Two NYS Senators Say They Helped Prevent Steep Health Care Cuts | WAMC

Two NYS Senators Say They Helped Prevent Steep Health Care Cuts

Apr 3, 2019

Two Democratic New York state senators from the Hudson Valley stood outside an Orange County nursing care facility Tuesday, one day after proposed health care cuts in the new state budget were staved off.

State Senator James Skoufis of the 39th District says there was $550 million in health care cuts in the governor’s 30-day budget proposal amendments that came out in early February. And these contained $123 million in cuts to nursing homes, including, says Skoufis, $4 million in immediate cuts to Valley View Center for Nursing Care and Rehabilitation in Goshen.

“What the governor and the Department of Health tried to advance was a retroactive cut. And so they are claiming that nursing homes, their case mix, so basically how nursing homes classify the acuity of patients, and reimbursements are based on those classifications,” Skoufis says. “The governor and Department of Health are trying to claim that nursing homes were widely misclassifying patients’ acuity and wanted to take back, retroactively cut these payments to nursing homes.”

Skoufis talks more about pausing the retroactive cuts, saying any alleged reclassification needs to be examined.

“Our proposals that were in the two House budgets were what were ultimately in the enacted final budget that we just adopted a couple of days ago, which is no retroactive cuts at all; $4 million would have been taken out of Valley View’s coffers immediately if the governor’s proposal had moved forward,” says Skoufis. “So what we said is not retroactive cuts, and we’re going to set up a work group to look at exactly what’s going on here and then we can make a decision about prospectively adjusting the case mix formulas.”

Valley View is in state Senator Jen Metzger’s District.

“The cuts that had been proposed in the 30-day amendments would have been really devastating to the Hudson Valley, to the 42nd District that I represent, which includes the western half of Orange County, all of Sullivan County and part of Ulster and Delaware,” Metzger says. “And our hospitals were going to lose $6.5 million over two years. Our nursing homes were going to lose up to $11 million and, of course, the cuts to EMS would be devastating. That really affects rural areas that are so dependent on emergency medical services, both for non-emergency and emergency visits, and would have disproportionately affected elderly, the disabled.”

Tim Egan serves on the board of directors of United New York Ambulance Network and works for Rockland Mobile Care.

“And it would have been absolutely catastrophic to the EMS industry. There would have been more ambulance services closing. And I say more because there were  already two that closed in Fulton County, in part, due to Medicaid cuts,” Egan says. “So the proposed budget and then the 30-day amendments really rattled us significantly. And both Senator Skoufis and Senator Metzger stepped up to the plate, along with many others in the legislature to really get our backs and to get us that funding back so that we can continue to serve the communities.”

Skoufis and Metzger say the Department of Health will form a working group to require that the acuity of patients on which rates in nursing homes are based are being reported properly. They say the Health Department commissioner will appoint members — experts in the field as well as potentially affected stakeholders. There are parameters for selecting members. Skoufis says the new group would meet soon.

“And look, I have, I’m the chair of the Committee on Investigations, and if we see that there’s malpractice going on here, whether it be inaction or something else, I think that’s something that our committee can also move forward and look into and compel action, but I fully expect that this working group will be convening very soon,” says Skoufis.

Skoufis says the proposed health care cuts was a heated issue.

“I know that stakeholders, not just the nursing homes, but residents, we received many calls on this issue,” Skoufis says. “Everyone was really engaged on this particular issue. In fact, there were mailers sent out to some of our districts; ‘Call Senator Skoufis today, save our nursing homes.’ I got this mailer.”

Meantime, the senators say there were other health care victories in the new budget, including codifying the Affordable Care Act and health exchange into law. The budget also includes $300 million to invest in health care facilities statewide.