ALBANY, N.Y., April 2 – This years state budget will expand New Yorks Child Health Plus program to include many of the 400,000 currently uninsured children and will lower bureaucratic barriers to allow more than 900,000 uninsured adults to qualify for Medicaid and Family Health Plus coverage.

These are important victories for New Yorkers who need care. It takes New York a few steps in a new, better direction on health care, said Michael Kink, spokesperson for Medicaid Matters New York (MMNY).

The budget also includes new resources for translation services, which should improve the quality of the communication between providers and patients. MMNY said it will work with the governor and Legislature to develop resources for language services at a range of health providers, in addition to the voluntary hospitals funded in this years budget.

In the final budget, more than $650 million will go to health care providers serving the largest number of Medicaid beneficiaries, including $546 million in workforce recruitment and retention funding " 77 percent of total recruitment and retention funding " and $108 million in hospital funding. Kink said, Thats an important victory in the effort to get Medicaid resources where they do the most good.

Budget language will allow hospital inpatient care reimbursement to be re-weighted to prioritize high-need health access areas, including OB/GYN, starting on January 1, 2008. For Kink, that means increasing the effort to make sure our public resources are used effectively and that weve got the right incentives in place to meet community needs.

The budget also includes $2.5 million for housing subsidies to help implement the Nursing Facility Transition and Diversion waiver, which will help people who need long-term care services live at home and receive care in non-institutional settings. Thats a good start towards a stronger disability housing policy that promotes independent living, reduces reliance on institutional sites, and makes the best use of health care expenditures, said Kink.

The New York State Association of Health Care Providers, Inc. (HCP) agrees with MMNYs support of the final budget, which took into account the valuable services home and community-based care delivers to New Yorkers, according to HCP president, Phyllis A. Wang. The home care industry and New Yorkers that have used home care have long known the benefits that home care provides, for both patient and taxpayer.

Another provision of the budget that was well-received by HCP was the development of telehealth reimbursement rates and enhanced Medicaid rate increases for rural home care agencies. Telehealth includes the use of communication and information technologies to deliver home care services and health education over a geographical distance. As the population ages and demand for care increases, said Wang, Im optimistic that this funding will demonstrate just how effective telehealth really is and result in additional funding in the future.

The state budget includes an additional $8 million for enhanced Medicaid rates for rural home care agencies pending federal approval, a measure that is praised by Wang who states that HCP [has] fought for this funding.

Criticisms

But not everyone is pleased with the final budget. The new state budget will deliver yet another in a series of blows to local pharmacies in the form of Medicaid and EPIC reimbursement cuts, said Craig Burridge, executive director for the Pharmacists Society of the State of New York, Inc. The bottom line just got thinner, and more communities will be at risk of losing a local pharmacy. Over the past two years, 15 rural upstate communities have each lost at lease one community pharmacy due to the impact of previous state cuts and Medicare Part D. For independents across the state, this budget will be a watershed event.

Burrdige criticized officials for assuming pharmacies will adjust to the changes. As drug inventory costs rise, he said, any projected state savings evaporates, and nothing is accomplished except for more pharmacy closings, fewer pharmacies offering delivery and other services, shorter pharmacy hours, more layoffs, jobs lost, and longer lines at the pharmacies that remain open.

Burridge also said that pharmacies will face a double-whammy budget cut later in the year when federal Medicaid rates for generic drugs decrease as part of the Federal Deficit Reduction Act.

The health care system is enormously complex and interconnected, said the Healthcare Association of New York State (HANYS) President Daniel Sisto, who remained wary of Governor Eliot Spitzers proposed health care cuts. It is impossible to work on one part of it without intentionally or unintentionally affecting other areas. Achieving real reform will be similarly complex and challenging. We will need the full cooperation of all parties, including insurers, if we are to succeed.

Gottfried Offers Praise, Outlines Study

The chairman of the Assembly Health Committee, Richard N. Gottfried (D"New York), had nothing but praise for the health care-related provisions of this years New York State budget.

The health budget lays the groundwork for achieving full universal health coverage, he said. Gottfried said that by increasing the eligibility threshold for Child Health Plus to four times the federal poverty level will bring all of the states 400,000 children without health coverage into the fold of the insured. This change, combined with changes aimed at simplifying the enrollment procedures for Child Health Plus, Family Health Plus, and Medicaid, will expand comprehensive coverage to half of the 2.6 million uninsured New Yorkers, Gottfried said.

The budget also includes $200,000 for the Department of Health to use to study a variety of proposals to establish universal coverage. [The study] will analyze the pros and cons of proposals for publicly-sponsored health coverage like Medicare or Child Health Plus, but for everyone, as well as proposals building on the current system of private coverage, Gottfried said. A report outlining the pros and cons of the studied proposals will be made available to the public when it is complete.

The study will consider, among other factors, how each proposal advances the goal of universal health coverage; controls the cost of health coverage and health care; affects the scope of benefits, the quality of care, and choice of providers for consumers; affects employers and employment, particularly small business; and promotes the economic viability of hospitals, community health centers, health care professionals, and other health care providers.