Assembly Health Committee Update

New York Health Single Payer Bill, “Safe Staffing” bills approved

The Assembly Health Committee favorably reported 21 bills at its meetings on April 19 and 27 including the New York Health Act single-payer bill; “safe staffing” bill to ensure appropriate staffing levels in nursing homes; bills to expand the Health Department’s oversight of health care in prisons and jails; and a bill to reform the “indigent care” system of State funding for hospitals serving low-income patients.

Almost every problem we face in health and health care – as patients, health care providers, employers, employees, taxpayers – is made worse and harder to solve because of how we pay for health care. Every year, millions of New Yorkers with health insurance go without health care because they can’t afford it. Deductibles, copays, out-of-network charges and unfair denials of coverage get in the way. People choose between health care and other basic necessities. And most New Yorkers say they have fears about the affordability of health care. 

No one says this is right. But there is no plan on the table other than the New York Health Act that can fix it. The bill will now be referred forward to the Codes Committee

For years, nurses, patients and their families, and others have pushed for passage of mandatory minimum staffing ratios in health care facilities. Recent reports by both Attorney General Tish James and the US Public Interest Research Group document the dangers of nursing home staff shortages during COVID-19. The “safe staffing” bill advanced by the Committee this week sets evidence-based thresholds for minimum care hours in nursing homes.

This builds on recently enacted budget language, similar to a bill I passed shortly before budget, requiring nursing homes spend at least a set percentage of their revenue on direct patient care and staffing. There have been too many examples of nursing homeowners siphoning funds away from patient care through real estate deals or shell companies. The safe staffing bill, which is expected to pass shortly, combined with the direct care spending law, are major steps toward ensuring that vulnerable nursing home residents receive the attentive, appropriate care we expect.

For more information on a bill, please contact the sponsor listed after the description. For the text of a bill, supporting memorandum, and information on its status, go to:

 April 19

Limited Services Pregnancy Centers Study – Entities known as “limited service pregnancy centers” offer limited services such as pregnancy tests or ultrasounds. They are generally run by organizations whose goal is discourage abortion. They do not offer a full range of reproductive health care, and often are not even licensed health care providers. They operate with little or no oversight. This bill requires the Commissioner of Health to issue a report on the impact of limited services pregnancy centers on the ability of women to obtain accurate and timely reproductive care information (A.5499, Glick).

New York Health Act – Single-Payer Plan - Establishes the "New York Health" program, providing universal, single-payer health coverage for all New York residents, regardless of income or other factors. New York Health would replace insurance company premiums, deductibles, and co-pays with a publicly funded total benefit package (including long-term care), more comprehensive than commercial health plans (A6058, Gottfried).

COVID-19 Vaccine Information – Requires the Department of Health to post on its website information including the total number of COVID-19 vaccine doses disbursed to vaccine providers and State-operated dispensing sites as well as the method by which the Department has determined how many doses to send to each location (A6173, Gunther).

COVID-19 Vaccine Site Locations – Requires the Commissioner to establish at least one state-run COVID-19 vaccination site each county over 300,000 population (A6209, Zebrowski). 

Sickle Cell Information – Requires the Commissioner to produce an informational packet about sickle cell disease, including screening, prevention, and treatment, and requires general hospitals to distribute the packet to patients at high risk for sickle cell disease (Hyndman, A6429).

Sickle Cell Education and Awareness – Provides for grants from the Department to approved community-based organizations for purposes of statewide public education and outreach to underserved populations and creates a sickle cell disease education program advisory council within the Department (A6430, Hyndman).

Sickle Cell Centers of Excellence – Directs the Commissioner to designate sickle cell disease centers of excellence (five hospitals or hospice providers and ten outpatient providers) which shall affiliate with medical colleges and other research organizations and receive state grants (A6431, Hyndman.) 

Nursing Home Visitation – Chapter Amendment – In 2020, in response to severe restrictions on nursing home visits, New York enacted a law permitting personal caregiving visitors (a family member or friend designated by the resident) to visit and aid nursing home residents, subject to appropriate regulations by the Commissioner for patient protection. This bill is a chapter amendment making technical clarifications (A6966, Bronson).

April 27

Medicaid Long-Term Care Auto-Renewal - Medicaid long-term care (MLTC) enrollees have to file annual renewals of income documentation. Although most MLTC enrollees are on fixed incomes, the recertification process is prone to errors that frequently disrupt eligibility for very vulnerable patients. With this in mind, Medicaid began to automate renewals in 2011 for certain MLTC recipients categorized as “Aged, Blind, and Disabled.” This bill extends the benefits of that program to other MLTC enrollees (A155, Gottfried).

