ITINERARY FOR MARCH 3, 2020 MEMBERS CATCH YOUR BUS & GET TRAINED (8AM – 11AM) Get breakfast with Lobby Day orientation & briefing Bus departure times vary. Contact your NYSNA Rep. Members driving to the event Breakfast served from 9am - 10am and Lobby Day orientation and briefing will be in the Convention Hall at 9am Madison Ave. The New York State Nurses Association is accredited as a provider A Member & Student Bus Drop Off (9AM – 11AM) of nursing continuing professional development by the American Lobby outside Conference Hall Nurses Credentialing Center’s Commission on Accreditation. B NYSNA Member Check-In (8AM - 11AM) Pick up T-shirt and proceed to your first Lobby Appointment. Meet Your Lobby Leader and team This program has been awarded up to six (6.0) contact hours outside the door of the legislator’s office through the New York State Nurses Association Accredited Provider Unit. C Student Check-In (9AM) Get breakfast with Lobby Day orientation and briefing in the Top Tier in the Convention Hall The New York State Nurses Association is accredited by the International Association for Continuing Education and Training D Lobby Visits (9AM – 3PM) “IACET” and is authorized to issue the IACET CEU. Meet your Lobby Team for 1-2 Lobby Visits to advocate for Equitable Healthcare Funding and Safe Staffing to Improve Patient Outcomes.. Check-in through security (multiple entrances underground and The New York State Nurses Association is authorized by IACET to above-ground) to Legislative Office Building or Capitol offer up to .6 CEUs for this program. Convention Hall In order to receive up to 6.0CHs/.6 CEUs all participants are E Lunch Available & Indoor Rally (12PM - 2PM) Enjoy a lunch with your colleagues before or after scheduled Lobby Visits required to attend the entire workshop, complete all in-session NYSNA & legislative leaders address the issues program assignments, complete an evaluation form, complete and return a post-program SurveyMonkey® questionnaire and/or complete and return a post-program checklist, where applicable. E Debrief & Boxed Dinner Distribution (1PM - 3PM) Prepare and turn in a Lobby Report Form on each visit outcome The New York State Nurses Association wishes to disclose that no Members go to table in Convention Hall commercial support or sponsorship was received. C Students go to upper tier in Convention Hall The New York State Nurses Association Program Planners and Buses Depart (3PM - 3:30PM) Presenters declare that they have no conflict of interest in this A Return to the bus that dropped you off. Roll Call. program. DOVE STREET DOVE STREET WEST CAPITOL WASHINGTON AVENUE WASHINGTON LEGISLATIVE PARK OFFICE BUILDING MADISON AVENUE MADISON A THE D CAPITOL B C E MADISON AVENUE MADISON WASHINGTON AVENUE WASHINGTON 1 WASHINGTON AVENUE WEST CAPITOL PARK CONVENTION CENTER LOB AND CAPITOL MADISON AVENUE 2 Summary of NYSNA talking points regarding the 2020-2021 Health and Mental Health Executive Budget Proposal February 15, 2020 1. Federal government tax and healthcare policy continues to threaten New York healthcare NYS is experiencing ongoing threats and uncertainties from Washington for 3rd year running. The 2017 Federal “Tax Cuts and Jobs Act”, not only gave huge benefits to corporations and to the wealthiest Americans, but also directly attacked New York’s state and local finances by limiting the deductibility of state and local taxes (SALT). Having purposefully and dramatically reduced its income, the federal government is now looking to cut funding to patients, hospitals and states. The Executive Budget presentation recognizes the punitive effects on the NYS budget of these federal tax and healthcare funding policies. 2. State Executive Budget for FY2021: What is wrong with cutting Medicaid? The Executive Budget for FY2021 is focused on addressing an estimated budget gap of $6.1 billion, of which more than $4 billion is identified as a Medicaid deficit or “structural gap” that exceeds the state’s self-imposed “Medicaid Global Cap” limiting year-to-year increases in state Medicaid spending. The Executive Budget proposal calls for the appointment of a new Medicaid Redesign Team (MRT II) to develop specific proposals to reduce the Medicaid gap by $2.5 billion, but does not provide much in the way of specific details as to how the gap is to be addressed. The MRT II, however, is supposed to avoid negatively impacting the availability or quality of health services with the Governor announcing that in carrying out this role, the MRT II would protect access to care and have “no impact on beneficiaries.” The state has already reduced Medicaid funding through executive action in the form of a 1% across the board reduction in Medicaid provider reimbursement rates implemented on January 1st as part of a mid-year savings plan. This action will reduce Medicaid funding by $559 million in FY2020 and an additional $851 million thereafter. NYSNA is generally opposed to any cuts to Medicaid spending, which provides health coverage to about 6.2 million New Yorkers, or about 30% of the population. 