January 8, 2024

Tomorrow (January 9) at 1:00, Governor Hochul will give her State of the State (SOS) speech, highlighting some of her proposals, followed by the release of the State of the State Book that lists all of the 2024 proposals.  speaking of dates, since this is an election year, the executive budget proposal is required to be released by January 16 and as such, it is also possible we will see Budget Hearings start quickly. In anticipation of the SOS event tomorrow, the Governor has released information regarding a total of 5 proposals.  

The first proposal, dealing with consumer protections and affordability, would increase paid medical and disability leave, eliminate copays for insulin, and expand consumer protections related to medical debt. Number 2 hopes to improve reading proficiency through a $10 million investment in teacher training and the expansion of SUNY and CUNY micro-credential programs for teachers. Other proposals included a slew of provisions aimed at addressing the maternal and infant mortality crisis, as well as the “NY SWIMS” program to increase swimming proficiency, as drowning is a serious threat to children.  Governor Hochul shared an artificial intelligence initiative this morning, the fifth pillar of her 2024 State of the State. To promote responsible research and development, create jobs, and utilize AI for the public interest, the Governor will be allocating $275 million of State funding and $125 million from other sources in her FY 2025 Executive Budget to create ‘Empire AI,’ an artificial intelligence computing center in Upstate New York. She will also be directing the NYS Office of Information Technology Services to establish AI Policy for use by state agencies. 

There are persistent rumors that the state’s new 1115 waiver deal with CMS will be announced this week, possibly tomorrow.  As Governor Hochul continues to lobby her colleagues in Washington DC for migrant crisis aid, and the headlines continue to scream about the extraordinary (unanticipated) state spending to address this ongoing  crisis, an announcement that the state has managed to draw down significant federal dollars is sure to be hailed as a major achievement, and a lifeline that will generally assist the state in mitigating costs and managing budget deficits.  

Since 2024 is an election year for all of the members of the NYS Legislature, we should anticipate a fast-paced Legislative Session ending in early June so lawmakers can go back to their districts to campaign.  However, since Governor Hochul ended 2023 by vetoing a slew of high-profile bills supported by both the Assembly and Senate, including the Grieving Families Act, a ban on non-compete agreements, and changes to the public campaign finance system, we can anticipate some pushback from Assembly and Senate leaders on several high profile issues.  

As you know, the New York State Council has been hard at work, advocating for our Budget and Legislative priorities since early September and we continue to meet with decision makers regarding the following high priority proposals:  

1. COLA at 3.2% plus $500M and other workforce investments including increased rates for peers, expanded eligibility for loan forgiveness initiatives, etc.1)  Commercial Insurance Rate Parity:  The NYS Council has proposed budget language to address this longstanding and discriminatory practice.  In the event that a remedy is not part of the Governor’s executive budget proposals, we are just about ready to announce sponsors for commercial insurance rate parity legislation in the Senate and Assembly.)
2. BH Carve Out from Medicaid managed care (outpatient services only):  NYS Council submitted draft budget language in November requiring a carve out, we surveyed our members and published important findings, and we have been meeting with Executive Chamber representatives and state leaders constantly on this topic, as well as the commercial rate issue.
3. OMIG Audit Reform legislation – NYS Council is lead on this ongoing statewide effort to compel lawmakers to bring fairness and balance to the OMIG audit process.  Today we are pleased to report that Assembly Health Chair Amy Paulin has agreed to continue to sponsor our OMIG Audit Reform bill with some further amendments in an attempt to address concerns raised, and we are working with Senator Harckham’s office to do the same.
4. Children’s Rate Reform – The HealthyMinds, Healthy Kids Campaign (of which the NYS Council is a Steering Committee member) has been shopping our rate reform proposal to address low rates that create barriers to access to care for children, youth and their families.
5. Waive co-pays and deductibles for MH and SUD services to increase access and remove financial and other barriers to care.
6. Expedite appropriation of the OASAS Opioid Settlement Funds and expand eligibility to all OASAS (and where appropriate, OMH) providers.

In addition to these priorities, we remain deeply concerned about the impact on our workforce associated with recent changes to scope of practice laws that impact practitioners who work in our programs.  We have been pressuring the state agencies to exercise their authority to mitigate the potential damage associated with these changes, and this includes a letter we sent to the Commissioners on December 20, making a number of requests: 

1. Issue a ‘hold harmless’ between June 24, 2022 and December 15, 2023 for those MH and SUD agencies impacted by the changes that took effect upon the sunset of the licensure exemption.
2. Announce a ‘transition phase’ that will give providers 120 days from the date of the Webinar you intend to co-host, to interpret and implement any staffing changes they must make based on the additional information you shared with them recently along with the information they take away from the upcoming Webinar.
3. Grant a grace period to any practitioner who is working in an impacted provider organization and is currently awaiting a response from SED to their application for a Limited Permit, or License.  Wait times associated with SED issuance of permits and licenses for MSWs and MHCs can be up to 4 months.  These delays have contributed to our ongoing access to care crisis across the state. 
4. Announce a date certain for the SED/OMH/OASAS Webinar.  Providers are anxious to attend this Webinar and have their questions answered. 

And finally, we have been pressuring OMH to issue the ‘provider toolkit’ they say they are preparing for release this month, to assist providers that operate, or will soon operate school-based mental health satellite clinics.  Some commercial insurers are now required to add this benefit to their offerings, and to pay either the Medicaid rate (in instances where the provider is out of network) or the negotiated rate (in instances where the provider is in network) until such time as the contract comes up for renewal.  We realize that NYS Council members have many questions regarding the operational steps for this new initiative, and we are working with state agencies to ensure they understand all of the issues associated with provider billing for these services, and to ensure adequate surveillance, monitoring and enforcement of this new requirement.