January 5, 2022
Here’s a wrap up of the Governor’s State of the State proposals. The full briefing book is available online here. We still need clarity on a number of issues, mostly pertaining to the Governor’s discussion of workforce investments and the COLA.
First, the Governor’s State of the State Briefing Book discusses a total $10B ‘Healthcare Workforce” investment. So, $10B appears to be the top line number. Sprinkled in is a non-specific discussion of the Human Services COLA. We say non-specific because we have been unable to confirm that the funds proposed equal the cost of a 5.4% COLA, as requested. There is a reference to $500M to help ‘raise wages’ for workers including Human Service workers although there is no specific explanation as to which Human Service Workers this includes.
There is discussion of a $2B Workforce Retention bonus package that we are told will mirror the eFMAP and Block Grant awards that are continuing to roll out across our sector thanks to federal COVID Relief.
(From the Briefing Book:)
$10 Billion Investment in Healthcare and Support Wages for Workers
New York’s essential healthcare workers have seen us through a once-in-a-century public health crisis and turned our state into a model for battling — and beating — COVID-19. But many of these workers are still earning a wage far below what they need to sustain a household and a fair quality of life.
To grow New York’s healthcare workforce by 20 percent over the next 5 years, we must attract talented people into the profession at a time of such significant strain. And to do that — while also retaining those who have been working so tirelessly and heroically these past two years — we must treat our healthcare workforce with the dignity they deserve.
Simply put, we must build the healthcare system of tomorrow. To do that, Governor Hochul will make more than a $10 billion, multi-year investment in healthcare, including more than $4 billion to support wages and bonuses for healthcare workers. Key components of this multi-year investment include:
- $2 billion to support healthcare worker wages.
- $2 billion to support healthcare and mental hygiene worker retention bonuses, with up to $3,000 bonuses going to full-time workers who remain in their positions for one year, and pro-rated bonuses for those working fewer hours.
- $500 million for Cost of Living Adjustments (COLAs) to help raise wages for human services workers.
- $2 billion for healthcare capital infrastructure and improved lab capacity.
- Other investments in workforce and healthcare access and delivery.
Other State of the State proposals of import to NYS Council members:
Telehealth This is a very significant proposal and one the NYS Council has worked relentlessly to see come to fruition. Now we just have to make sure it sticks.
Require Private Insurers to Reimburse Appropriate Telehealth Services at the Same Levels as Traditional Services
The pandemic demonstrated the inequities in our healthcare system and showed that telehealth is a critical tool to expand access to healthcare, especially for behavioral health support. During the crisis, New York saw an approximately 130- fold increase in telehealth usage. Increased telehealth usage has been demonstrated to lower health costs and improve the patient experience, including expanding access to care and improving health outcomes.
Medicaid already pays for telehealth services at the same rates as equivalent traditional services. But that isn’t true for many private healthcare plans, and this limits access to these important services for many New Yorkers. Governor’s Hochul will establish parity for telehealth services across commercial insurance plans and require insurers to offer an adequate network of telehealth health care providers, expanding access for telehealth services throughout the state.
Interstate Medical Licensure Compact
Governor will propose legislation for New York to join the Interstate Medical Licensure Compact and the Nurse Licensure Compact. Joining these compacts will enable doctors and nurses to relocate to New York and use their existing license to quickly begin to practice in the state through telehealth or otherwise, thereby attracting more healthcare workers.
Provide Home-Based Crisis Intervention to More Families:
To help even more New York families struggling with suicide, OMH will develop new HBCI teams and increase funding to existing HBCI teams to expand current caseloads and improve staff recruitment and retention. This expansion will enable HBCI programs to serve 2,640 families each year, doubling the current volume.
Integrate Mental Health Services into Pediatric Primary Care :
OMH and DOH will partner to provide Medicaid reimbursement for dyadic services delivered in integrated primary care within New York State HealthySteps sites. Under this program, licensed behavioral health professionals will be fully integrated into pediatric primary care well-child visits.
Access to Care: Children’s BH Services
The item directly indicates the Governor is proposing a change that will ensure many children’s BH services are covered by Child Health Plus. Since behavioral health CHP services must be reimbursed at the APG government rate, this is a potentially very important proposal that we have worked on alongside the NYS Coalition for Children’s Behavioral Health and the HealthyMinds, HealthKids Campaign:
Improve Access to Child Health Plus Insurance and to Mental and Behavioral Health Services for Children in Low-Income Households
The Governor will improve access to children’s mental and behavioral health services by aligning Child Health Plus benefits with Medicaid benefits, including mental health and substance use services, home- and community-based services, evidence-based treatment for individuals diagnosed with serious mental illness, and residential rehabilitation for youth.
