New York Hospital Association are pressing for rate increases in a big way: through an 8-figure ad campaign, as POLITICO reported.

“I know there’s a lot of ‘this is going to be a tough budget year,’ but the state is sitting on a lot of cash,” Helen Schaub, 1199SEIU’s interim political director, said in an interview, referencing the state’s billions of dollars in reserves.

Hochul, however, appears inclined to pursue smaller policy changes.

Instead of building toward her 2024 State of the State address with previews of big-ticket investments, as she did last year by unveiling a $1 billion mental health initiative, Hochul announced a series of consumer protection proposals and a maternal and infant health plan with little in the way of a price tag.

The investments that are coming appear to be extremely targeted. The maternal and infant health plan, for example, calls for Medicaid incentives for hospitals that perform fewer unnecessary C-sections.

One splashy announcement expected imminently is federal approval of a long-anticipated Medicaid waiver that could infuse an additional $13.5 billion into the program over five years.

The so-called New York Health Equity Reform proposal would be the most significant overhaul of the Medicaid program since New York’s $8 billion Delivery System Reform Incentive Payment Program in 2014, better known as DSRIP. It would also provide a significant new funding pool for financially distressed safety net hospitals, which predominantly serve patients who are on Medicaid or uninsured.

Given the budget deficit, state Assemblymember Amy Paulin, who chairs her chamber’s health committee, said lawmakers should consider actions such as authorizing the state to enter interstate licensure compacts for physicians and nurses. The two compacts would enable physicians and nurses from other participating states to more easily work in New York, either physically or virtually.

Hochul proposed legislation to join the two compacts in both of her prior executive budgets, but the state Education Department and some unions are opposed, arguing that other states’ licensure standards are not and should not be interchangeable with New York’s standards.

“New York’s lawmakers should focus on long-term solutions to the nurse staffing crisis, including creating a robust plan for nurse education, recruitment, and retention and ensuring our safe staffing laws are enforced to the full extent of the law,” said Pat Kane, executive director of the New York State Nurses Association. “They should reject false solutions that the hospital industry is proposing, like the Nurse Licensure Compact, which has not been proven to increase the supply of nurses and could lower patient care standards.”

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Legislative Committee Assignments:  First (Partial) List from Assembly Speaker Heastie

Yesterday, Assembly Speaker Heastie announced several Assembly Committee leadership positions including the appointment of Rochester Democrat Harry Bronson who will chair the Assembly Labor Committee.  This is the first of several announcements to come from Assembly and Senate leaders re: committee chairs and committee assignments for 2024.

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State AND City Preliminary Budget to come out next Tuesday:(Excerpts from Politico article, 1/09/24 below)

“Mayor Eric Adams is planning to release his preliminary budget the same day as Gov. Kathy Hochul is expected to unveil her own executive budget next week — a bizarre fiscal pileup that will reduce transparency and force the two executives to compete for headlines.

The dueling spending plans are both set to be released Jan. 16, according to city and state officials, a budgetary eclipse that has baffled longtime New York fiscal analysts.

“Both of them coming at the same time … makes a conversation and examination of their full impact, at least in the short run, much harder,” said Andrew Rein, head of the Citizens Budget Commission. “You want to give each the time and the focus because they are so important.”

Complicating matters, municipal bean counters normally have a sense of what the state is proposing by the time mayors deliver their preliminary budget addresses in January — even though they don’t officially incorporate that information into their own spending plan until a few months later.

The City Charter requires the mayor’s preliminary budget to be out each year by Jan. 16. But previous mayors regularly received a deadline extension from the City Council. A Council spokesperson said the Adams administration made no such request this time around.

Mayoral spokesperson Charles Lutvak confirmed the two budgets would come out on the same day but cautioned the presentations will not occur at the exact same time. He added that Jan. 16 is the statutorily mandated deadline for both the city and state to release their spending plans this year.

The mayor’s decision to horn in on Hochul’s budget presentation also upends a long tradition of the state going first.

For 10 straight years, from 2010 to 2019, the state released its spending plan, and the city followed a week or two later. That has changed in recent years — former Mayor Bill de Blasio twice announced his preliminary budget before former Gov. Andrew Cuomo’s executive budget. And Adams’ budget came out nearly three weeks before Hochul’s last year. But over that time period, they have never come out on the exact same day, or even within a few days of each other.”

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The NYS Council signed on to this letter calling for Governor Hochul to expand overdose prevention centers, along with 100 organizations.  See “Read more” link below:

Groups want New York opioid settlement funds to go to overdose prevention centers

By Luke Parsnow, Capital Tonight

More than 100 organizations are calling for opioid settlement dollars to fund and expand overdose prevention centers, according to a letter dated Monday sent to New York Gov. Kathy Hochul.

Made up of criminal justice reform groups, AIDS service and harm reduction providers and health care organizations, the letter states the disapproval of the state’s rejection of recommendations from the state Opioid Settlement Advisory Board to fund harm reduction efforts including needle exchanges, fentanyl strips, in-patient treatment and safe injection sites.

Read more.

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InPatient Psychiatric Beds:  Over the past year the Executive, in partnership with the Office of Mental Health, has been pressuring hospitals that converted inpatient psychiatric beds for other purposes during the height of the COVID-19 crisis, to put the beds back online.

A year after vowing to add 850 mental health beds to public and private hospitals, Hochul is reporting progress with 629 regained – half of which are in New York City, The City reports.