January 10, 2023

Following (below and linked) is a summary of the Governor’s State of the State proposals highlighted in her speech earlier today, and described in more detail in the State of the State Book we sent you right before the 1:00 presentation began. The summary was prepared by our government relations consultants at Reid, McNally & Savage.

“After three very difficult. Tragic, painful, and uncertain years, I am proud to say that the state of our state today is improving, but we have work to do.” Governor Hochul led with these words as she gave her first State of the State (SOS) address as the first newly elected woman Governor of the State of New York (her second SOS address).

Her official address totals over 277 pages. The address focused on public safety, affordable housing, addressing mental health, building a better health care system(transform how we pay for and deliver care, strengthen the foundation, prepare for future of emergencies), providing high quality education, attracting and growing state businesses, growing the agricultural sector, lifting up all New Yorkers(Reproductive Freedom, Data Privacy, ERA), building a strong equitable child care system, prioritizing transportation , safety, equity and efficiency, improving the state government customer experience and improving state government agency operations.

The Governor’s State of the State Briefing Book can be viewed here. Included below (and attached) are summaries of key items relating to the following sectors.

General Health

Behavioral Health

Professions

Long Term Care

EMS

Reproductive Health

Public Health

Disabilities

Other Proposals

General Health
Building a Health Care System for New York’s Future p. 90

Governor Hochul will invest $20 billion in New York’s health care system including:

● $1.2 billion towards health care and mental hygiene worker retention bonuses with $3,000 in extra support being provided to full-time workers who stay in their positions for one year.

● Home care worker minimum wage increase of $3 per hour, taking place over the course of four years

● $500 million invested in Cost-of-Living Adjustments

● $2.4 billion for health care capital infrastructure and improved lab capacity

● $3.9 billion to support hospitals struggling from the COVID-19 pandemic

To address future health system challenges, Governor Hochul will invest in transforming the health care system to improve how care is paid for and delivered. The most pressing health care issues facing New Yorkers, especially New Yorkers from underserved communities, will be focused on.

Establish a Commission on the Future of Health Care p. 94

● The new ‘Future of Health Care’ Commission will develop a data-driven, comprehensive plan to transform the health care system in New York State

● The Commission will develop statewide and regional short and long-term goals for continuum of care and devise other policies, regulations, and strategies to improve care delivery

● Governor Hochul will provide additional health care funding on top of the $1.6 billion committed last year to support the projects and recommendations of the Commission

Establish a New Health Care Technology Capital Program p. 97

● A new capital grant fund will be established to aid safety-net providers in making technological investment upgrades.

● This will help to protect patients from cybersecurity attacks, stimulate clinical technology advancement, and improve efficiency and patient experience.

Reform Traveling Nurse Agency Staffing Practices p. 98

Legislation will be introduced to require staffing agencies to register and report data about their operations in order to increase transparency and gain a better understanding of contract labor.

Reform Approval Processes of Health Care Projects p. 100

Governor Hochul will direct the Department of Health to review and amend the Certificate of Need (CON) process to reduce administrative barriers health care providers face in modernizing their facilities. This will include raising the cost threshold for projects that need to file a CON and revisiting the definition of “public need” used in the application process.

Expand Medicaid Coverage of Preventative Health Services p. 101

Governor Hochul will support preventative care for Medicaid enrollees including increasing supportive housing funding, dental care rates, rates for children’s vaccine administration, and expanding diverse Childhood Experiences screening, coverage for therapy, screening for social determinants of health, and more.

Expand Access to Primary Care p. 105

To improve access to primary care for Medicaid enrollees and reduce preventable hospitalizations and emergency room visits, Governor Hochul will:

● Increase overall Medicaid reimbursement rates for all primary care and nurse practitioners who are critical providers of primary care

● Ensure Medicaid coverage of primary and urgent care within the shelter system

● Expand Medicaid coverage of community health workers

● Increase Medicaid reimbursement rates for school-based health centers

● Support primary and mental health care integration by allowing Medicaid reimbursement for other types of licensed mental health providers in community health centers, creating a working group on integrated care, and relaxing licensure restrictions for Article 28, 31, and 32 facilities