3 The Affordable Care Act (ACA) substantially increased Medicaid enrollment by raising the income eligibility levels for Medicaid and increasing the Federal matching rate on Medicaid costs for this expanded coverage to 90%. The ACA played a decisive role in the dramatic reduction in uninsured rates in New York. We need to maintain the gains in coverage from the passage of the ACA. The people receiving Medicaid services are the poorest and most vulnerable New Yorkers. Furthermore, adequate Medicaid funding and reimbursement rates are critical to keeping vital safety-net providers open and caring for our communities. 3. Medicaid Redesign Team should have included strong representation of direct care workers and healthcare advocates and patients NYSNA believes that the MRT II, must include a wide range of representatives of front-line health care workers, advocates for quality patient care, as well as patients. MRT II should not be stacked in favor of providers, but be evenly balanced with health care users and nurses, physicians, and other care practitioners that actually provide the care. On Feb. 4, Gov. Cuomo released the list of Medicaid Redesign Team members, chaired by Northwell President and CEO Michael Dowling and former 1199SEIU President Dennis Rivera (attached). The membership does not achieve that balance. 4. Cutting Medicaid to meet arbitrary spending caps will negatively impact health care NYSNA is concerned that the recent reduction in Medicaid reimbursement rates, coupled with any additional budget cuts, will adversely affect the overall healthcare delivery system and will be particularly devastating to the safety net hospitals and other providers of care for the 6.2 million New Yorkers receiving Medicaid coverage. NYSNA has no objection to reducing Medicaid costs by rooting out fraud or waste in the system or by reducing administrative or overhead expenses. NYSNA, however, is opposed to broad spending cuts that reduce access to needed health care services and dilute the quality of care. 5. Cutting Medicaid spending is financially short-sighted Medicaid is a program under which New York receives matching funds from the Federal government. Under the normal FMAP formula, the Federal match is 50%, but under the Medicaid expansion provided by the ACA, the matching rate reaches 90%. In total, New York’s federal match is almost 60% of total spending. NYSNA is against any budget cuts that will reduce federal funding for NYS (effectively increasing the rate of revenue outflow to the federal government), particularly when those lost revenues are being used by the Trump administration to finance unprecedented tax cuts for corporations, billionaires and hedge fund managers. 4 6. The State should search instead for revenue enhancements and to maximize federal funding There is already a gap between how much New Yorkers send to DC in taxes and how much federal funding comes back to NY. Cutting Medicaid funding will significantly increase this gap, with negative consequences for the health care system and the broader economy. NYS should focus its efforts on maintaining or increasing Medicaid funding and closing the budget gap through increased taxes, surcharges and fees on economic actors that have profited from the changes in federal tax laws and/or from state health spending. NYSNA urges the state to consider the following measures to address the Medicaid budget gap: Increase corporate tax rates Corporations, utilities, insurance companies and banks have greatly benefited from the federal tax law changes and are in a position to pay more to support vital social programs. In addition, they can fully deduct these increased levies from their federal tax obligations. Increase the millionaire surcharge The state should consider further increasing the tax rates on the highest income individual payers. Accordingly, NYSNA would support a restructuring of the personal income tax code to reduce tax rates for working people and to increase in rates for those with annual incomes in excess of $1 million. Target taxes and fees at corporate and business entities with major profits in healthcare We recommend that the state should increase taxes, fees and surcharges on the following healthcare market business entities: . Private for-profit health insurers; . For-profit corporate providers, including pharmacy chains, urgent care companies, imaging and laboratory companies, large physician practices, medical device manufacturers and distributors, pharmacy benefit managers, and other for-profit entities that generate high profits in health care; . Pharmaceutical manufacturers and distributors; . Highly profitable hospital systems with low rates of Medicaid and uninsured/charity care services. 7. Reduce Medicaid costs by setting price controls on drugs/pharmaceuticals NYSNA supports the proposal to enhance the power of the Dept. of Financial Services to investigate and enforce restrictions on abusive drug pricing practices. But, the state should also consider stricter regulation of drug prices, including wider price controls and increased penalties for abusive practices.