Budget Victory In 2018 For Nurses, Patients, And New York Communities
The just-completed budget is a win on many levels. We won because NYSNA members and staff persevered in a critical and effective advocacy effort. We were joined by other unions, public health organizations, community groups and other supporters who banded together to ensure funding in NYS was geared to meet the needs of the people.
Here are some details: The “Essential Plan” is intact, at least for now. By its terms, this plan pays for insurance co-pays and deductibles for low- and middle-income individuals and families — including 700,000 New Yorkers. The Essential Plan has been very effective, and we must continue our efforts with the U.S. Congress and the federal government to keep the underlying funding in place.
The “Enhanced Safety Net Hospital” legislation is now a law! All of us at NYSNA worked hard to achieve this very important victory. Again, as we strengthened our work with allies, we worked with a coalition of unions, public health groups and community organizations. This law gives supplemental funding to urban and rural safety net hospitals — healthcare facilities that provide care to the highest levels of Medicaid and uninsured New Yorkers — steering resources to the medically underserved communities. By its terms, there will be a workgroup convened to look at the issues this law addresses, opening up a chance to build more support.
The budget contains $1 billion in the Health Care Contingency Fund. This is a reserve in the event Washington reduces Medicaid, ACA (Obamacare) or other critical healthcare programs. Also, this Contingency Fund can be used for health services in the state even if federal cuts are not carried out.
More money for safety net hospitals and other providers is included in this budget. A total of $525 million has been allocated, a majority available for safety nets.
An “Opioid Stewardship” program funded by opioid makers and distributors in the amount of $100 million will go to programs for inpatient, outpatient and community health programs. More funds to help opioid and substance abuse — $37 million — is also in this year's budget.
An important protection to our Scope of Practice was accomplished in this budget. The “Community Paramedicine Collaborative” proposal is removed from the budget. NYSNA has no objection to authorizing EMTs and paramedics to work in integrated health initiatives with nurses and other licensed healthcare professionals, but this proposal opened the door to an incursion into our scope of practice and that would potentially harm patients and undercut our professional responsibilities.
NYSNA supported legislation to codify CRNA Scope of Practice; however, this proposal was not included in this year's budget. We will continue to work for the right of CRNAs to expand their scope of autonomous practice.
Rejected again from the budget was the for-profit ownership and operation of retail health clinics. We strongly oppose the “Walmartization” of healthcare in New York, along with many allies from other sectors in our state.
Also in the budget was restored funding for school-based health centers, giving $3.8 million that had been cut last year and preserved funding for Nurse Family Partnership and Nurse Scholarships and Loans Forgiveness. The First 1000 Days Program was enacted, a law that expands access to services and health outcomes for children from birth to age three. More funds for the Vital Access Provider Assurance Program and the Value Based Payment-Quality Incentive Program were allocated. This year’s budget also includes some measures that are very important to the welfare and protection of New Yorkers. There are provisions to reduce the effect on New Yorkers of the federal tax changes that favor corporations and the wealthiest Americans. These include expanding charitable contributions, an “Employer Compensation Expense Program,” that helps working New Yorkers keep their take- home pay and avoid unfair limitations on deductions imposed by the federal government. Also included is a provision that decouples state income tax from the federal tax code, protecting New Yorkers from unfair tax increases. The new budget includes legislation to crack down on sexual harassment in the workplace.
NOTE: The final budget did not include legislation that NYSNA strongly supported: Codification of CRNA Scope of Practice. We are committed to continue to advocate for this law and will pursue its passage in the next regular legislative session.