Adverse Determinations - Chapter Amendment - A bill signed in 2020 required that notices of adverse determinations by Medicaid plans to patients (meaning, when the plan fully or partially denies coverage of a particular service) include contact information for consumer assistance programs that may be able to help patients contest these determinations. This bill is a chapter amendment making technical clarifications (A985, Gottfried).

Hospice Beds Expansion - Current law allows hospice residences to use 25% of their beds for inpatient services that require medical intervention to aid the comfort of the patient. When a facility needs to treat a patient above their threshold, the facility is required to transfer the patient to a hospital even if the patient could be cared for on-site. These transfers are extremely disruptive to already-frail patients, and during COVID-19 hospices have been allowed to use up to 100% of their beds for this purpose under an Executive Order. This bill makes the Executive Order permanent in order to ensure continuity of compassionate end-of-life care (A4594A, Gottfried).

School Access to Immunization Registry - Currently, schools are allowed “read-only” access to data in the Health Department’s immunization registry. This means that in order to update the school’s student immunization records, school nurses must manually download every student’s information one at a time and then manually re-type them each into their own database, a time-consuming and error-prone process. This bill allows schools to “batch download” the immunization records for students under their administrative responsibility (A5062, Kelles).

Technical Corrections to Law on Do-Not-Resuscitate (DNR) Orders – Repeals sections of Public Health Law related to DNRs that are now covered by the Family Health Care Decisions Act (A5508, Gunther).

Infection Preventionist Certification - Infection Preventionists are employed by health care providers to design and implement programs to reduce facility-acquired infections. They can be health care practitioners such as nurses or medical technologists or public health experts such as epidemiologists. This bill creates certification and scope of practice requirements for this emerging category of practitioners (A5668, Gunther).

Ambulatory Care Study and Notices - This bill directs the Commissioner to conduct a study on ambulatory (outpatient) health care delivery during COVID-19, including urgent care facilities, retail clinics, and other providers. It also requires that during the study, any major ambulatory practice closure or relocation shall require 30 days’ notice to the Department and local officials (A5713, Fall).

Prison and Jail Health Oversight – In 2009, a law was enacted giving the Commissioner of Health authority and responsibility to “review any policy or practice” in correctional facilities relating to HIV/AIDS and hepatitis C. Advocates have universally praised the law for improving care in these areas. Last year, the law was expanded to include COVID-19. This bill expands the law to provide for DOH oversight for additional populations and conditions, such as women and transgender inmates, older inmates, and those with chronic conditions. It also requires a staffing adequacy study in response to evidence of severe health care staffing shortages (6386, Gottfried).

Prison and Jail Health Oversight – Infectious Diseases - Similar to the previous bill but narrower, this bill amends the correctional health oversight law to just add “emerging infectious diseases” as an oversight category. This bill passed last year, but the Governor insisted as a condition of signing it that it be narrowed to only COVID-19. We should not have to go one at a time naming every new emerging disease in statute as we did with COVID (A6394, Gottfried).

Early Intervention Rate Study - The Early Intervention (EI) program provides services to babies and toddlers with developmental delays and disabilities. Many areas of the state face provider shortages and payment rates have not increased commensurate with increases in administrative responsibility put on providers by the State. This bill requires a rate adequacy study by the commissioner (A6579, Gottfried).

Indigent Care Pool Reform – The Indigent Care Pool (ICP) is a pot of money to supplement payments to hospitals who serve high proportions of low-income uninsured and Medicaid patients. However, ICP money has historically been distributed according through formulas that actually give disproportionate funding to hospitals that do relatively little actual indigent care, including some of the highest-profit hospitals in the state. In 2020, the legislature took steps to reform the ICP distribution. This bill, drafted in consultation with New York City Health + Hospitals, rebalances the ICP further to better target the facilities who actually provide the bulk of care to low-income patients, typically including both urban public hospitals and rural hospitals (A6883, Gottfried).

Residential Facility Discharges - Chapter Amendment - A bill signed in March codified regulations protecting people in residential facilities from being inappropriately discharged to homeless shelters that cannot meet the persons’ needs. This bill is a chapter amendment making technical clarifications (A7018, Hevesi).

Safe Staffing Levels – Sets minimum nurse staffing standards for nursing homes in order to increase quality of care (A7119, Gunther)