End Preventable Epidemics p. 114

● Require third trimester screening during pregnancy to prevent future congenital syphilis cases

● Introduce legislation to require more people, including all pregnant persons, to be screened for Hepatitis C

Modernize our Health Reporting Systems p. 115

● A first-of-its-kind analytic platform will be developed by a Department of Health Program Office to combine real-time health information with key data like chronic condition risk factors

● The Department of Health will automate data reporting, collect data from health providers on what information is important for decision-making, and provide non-hospital health care providers with support to install electronic medical record systems and connect to the State’s health data reporting systems

Improve Essential Plan Coverage p. 103

Several changes to the Essential Plan will be considered, like reducing cost sharing for patients, expanding funding for health plans to cover more mental health and social services, increasing reimbursement rates for health care providers, etc. to make health care coverage more affordable and equitable.

Protect New Yorkers from Medical Debt and Other Burdensome Medical Costs p. 103

Governor Hochul will develop a plan to help alleviate New Yorker’s medical debt and protect New Yorkers from medical costs consisting of:

● Amending the Consumer Credit Fairness Act to cover medical debt

● Launching an industry and consumer education campaign concerning medical debt and affordability

● Reforming hospital assistance applications to mandate hospitals use a uniform application form

● Build on the Pharmacy Benefit Bureau launched last year to require drug manufacturers to report changes to drug prices ahead of time and require that this be made publicly available to consumers

Behavioral Health
Expand Insurance Coverage for Mental Health Services p. 55

· Advance legislation to expand Medicaid and commercial insurance coverage to ensure that individuals have access to behavioral health services

· Push legislation that prohibits insurance companies from denying access to medically necessary high need crisis mental health services for children and adults

· Adopting appointment availability and geographic accessibility standards for behavioral health services

· Ensuring payment parity for behavioral telehealth services

Expand Mental Health Services for School Age Children p. 56

· Increase youth access to mental health services through their school system by making changes to commercial and Medicaid reimbursement rates

· Investing in annual school-based partnership grants that provide funding to get expanded school-based services off the ground

Increase Operational Capacity for Inpatient Psychiatric Treatment by 1,000 beds p. 57

· 850 of the beds will be Article 28 Community hospitals

· 150 will be new adult beds in State run psychiatric facilities

· OMH will be given capacity to levy fines for non-compliance with operating certificates of up to $2,000 per violation per day

Improve Admissions and Discharge Planning and Establish Systemic Accountability p.60

· Adoption of new comprehensive standards for evaluation and increased state oversight of the adoption of new protocols

· Creation of 50 new Critical Time Intervention Care Coordination Teams

· Instituting new requirements that inpatient providers discharge high risk patients immediately into wrap-around services and provide immediate and ongoing appointments during the discharge process to ensure a warm handoff

Dramatically Expand Outpatient Services p.61

· Utilizing 12 new comprehensive psychiatric emergency programs providing hospital level crisis care across the state

· Lean further on Assertive Community Treatment teams organizing 22 new mobile teams in New York City and 20 more in the rest of the state

· Expanding Certified Community Behavioral Health Clinics (CCBHCs) statewide by adding 26 new clinics supplemented by an Indigent Care Pool (ICP) to ensure access

· Supplementing the Safe Options Support Teams by adding Five new teams in New York City and three more in the rest of the state

· Expand capacity of article 31 clinics at 20 sites

Create 3,500 New Housing Units for Individuals with Mental Illness p.64

· 500 of these units will be Community Residence Single Room Occupancy (CR-SRO) units

· 900 more will be transitional step down units under a medium length stay model

· 600 will be Licensed Apartment units aimed at assisting those with intermediate needs

· 1,500 Supportive housing units will serve those with serious mental illness of which half will be scattered site and the other half newly constructed or renovated units

Save Lives Through Treatment of Opioid Addiction p. 111

● Launch an interagency task force to consider all options with regard to opioid use disorder treatment and harm reduction strategies

● Make advanced drug testing technology available at Drug User Health Hubs and to engagement service and street level outreach providers

Professions
Scope of Practice p. 99

· In response to the COVID-19 pandemic, Governor Hochul signed an Executive Order in September 2021 that temporarily expanded the scope of practice for certain professions. Noting continued health care workforce shortages in New York, Governor Hochul states “making these flexibilities permanent and expanding scope further will help alleviate the shortage, by continuing to allow the current workforce system to provide more care.”

