February 14, 2011

Budget cuts threaten health care services

Author: Liza Frenette
Source: NYSUT Communications

With the largest cuts to health care services in New York's history looming, health care professionals, the poor and elderly are especially concerned that the level of care they give and receive will be severely weakened.

The Executive Budget proposes to reduce the state's share of Medicaid spending by $2.85 billion in the coming fiscal year and by another $4.6 billion in 2012-13. Combined with the loss of federal matching funds, the total impact on Medicaid would be about $15 billion over two years.

"Our health care institutions can't absorb more cuts. Many of these cuts are associated with delivery of programs and would impact professional health care providers who work in hospitals - especially SUNY's public teaching hospitals - home care providers, and those who work in nursing homes," said NYSUT Vice President Andy Pallotta, who leads the union's legislative department.

He is urging members to coordinate with their local union president and call, visit or write their state legislators, and visit www.nysut.org for updates about the union's advocacy for affordable health care for New Yorkers.

"Ultimately the workers and the families we care for are on the line in every sense of the word," said Anne Goldman, special nursing representative to the United Federation of Teachers and chair of NYSUT's Health Care Professionals Council. "The proposed Medicaid cuts cripple those people we serve by making families decide between food, shelter or care."

The Executive Budget does not provide many specifics regarding how reductions in Medicaid spending will impact hospitals, home care or nursing homes, yet changes in the state's Medicaid program could include modifying or suspending reimbursement methods, modifying or discontinuing Medicaid program benefits, and suspending timeframes for notice of rate adjustments for home care nurses, visiting nurses and hospital nurses. It does propose discontinuing reimbursement for optional services including home health services and long-term care, two areas that affect NYSUT members and the patients and residents they serve, and NYSUT retirees.

A 27-member Medicaid Redesign Team (MRT) - created by the governor to develop ways to cut Medicaid spending by $2.85 billion - is expected to make its recommendations by March 1. The team includes state lawmakers; the commissioners for health, mental health, developmental disabilities and substance abuse; and CEOs of health systems.

Most health care institutions and providers fear the changes and cuts would result in facility closings, layoffs, inadequate health care services and a general erosion of the state's health care system.

"Less services and visits to people in their homes will result in greater hospital visits, costing more money," Goldman said. "Health care must be fixed as a whole, and fragmented cuts weaken the effectiveness of the system."

 At Albany County Nursing Home, 95 percent of the home's 250 residents are Medicaid or Medicare recipients, said Jeff Bradt, director of food and nutrition at the nursing home and president of the 88-member Professional Staff Association.

The county nursing home is often the last hope for many elderly residents with multiple needs. "We end up with so many complex residents because many facilities won't take the people we serve. They are too costly. We're the last safety net for many of these people," Bradt said.

More than 100 people testified at a public hearing in New York City conducted by the MRT, expressing concerns about maintaining their health without Medicaid, sharing ideas on how to gain efficiencies in the system and raising concerns about the lack of consumers and community organization members on the Medicaid team.

"Health care providers have already endured significant cuts as part of the state effort to close budget gaps. More must be done on the revenue side so that the budgets are not on the backs of health care workers and the patients they serve," said Pallotta.