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Assembly Health Committee Year in Review

Assembly Health Committee Year-End Update

The Assembly Health Committee wrapped up 2017 with 34 bills signed into law and 19 vetoed, including four which were vetoed with specific agreement for further administrative actions. Some bills were signed or vetoed based on agreements to enact changes in 2018. (A governor often raises concerns and wants changes in a bill after it has been passed by the Legislature. This usually happens after the Legislature has adjourned for the year. It is not widely known to the public, but in New York it is common for a governor to insist that the leaders of the Legislature agree to changes in a bill as a condition of the governor signing it. If the legislative leaders and the bill’s sponsors agree, the governor then signs the bill and the Legislature enacts the changes early in the following year.)

The Assembly Health Committee also held public hearings including:

  • Home care workforce adequacy.
  • Adult home oversight and funding.
  • Health care services in state prisons and local jails.
  • Nursing home quality of care and enforcement.
  • Water quality budget implementation.
  • Immigrant access to healthcare.

Below are summaries of bills acted on by the Governor as well as the public hearings.

City and State: Federal uncertainty keeps New York’s health care agenda in limbo

November 20, 2017

Health care legislation in Albany during the 2018 session will be largely affected by decisions made in Washington. State Sen. Kemp Hannon, chairman of the Senate Health Committee, said the state Legislature would be “very careful” and will be “watching what happens” in Congress this year when deliberating health care issues.

Last week, U.S. Senate Republicans launched another effort to dismantle the Affordable Care Act by including a measure in their sweeping tax reform proposal to eliminate the requirement that Americans buy health insurance or face a fine.

Additionally, the Children’s Health Insurance Program, which gives federal aid to provide medical coverage for low-income children, expired on Oct. 1. Nearly 700,000 children in New York state were enrolled in CHIP as of last year, according to Medicaid data.

Gotham Gazette: Amid Health Care Funding Fights, Cuomo Explores Special Session

By Rachel Silberstein, October 12

Governor Andrew Cuomo has been floating the idea of a special legislative session to address federal cuts to the state’s health care programs, as well as other concerns that have developed, since the state budget was agreed to in April.

In that budget, Cuomo pushed to include and won a provision granting him nearly unilateral power to adjust the state’s financial plan mid-year in the event of at least $800 million in federal cuts to the state. In April, the governor said the provision would ensure that “we do not overcommit ourselves financially” and indicated it allowed him to sign off on a budget that did not otherwise account for likely federal cuts. But, it appears as if Cuomo may call lawmakers back to Albany — likely with agreement from the legislative majorities to an agenda — regardless of whether the threshold has been met.

Albany Times-Union: N.Y. hospital prices tied to market power, not quality

By Claire Hughes. 12/17/16

If a knee joint replacement costs $20,000 at Hospital A and $35,000 at Hospital B, what does that whopping 75 percent difference tell you about the likely results of surgery at each place?

Unfortunately, nothing.

Certainly not that Hospital B does a better job at knee replacements. Nor that hospital B has patients with more complex problems, provides more advanced care or is making up low government payments by upcharging your insurance company.

City Limits – Fewer hospitals, more worries: What medical mergers mean for health care in NYC

By Toni Kamins, 6/22

These days the Mount Sinai Health System (MSHS) name and logo are omnipresent in Manhattan with a few outposts in parts of Brooklyn and Queens. Appended to pre-existing hospital and health-care facility signs – New York Eye and Ear Infirmary, St. Luke’s-Roosevelt Hospital, Beth Israel Hospital, many dozens of group medical practices, urgent-care centers, testing labs, and diagnostic and imaging centers – they are the outward manifestation of New York’s (and the country’s) rapidly changing health-care delivery environment. But the changes go far beyond mere names and signage; they represent the corporatization of one of our most basic services.

One recent change, the announcement in late May that MSHS will close or significantly downsize its Mount Sinai Beth Israel Hospital over the next four years, has sent a shockwave through lower Manhattan. Neighborhoods such as Chelsea and the West Village, which are still reeling from the health-services void left by the closing of St. Vincent’s hospital in 2010, will now have additional challenges as geography coupled with Manhattan traffic result in longer—perhaps life-threateningly long—trips to emergency rooms attached to far-away full-service hospitals.

PRESS RELEASE: Safe Staffing for Quality Care Act Passes Assembly

PRESS RELEASE

“Safe Staffing for Quality Care Act” Passes Assembly

Bill Sets Standards for Adequate Hospital, Nursing Home Staffing

(6/14/16 – Albany)  The New York State Assembly today passed the “Safe Staffing for Quality Care Act” (A8580A/S782) with bi-partisan support.  The bill would set a maximum number of patients that nurses and other “direct care staff” can care for in hospitals and nursing homes (staffing ratios) and was based on peer-reviewed academic and evidence-based recommendations.

“Safe staffing is a critical step to ensuring the safety of patients and the safety of nurses,” said Assembly Member Aileen Gunther, the lead sponsor of the bill. “Study after study has shown that investments made in nurses are good investments – whether it’s ending mandatory overtime, requiring safe patient handling policies, or setting safe staffing ratios. As our system of care is evolving, patient outcomes are a key factor in determining provider payments. Safe staffing will improve outcomes, save money, and save lives.”

“Safe staffing saves lives, improves outcomes and reduces avoidable patient injuries,” said Assembly Health Committee Chair Richard N. Gottfried.  “Research published in the Journal of the American Medical Association (JAMA) determined the odds of patient death increased by 7% for each additional patient the nurse must care for at one time.  The ratios and hours specified in this bill are based on peer-reviewed and evidence-based recommendations, and will ensure that hospitals and nursing homes are safer and provide higher quality care.”