· Interstate Licensure Compact: Governor Hochul plans to advance legislation to allow New York to join the Insterstate Licensure Compact to which would allow physicians licensed in other states to practice in New York, either physically or virtually.

Long Term Care
Ensure Access to Aging Services and High-Quality Long-Term Care p.109

● Investments in care teams to allow low-income New Yorkers to age in place

● Provide respite care for high-need family caregivers

● Establish reporting, accreditation, and quality improvement initiatives for assisted living residences

EMS
Revitalize Emergency Medical Services and Medical Transportation p.107

● Ensure adequate reimbursement for emergency transportation providers

● Establish a working group to recommend ways to expand access to non-emergency medical transportation

● Establish nine regional EMS organizations to coordinate personnel and equipment under a statewide EMS disaster response system

● Allow for community paramedicine by EMS providers

● Permit ambulances to treat patients in place or take patients to urgent care clinics without sacrificing payment.

Reproductive Health
Protecting Reproductive Rights and Access p. 191-194

Governor Hochul includes a plan for New York to continue to be a safe haven for all those seeking abortion care after Roe v. Wade was overturned. The plan will include:

● Increased reimbursement rates for reproductive health providers;

● Legislation to expand access to hormonal contraception by allowing pharmacists to directly provide such medications;

● Legislation to protect personal data, including location history and search history for anyone who seeks abortion care in New York State;

● Require all public colleges and universities in the SUNY and CUNY systems either offer medication abortion in their college health centers or establish a relationship with a local reproductive health care provider to directly refer students to a trusted facility for abortion services; and

● Enact the Equal Rights Amendment, passing the Amendment for the second time as required to be brought before voters on the ballot in 2024.

Public Health
Tobacco Control Initiatives p.110

● Prohibit the sale of all flavored tobacco products

● Increase the cigarette tax from $4.35 to $5.35 per pack

Disabilities
Interagency Coordinating Council for Services to Persons who are Deaf, Deafblind, or Hard of Hearing p.195

Governor Hochul plans to reinvigorate the previously established Council, tasking the Office of the Chief Disability Officer with coordinating and overseeing council operations, initiatives, and recommendations for policy relevant to the Council’s charge.

Designate New York as a Model Employer for People with Disabilities p. 197

Governor Hochul will make New York a “model employer for people with disabilities” through an Executive Order. The State will identify practices that will help increase the employment rate of people with disabilities and work with businesses to adopt inclusive policies and integrated employment practices.

Expand the Medicaid Buy-in Program for New Yorkers with Disabilities p. 102

Due to Medicaid eligibility income and asset limits, people with disabilities often have to choose between maintaining their Medicaid coverage and pursuing employment opportunities. Governor Hochul will submit a waiver to expand the Medicaid Buy-In program so that more New Yorkers with disabilities can work and qualify for Medicaid coverage.

Other Proposals
Index the Minimum Wage p.144

After reaching 15 dollars an hour each region’s minimum wage will increase consistent with the year over year consumer price index-W for the Northeast region. These annual increases will be capped and “off-ramps” will be provided in the case of certain economic conditions.

Expand Access to Paid Parental Leave p.254

Offer State employees 12 weeks of fully paid parental leave the Office of Employee Relations will be directed to implement this policy for all unrepresented employees immediately.

Rebuild the Wadsworth Laboratories p.116

Governor Hochul will provide additional funding, building on a 2019 investment of $750 million, to consolidate the Wadsworth Laboratories. Wadsworth’s five unconnected sites located throughout the Capital Region will be consolidated into one state-of-the-art facility on Albany’s W. Averell Harriman Campus by 2030.

Modernizing Gender-Based Violence Policies and Procedures p.195

Governor Hochul proposes to amend the State’s outdated Domestic Violence Model Policy, and update corresponding policies for providing social services and screening potential survivors. The goal will be to increase the number of survivors who receive services, including the Family Violence Option, a federal program to protect survivors, and housing navigators training in screening for domestic and gender-based violence.