2021 budget and legislative priorities
- Supporting Budget Fairness
- Investing in New York’s Economic Recovery and Its Most Vulnerable Communities
- Suburban hospitals by the numbers
- 51 hospitals in nine counties
- Range from major academic medical centers to rural community hospitals
- $33 billion in economic activity
- 160,000 jobs
- $2 billion in community benefits and investments
- $5.1 billion in tax dollars generated
- Learning the Lessons of the COVID-19 Response
- Allowing for acceptance of clinical credentials across state lines,
- Expanding the scope of practice of nurses and other professionals to the fullest extent of their training,
- Allowing for rapid deployment of retirees willing to volunteer,
- Expanding access to telehealth,
- Facilitating transfers between hospitals,
- Allowing for expansion of capacity and construction of alternative facilities, and
- Suspending administrative billing requirements to facilitate care and expedite payment.
- Strengthen and Modernize the Healthcare Workforce
Suburban Hospital Alliance members recognize the damage done to the state’s finances by the COVID-19 pandemic and the resulting economic downturn, and we share the view that the federal government has an obligation to provide support to state and local governments for their recovery. We have not only expressed to our congressional delegation the urgent need for direct aid but have engaged local officials and the business community in this advocacy.
We are deeply concerned about the contingency plans included in the proposed FY 2021-22 Executive Budget, should Congress fail to provide sufficient support to the state. The FY 2021-22 proposal doubles down on cuts to healthcare included last year’s budget by calling for additional Medicaid rate cuts and additional cuts to important capital payments and to the Indigent Care Pool. It is unreasonable to ask hospitals and health systems —still in the throes of the COVID-19 crisis and facing their own fiscal uncertainties with respect to federal funding —to once again bear the burden of closing the state’s budget gap.
The State’s already struggling healthcare institutions bore much of the burden of closing last year’s FY 2020-21 budget gap and are still working though the implementation of those cuts. Those budget actions included: an across-the-board Medicaid rate cut; an across-the-board cut to the Medicaid capital payment, elimination of several critical funding pools, and a significant cut to and reformulation of the Indigent Care Pool that disproportionately impacted hospitals in the suburban regions. In addition, the state has withdrawn capital funding for hospitals that was committed in prior years for the purpose of modernizing institutions.
The FY 2021-22 Executive Budget proposes key investments in COVID-19 testing capacity and the vaccine effort, and calls for new funding for the Essential Plan that would make coverage more affordable, improve reimbursement rates and enhance health plans’ networks of providers. The Suburban Hospital Alliance supports these proposals.
Strong hospitals and health systems are an essential component of the state’s recovery. Hospitals in the suburban regions generate an estimated $33.3 billion in economic activity and create 160,000 jobs. They also provide a stabilizing force in economically distressed communities.
Keeping these institutions strong requires investment in their growth and in the communities they serve. The struggles of COVID — access to care for vulnerable populations, social supports for patients beyond the hospital, the capacity to do testing and contract tracing, delivery of the vaccine — have exposed the fragility of our public health infrastructure
Community Reinvestment – For-profit health plans should also be required to make a commitment to the health of the communities where they do business. We propose that for-profit plans be required to dedicate a percentage of their considerable profits to addressing the needs of vulnerable individuals and ensuring access to care on a regional basis, similar to the Community Reinvestment Act requirements for the banking industry.
Population Health – We also urge the state to renew its commitment to regional population health planning in its next federal Medicaid waiver submission.
Over the past year, clinicians and scientists have made enormous progress in the effective treatment of COVID-19. We also have had nearly a year to assess the impact of COVID on healthcare operations and identify areas for improvement.
Regulatory Flexibility – Among the lessons learned is that response to a healthcare emergency of this magnitude required considerable flexibility from existing state regulations. The Legislature could ease administrative and operational burdens on providers by permanently rolling back many of these regulations such as:
The hospital sector has demonstrated that it can operate safety and effectively with these regulations waived. We would welcome the opportunity for further discussion of these issues.
All of these flexibilities required the issuance and re-issuance of executive orders, of which there have now been more than 90, that generally need renewal every 30 days. This lack of predictability slowed the initial response to COVID and has created an ongoing administrative burden to ensure continued compliance. We urge the Legislature at minimum to consider statutory changes that would allow for a package of regulatory waivers to be invoked by a governor or commissioner of health in the event of declared public health emergency.
Our dynamic healthcare system demands a modern and flexible workforce.Never has that been more evident than during the response to COVID, as clinicians and non-clinicians alike worked heroically in teams to respond to the rapidly evolving crisis.The state should support worker retraining, stronger education requirements and expanded scopes of practice to ensure that that teams of nurses and ancillary professionals are prepared to provide the best care for patients and have the opportunity to grow and add to their skills.
Proposed legislation, The Safe Staffing for Quality Care Act, instead would freeze the healthcare workforce in time, by mandating inflexible nurse staffing ratios that every provider would be required to maintain.The same cookie-cutter approach would apply to every unit of every hospital in the state, every hour of the day, without any flexibility to account for the severity of their patients’ illnesses or the skill set and experience levels of their workforce.Appropriate staffing levels should be determined by management in consultation with its nursing workforce — as has been the case in recent high-profile collective bargaining agreements — not by legislators.The Suburban Hospital Alliance urges your opposition to the bill.