The Villager – Prognosis for Beth Israel: New E. 13th mini-hospital

By Lincoln Anderson, 5/26

BY LINCOLN ANDERSON | Answering mounting questions about the future of Mount Sinai Beth Israel Hospital, on Wednesday, Mount Sinai Health System announced a $500 million investment to create a new “Mount Sinai Downtown” health network — the centerpiece of which will be a new, much smaller hospital on E. 13th St.

The new Downtown network, a press release said, will “usher in a sweeping transformation of care delivery from river to river below 34th St.”

As has been rumored and reported over the past year, the current Mount Sinai Beth Israel Hospital — which occupies the full block of prime Gramercy real estate between E. 16th and E. 17th Sts. and First Ave. and Nathan D. Perlman Place — will eventually be sold, a P.R. spokesperson confirmed.

In turn, the key feature of the new plan is a vastly scaled-down Mount Sinai Downtown Beth Israel Hospital to be built on the site of the New York Eye and Ear Infirmary of Mount Sinai — specifically, on the site of its residents building, at 321 E. 13th St. The press release said the new hospital would be built at E. 14th St. and Second Ave. However, the spokesperson confirmed that the plan is for it to be built at the residents building site.

Press Release – Assembly Health Committee Update

Assembly Health Committee Update:
New Legislation Advanced to Improve Access to Medical Marijuana

The Assembly Committee on Health favorably reported 10 bills at its meeting on April 5. The Health Committee had not met since its March 1 meeting because of work on the state budget.

The Committee reported bills to expand public access to epinephrine auto-injectors (“epi-pens”); establish age-appropriate sex education grant programs; and require apartment building owners to develop and distribute smoking policies.

The Committee also reported three bills to improve the 2014 Compassionate Care Act medical marijuana law and expand patient access. Changes required by the Executive as conditions of signing the bill, and Health Department regulations, drastically limited the scope of the program. The three bills reported by the Committee would:

  • Allow physician assistants and nurse practitioners to prescribe medical marijuana (today they are already fully authorized to write prescriptions for even the strongest and most dangerous controlled substances).
  • Expand the list of eligible conditions. The conditions added in this bill were initially passed by the Assembly but deleted from the final law at the Executive’s insistence.
  • Create an advisory committee to assist the Commissioner in making regulations, advise the Commissioner on clinical matters, and review appeals of denials of patient or caregiver applications; require that medical marijuana regulations conform to the legislative intent and have a valid clinical or public safety basis.

Assembly Health Committee Update, 1/21/16

Assembly Health Committee Update

The Assembly Committee on Health favorably reported 22 bills at its first meeting of the 2016 session on January 21.

The Committee reported the bill to establish safe staffing requirements in hospitals and nursing homes (A8580, Gunther). The evidence is clear that having enough nurses on staff has a direct impact on the quality of patient care. Research published by the American Medical Association estimates five additional deaths per 1,000 patients in hospitals with an 8-to-1 patient-to-nurse ratio compared to those with just a 4-to-1 ratio. More nurses per patient means fewer deaths and improves patient outcomes. It is well documented that hospitals with better staff ratios have lower rates of problems such as pneu­monia, shock, and cardiac arrest.

The ratios in the bill are based on academic and evidence-based studies. The Health Department could also set more demanding and specific ratios. California was the first state to mandate nurse staffing ratios and it has seen significant improvements in outcomes for both patients and staff.

For more information on a particular bill, please contact the sponsor listed after the description. For the text of a bill, supporting memorandum, and information on its status, go to: http://public.leginfo.state.ny.us/menuf.cgi

Genetic Disease Screening and Counseling – Authorizes grants for familial dysautonomia, Canavan’s and Tay-Sachs disease screening and counseling. (A126, Dinowitz)

Adult Home Residents Right to Sue – Lets adult home residents go to court for a court-appointed receiver to operate the adult home when the operator has endangered the health, safety, or welfare of the residents. (A154A, Weinstein) 

May Health Committee Update

Assembly Health Committee Update:
Protecting Nursing Home Residents From Abuse of Psychotropic Drugs

The Assembly Committee on Health favorably reported 39 bills at its meetings in May.  The Committee advanced legislation strengthening the “prescriber prevails” rule in Medicaid Managed Care; authorizing community paramedicine; and protecting nursing home residents from overuse of psychotropic drugs.

New York law gives patients in nursing homes the right to be fully informed of their proposed treatment, including the right to refuse treatment and be free from chemical restraint unless consistent with certain requirements.  However, psychotropic drugs are being used not just to treat illness but as a form of behavioral control.  The Assembly Health Committee held a hearing in February in which patients’ families, advocates, and adult care experts testified to the frequency of overuse.  A.7351 (Gottfried) requires that before psychotropic drugs are ordered in a nursing home or adult care facility, the patient or their surrogate must be informed of the potential benefits and side effects; dosage and duration of the prescription; reasonable alternatives (such as therapeutic activities); and their right to refuse consent.  The bill also requires written consent by the patient or surrogate.

For more information on a particular bill, please contact the sponsor listed after the description.  For the text of a bill, supporting memorandum, and information on its status, go to: http://public.leginfo.state.ny.us/menuf.cgi .

Tuesday, May 5

Early Intervention Covered Lives Assessment – Provides funding for Early Intervention services through the “covered lives assessment” paid by health insurance companies.  (A273, Paulin)

Credentialing for Group Practices – Requires insurers to expedite review of applications of health care professionals who are joining a group practice and grant provisional credentials to these professionals (A501, Cusick)

Healthy Teens Act – Establishes a Department of Health grant program for providers of age-appropriate sex education.  (A1616, Gottfried)