Scope of Practice
Healthcare “scope of practice” refers to the health-related actions permitted by a worker’s professional license. In September, Governor Hochul issued an Executive Order8 declaring a statewide emergency due to healthcare staffing shortages that expanded the scope of care for some professionals, enabling them to help New Yorkers in urgent need. To maintain this critical flexibility, Governor Hochul will propose legislation to make permanent the most beneficial provisions from the Executive Order, listed below, as well as others implemented during the pandemic.
Under the Governor’s proposal, more professionals will be allowed to administer vaccines, flu, and COVID-19 testing; supervisory requirements in clinical laboratories will be modernized; and requirements will be waived for Nurse Practitioners to have a written practice agreement with a physician, which is an obstacle that stands in the way of Nurse Practitioners providing the maximum amount of care to New Yorkers. The proposal does not specifically mention LMHPs so we will need to keep the pressure on to ensure these valued workers can practice at the top of their scope.
· Accelerate a $1.2 billion-dollar tax cut originally scheduled to take effect between now and 2025.
· Establish a $1 billion middle-class property tax rebate to more than 2 million homeowners.
· Expand access to affordable childcare to 100,000 more working families and invest $75 million in childcare worker wages.
· Deliver $100 million in much-needed relief to nearly 200,000 small businesses.
· Provide a business tax credit for COVID-related purchases, like outdoor heaters and seating.
· Re-establish the sale of to-go drinks.
· Establish a farmer tax credit for overtime hours, increase the Investment Tax Credit, and extend and double the Farm Workforce Retention Credit.
· Reboot the Workforce Development Office and house it in Empire State Development with funding incentives tied to high job placement rates.
· Ease qualifications for MWBEs.
SUNY/CUNY and Higher Education
· Increase enrollment at SUNY colleges and universities to 500,000 students by 2030.
· Extend TAP funding to part-time students.
· Create flagship institutions at Stony Brook and the University at Buffalo and invest in premier research facilities at Binghamton and Albany.
· Lean into the strengths of four-year comprehensive colleges, technology colleges, and community colleges to impact local communities.
· Provide childcare on each campus.
· Support individuals who have been incarcerated with a “Jails-to-Jobs,” initiative to assist with employment during re-entry and also restore the Tuition Assistance Program for incarcerated people—ending a 30-year ban.
Infrastructure & Environment
· Transform and update Penn Station, ensure progress with the Gateway Project, deliver long overdue upgrades to both LaGuardia and JFK Airports, and finish the 2nd Avenue Subway to connect East Harlem to jobs.
· Establish the Inter-Borough Express, a new rail service that will connect Brooklyn and Queens.
· Direct the Port Authority to move on the Cross-Harbor freight tunnel and also address other roadway initiatives across the state.
· Invest $1 billion into connecting more New Yorkers with high-speed internet.
· Key investments in infrastructure to be more resilient against climate change and extreme weather events.
· Increase the Environmental Bond Act to $4 billion to go on the ballot this Fall.
· $500 million investment in offshore wind energy that will create thousands of green jobs.
· Cut 80% of New York City’s power plant emissions by 2030 and require new construction in the State to be zero-emission by 2027 and promote electric cars, trucks, and buses.
Public Safety & Homelessness
· Form a new consortium between the New York State Police, the NYPD and other law enforcement agencies, including neighboring states to trace guns used in crimes and stop the flow of guns into the State.
· Triple resources for gun-tracing efforts and community-based programs targeting gun-based violence.
· Create teams of mental health professionals and social workers, who will partner with New York City outreach workers to reach homeless individuals and move them into shelters and housing.
· Address the root causes of homelessness unmet mental health needs: poverty, addiction, and housing insecurity.
· Launch a five-year housing plan to create and preserve 100,000 affordable homes, including 10,000 units with supportive services for high-risk populations, like runaway youth and formerly incarcerated individuals.
· Establish two term limits for all statewide elected officials and ban outside income for these officials.
· Replace JCOPE with a new ethics enforcement watchdog, subject to FOIL and Open Meeting Laws like other State agencies. The new ethics board would consist of a rotating board of five members made up of the 15 state-accredited law school deans or their designees.