News & Info for Members of the NYS Council

August 18, 2023

(See announcement directly below, and additional information below the message from OASAS): 

1)  Dear Providers, 

 OASAS is offering an additional opportunity for funded OASAS Prevention Providers to apply to receive one-time funding to support the recruitment and establishment of a Paid Internship position for up to twelve months. OASAS intends to award at least thirty internships.  The Paid Prevention Internship Opportunity (PPIO) is designed to support and build the Prevention Workforce by bringing in talented, skilled, knowledgeable, and diverse staff to the field.

Funding available: 

Up to $900,000 in funding is available to support up to $30,000 for each internship. 

Eligible applicants:

Existing OASAS-funded Prevention providers including Prevention Resource Centers are eligible to apply for this funding opportunity.

Application Deadline:

9/23/2023 

Full RFA can be found at:  https://oasas.ny.gov/request-applications-rfa-supp1020

2)  Next, as we approach budget-making season here in NY, we wanted to provide some education re: New York’s Medicaid Global Cap that continues to have such a significant impact on state Medicaid spending here in New York:

Background: First enacted in 2011 as part of the recommendations of the Medicaid Redesign Team (MRT). the NYS Medicaid global cap mandates that state Medicaid spending be held to the 10-year rolling average of the medical inflation rate. If spending is on track to exceed the cap, the health commissioner has unilateral authority to cut Medicaid fees as necessary. The Cap was first presented as a mechanism to limit growth in Medicaid spending and instill discipline in Medicaid budgeting. In our opinion, the Cap was set at an arbitrary, fixed moment in time and not designed to keep pace with program growth.  As such, it should be rescinded.  

Here’s what the Children’s Defense Fund said about the Cap and its’ impact on affordable health coverage for children in its’ 2020 testimony presented to the members of the NYS Joint Legislative Budget Committees on Health and Medicaid:

“…Medicaid provides comprehensive and affordable health care coverage to 50 percent of the children in our State, most of whom live in households earning less than 154 percent of the federal poverty level.  Medicaid is especially critical for children under the age of three in New York, with 60 percent of this demographic receiving needed coverage under the program.  And children are certainly not the only New Yorkers who Medicaid serves – about one out of every three of our State’s residents, or 6.3 million people, are Medicaid beneficiaries.

Because Medicaid plays such an important role in the lives of low-income children and other vulnerable New Yorkers, we must safeguard it and ensure that adequate funding is available to meet the needs of its beneficiaries.  One threat to Medicaid’s future is New York’s Medicaid Global Cap, which was established by the Cuomo administration back in 2011.  The Cap prevents New York’s Medicaid program from ensuring that there is sufficient funding to meet the needs of all of our State’s Medicaid recipients.  The Cap is set by limiting annual growth of the program to the 10-year rolling average of the medical inflation rate.  This means that whenever the current costs required to meet beneficiary needs exceed the decade-long average, an artificial “budget gap” is created.  When this happens, the Health Commissioner is allowed to reduce Medicaid provider payments.  If these payments are cut too much, the quality of services may be diminished or there may not be enough providers willing to accept smaller payments.  As a result of the Cap, the Cuomo administration has identified a $2.5 billion Medicaid “budget gap” for the next fiscal year.

The Medicaid Global Cap is flawed for many other reasons.  While the Cap accounts for inflation, it fails to properly take into consideration the overall growth in health care costs, demographic changes due to an aging population, population needs during epidemics or natural disasters and the higher care costs associated with complex patient needs.  The Cap therefore does not match our beneficiaries’ needs for vital care and services.  Furthermore, the Cap creates an artificial shortfall for vital services that enable our most vulnerable New Yorkers to remain healthy and independent members of society and provide for their families… ”  (end excerpt). 

Bringing up to present day, earlier this week the Department of Health (DOH) and the Division of the Budget (DOB) reported that spending for the FY 2023 Medicaid Global Spending Cap was $8 million (-0.03%) below the $26.2 billion target.  The Medicaid Global Spending Cap increased from $22.3 billion in Fiscal Year (FY) 2022 to $26.1 billion in FY  2023, a net increase of $3.9 billion, which reflects an update as a part of the FY 2024 Executive Budget Financial Plan to increase the Medicaid Global Cap index allowable growth metric, from 4.7 percent to 5.8 percent. The FY 2023 Enacted Budget included a modification of the Global Cap metric moving from the 10 year rolling average of the medical component of the Consumer Price Index (CPI) to the 5-year rolling average of the Medicaid annual growth rate within the National Health Expenditure Accounts produced by the Office of the Actuary in the Centers for Medicare and Medicaid Services (CMS). Read the report here. 3) Here’s a link to an upcoming event in New York City that you may be interested in regarding value-based care: (City & State)https://www.cityandstateny.com/feature/Innovations-in-Value-Based-Care-2023/?oref=csny-events-upcoming

4) EDs are Drowning Under Rising Number of Pediatric BH Patients Organizations Warn (Fierce Healthcare)https://www.fiercehealthcare.com/providers/eds-are-drowning-under-rising-number-pediatric-behavioral-health-patients-orgs-warn

5) Marijuana and Hallucinogen Use, Binge Drinking Hit Historic Highs (The Hill)
https://thehill.com/policy/healthcare/4157254-marijuana-and-hallucinogen-use-binge-drinking-hit-historic-highs/

6) Capital Connection Broadcast Playback: New Yorkers pay – on average – some of the highest health care premiums in the country, so we explore the root of those costs and how they can be addressed, with Eric Linzer, president and CEO of the New York Health Plan Association
https://capitolpressroom.org/2023/08/17/the-root-of-new-yorks-nation-leading-health-care-premium-costs/?mc_cid=6168ac7d26&mc_eid=101f23c33c